Hashi sufferer - FT3/rT3 results, advice requested

[thyroidquestions]

Hi All,

I have Hashimotos and posted 5 months ago on my status and plans. I am taking 100mcg levo pd only - stable on this dose over last 4 months. Low on gluten, dairy, sugar, cocoa, eggs, all of which show up as intolerances. I was very poorly 2007-2017 despite normal NHS T4/TSH advice. Since I got off Actavis and Teva in April and take only Wockhardt my headaches have gone, and diet is a biggie for me. Clean diet with the above, do well. Compromise the diet, it all falls apart.

I'm doing much better in 2018 but after a hard two weeks of work, I needed 14 hours sleep on Fri and Sat, so still low on energy and ability to work (and at least without dragging or brain fog) is vulnerable.

Any advice please on my new Medichecks numbers and what more I can do:

TSH 1.42 (0.27-4.2)

FT4 19.7 (12-22)

FT3 4.12 (3.1-6.8)

rT3 23 (10-24)

rT3 ratio 11.66 (15.01-75.00)

Thyroglobulin antibody 170 (0-115)

Peroidase Antibody 118 (0-34).

Active B12 66.4 (25.1-165)

Folate (Serum) 14.61 (2.91-50)

25OH Vit D 72.3 (50-200)

CRP - high sensitivity 0.59 (0-5.00)

Ferritin 176 (30-400).

I saw advice on increasing B12/Folate/Ferratin/Vit D and since the blood test was taken on 7 Sept (now 24th) I now take liver, Vit D3 K2 drops x6pd, plus one-a day of each of Asda MultiVit, Asda Folic Acid, Asda B-complex, Selenium, Asda Vit C 100mg.

I have access to my local Endo.

Thanks for any advice. I'm doing better, but still want my life back, so I can achieve and contribute more again.

[SeasideSusie Remembering]

Ditch the Asda supplements. Supermarket, high street and H&B own brands tend to contain the cheapest, wrong form and least absorbable forms of active ingredients. Often contain calcium and iodine which should both be tested for and only supplemented if found to be deficient. Also many contain iron which affects absorption of other vitamins. Your Asda one contains all these.

Ditch the Asda B Complex and folic acid. Buy a decent B Complex containing methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Look at Igennus Super B or Thorne Basic B.

Your Active B12 is actually low enough to suggest testing for B12 deficiency, anything below 70 is suggested to test for this according to viapath.co.uk/our-tests/act...

If you have signs of B12 deficiency - check here b12deficiency.info/signs-an... - then don't take folic acid/folate/B Complex until further testing has been carried out as it will mask signs of B12 deficiency.

What dose of D3 are you taking, are you taking magnesium to help your body utilise D3?

[thyroidquestions in reply to SeasideSusie]

Thank you very much SeasideSusie. OK...Asda vits/mins ditched, and will replace with those suggested. Will ask GP/Endo for B12 deficiency test. As recommended and provided by my chiro, I use liquid - Nutri Advanced D3 drops with K2 as MK-7. 2000iu per day in two 3-drop doses. Is that optimal?

[SeasideSusie Remembering in reply to thyroidquestions]

thyroidquestions

For your current level, the Vit D Council recommends a daily dose of 2,000 D3 to reach 100nmol/L, 3,700iu D3 to reach 125nmol/L or 5,800iu D3 to reach 150nmol - the recommended level being 100-150nmol/L. As it's now winter and we can't make D3 naturally from the sun so we draw on our store, then personally I would increase my dose during the winter and retest in March.

[thyroidquestions in reply to SeasideSusie]

Excellent thanks SS

[SlowDragon Ambassador]

As SeasideSusie say, ditch the multivitamins and cheap high street supplements

Which vitamin D are you taking? Aiming to improve to around 100nmol. Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement 2000iu for 2-3 months and retest. It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk




Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

articles.mercola.com/sites/...

healthy-holistic-living.com...

articles.mercola.com/sites/...


betterbones.com/bone-nutrit...

Multivitamins are not usually recommended on here as they often have too little of anything we actually need, and most contain iodine, which is Definitely best avoided with Hashimoto's

drknews.com/iodine-and-hash...

Once you have had full testing for Pernicious Anaemia then, assuming Gp not provided B12 injections, you may benefit from a good quality daily vitamin B complex, one with folate in not folic acid. Eg Igennus Super B or Jarrow B-right

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

If you have symptoms of low B12 then you may also need sublingual B12 lozenges as well for a few months

A better quality vitamin C at a higher dose might be good too

Eg Quali-c 1000mg

[thyroidquestions in reply to SlowDragon]

Thank you SlowDragon. OK...Asda vits/mins ditched. Will move to those higher quality ones recommended - thanks. Will ask GP/Endo for B12 deficiency test. As recommended and provided by my chiro, I use D3 as liquid - Nutri Advanced D3 drops with K2 as MK-7. 2000iu per day in two 3-drop doses. Is that optimal? Poor gut function with drops and move to mouth spray??

Finally - how much magnesium to take (600mg? 1g?) and in what form do you recommend? And do I need to ensure the right mag/calcium balance? I've heard knocking this balance off is sub-optimal too.

Thanks for helping.

[SlowDragon Ambassador in reply to thyroidquestions]

Personally with Hashimoto's and gluten intolerance I find vitamin D mouth spray is good. Perhaps change to that when you run out

Magnesium. I use Calm vitality magnesium powder. It's cheap and you can start on low dose, increase slowly. Too much causes diarrhoea. Must be four hours away from Levo

Re-mag is another option but expensive and I don't like the taste. Doesn't seem to cause diarrhoea

botanicahealth.co.uk/shop/r...

Do you supplement selenium?

Getting vitamins optimal should help

Really you need to be absolutely strictly gluten free not low gluten

chriskresser.com/the-gluten...

Will your GP/endo try small increase in Levo dose?

TSH too high. FT3 too low

But FT4 is right at top of range. You're a poor converter

If FT3 remains low after Improving vitamins and strictly gluten free then you likely need addition of small dose of T3

Perhaps get DIO2 gene variation test. This can help persuade them to prescribe T3 on NHS

thyroiduk.org.uk/tuk/testin...

[thyroidquestions in reply to SlowDragon]

Really appreciate this. OK I'm on it! Thanks SD. Will let you know...

By the way I came down from 125mcg Levo to 100 as I was feeling hot in April/May. But now on 100mcg I'm getting more cold intolerance. And this fits with your suggested 25mcg increase. Do people need slightly more levo in Winter than Summer? Symptoms of hot and cold intolerance affected by season?

[SlowDragon Ambassador in reply to thyroidquestions]

Some people do notice different requirement summer to winter

Also vitamin D levels can vary seasonally and this can affect Thyroid

Or 25mcg was too big a change. Could try 12.5mcg increase

100mcg one day and 125mcg the next day

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

[thyroidquestions in reply to SlowDragon]

I got bad headaches for years. Suspected Levo. Had to manage time-lags in the experience, Eventually got Wockhardt only prescription - hey presto, no headaches!