Confusion over convertion issues

[Cup-cake7]

Hi

I feel I'm going back to the beginning here re this, frustrating, although have acted positively on gut health and diet for sure

These are my latest bloods below?

Basic questions please?

I've tried levo to 75 and feel ill on it and so struggle to maintain it, I even felt marginally better even on 50 and of course the tsh doesn't reduce

🔍. Can you judge if you are a poor converter please when tsh is still high, This is the basic question please?

Or can you only judge this when tsh is low down in range? (Feel silly asking this after reading so many posts)

I've felt really ill some days, spirit gone brain fogged anxiety feelings rampant and so fatigued, the usuals, Lonely place, feeling so ratty about it all now, patience down the Swaney

I just hoped levo would sort me, what to do now is the question?

I aimed to get gut right before taking more meds, it made sense for me to be systematic I guess

Also, I go hot quite often, I RARELY get the cold chilly thing, temperature around 36 pulse 60 (these two have improved over the months for sure).

Are you more lightly to be hot when hashi flaring?

I think the results are in hashi flare as regularly don't have any antibodies out of range but having said this the numbers haven't changed in fact my t4 was higher in range BEFORE any meds

Any help so appreciated.

Tsh. 4.8. (0.27-4.20)

T4. 16.2. (12 - 22)

Free t3. 4.52. (3.10 - 6.80)

Thyr antibodies. 148. (0 - 115)

B12. 149. (25 - 165)

Folate. 7.35. (2.9 - 50)

Ferritin. 78.2. (13 - 150)

D. 76. (50 - 200)

On reflection I dont understand why D so low as take it sublingual, whatndise should I take please? and take nutri folate, and these two make me feel so utterly miserable 🙈

Many thanks in advance

[Cup-cake7]

'Can' these two. (Sorry, iPad)

[Cup-cake7]

Is this all about low D and folate I'm wondering? but hoping, wanting, to experience tsh one- ish in shortest time feasible

[SlowDragon Administrator]

Which brand of Levothyroxine are you on?

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

Clearly you are under medicated. Some patients need to increase dose very slowly. Perhaps try 50mcg/75mcg on alternate days for 6 weeks. Then up to 75mcg and retest 6-8 weeks after

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels. Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

How much vitamin D are you currently taking?

A good quality daily vitamin B complex may be beneficial, one with folate in not folic acid.

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...

[Cup-cake7]

Many thanks slow dragon

Yes been gf for 16 months

I take b12 twice a week. b complex every day Magnesium powder, Eskimo

Vit C. Nutri Sustain, and Gest. Live yoghurt, apple cider vinegar folate, q10. Adrenavive To name a few,

How much D please to get back up there? And then stay there?

I'd better get k2 maybe?

I just struggled with levo so much, I tried alternating with 75, I was in concrete all day so didn't know if you push through or decided it wasn't right for me??

Yes I worked through them all and stayed with Armetist

Dr P said natural is better ?

Please can you say if you should push through these horrid levo symptoms or call it a day with levo.

Thanks again

No I'm not celiac

[BadHare in reply to Cup-cake7]

Bought yoghurt's not very live or it would explode on the shop shelves. For K2 & a better source of probiotics & B12, try fermenting your own kefir. It's as complicated as making a pot of tea twice a day, though it doesn't taste so good if it's not fed regularly.

[Cup-cake7]

Thankyou badhare for that. So il have a google at fermenting kefir

So is k2 in this, do we need it daily

[silverfox7]

Conversion issues you really need to get your levels to the right level first. Conversion issues are apparent if your FT4 is high in its range and FT3 is low in its range. At the moment you are undermedicated so both is low but with more medication both should rise but you may find that FT4 is high but FT3 is considerably lower showing bad conversion from T4 to T3. You also need to test Vit D, B12, folate and ferritin as these help the Thyroid work work better but they must be optimal, not just in range. They also improve your general health, help with conversion and can help with some symptoms as well.

[Cup-cake7 in reply to silverfox7]

Hi silver fox I replied but sorry I did t press your reply button!

[Cup-cake7]

Thankyou silver fox for reply

When you out in first sentence, you really need to get your levels to the right levels first

Please can you explain that ?

Are you meaning that tsh level has to be low before you can access convertion levels?

[Cup-cake7 in reply to Cup-cake7]

That's assess not access sorry about that

[silverfox7 in reply to Cup-cake7]

Yes I think you have worked it out. When values are low then they don't tell really much about why. As you increae then in an ideal situation both should rise but that's when you need to check and see if you have the high. FT4 and low FT3 showing you aren't converting enough of the T4 into T3. So if you are converting well your FT4 will drop a little and your FT3 will go up so ideally you need then both to be in the top third or even a little higher in their ranges. Then see how you feel on that. You may find you have to do a small increase again or you may find that you may need to add in a little T3 as well. But that would come under 'fine tuning'.

[Cup-cake7 in reply to silverfox7]

Thankyou silverfox

I have problem with taking levo over 50

So i have thought its gut health connected and or adrenals

Iv worked on these so as i still couldnt tolerate 75 iv messed up

I tried metavive which is a big drop in t4 as took one ( i have a phobia anxiety as well taking tabs maybe two woukd be better)

And have had a dive, felt dreadful and yesterday awful discimfort, coukdnt bend fown, think its cinnected, used heat pad and its eased off today

What to do now i dont know, any thoughts much appreciated

Im going nowhere slow!!

[silverfox7 in reply to Cup-cake7]

Have you got optimal levels of Vit D, B12, folate and ferritin? If not got everything in place then that can hold us back. SeasideSusie is the expert on this if unsure so search for her postings as that will tell you what your levels should be and how to address it. They, when optimal, will also help conversion and can rid you or reduce other symptoms you may have. Remember though it's not an instant fix as it can take time to get everything in place depending how low your readings are. It's well worth the effort!

[Cup-cake7 in reply to silverfox7]

T h a n k y o u

.....no disappointingly D and folate are too low 'still'

Please tell me if you know the largest does I can have of these

Ferritin is halfway. I think this is about ok

[Cup-cake7]

(Sorry I'm not concentrating too well at moment)

You probably mean to get t4 higher and see where t3 is at?

I really struggle taking levo, (bit better since supporting adrenals so maybe that's the link?)

So I'm thinking I may just take metavive but that way unsure about how much to tak e (only 19 of t4 each tablet )

At a loss right now what to take

Please refresh me. How high in range has ferritin to be. I thought it halfway ?

[SeasideSusie Remembering in reply to Cup-cake7]

Jeppy

Whoever you are replying to wont know that you have responded to their comment.

If you are replying to someone specifically, for them to get notification of your reply you need to reply directly to their message by clicking on the blue "Reply" and a message box comes up which says "Reply to xxxx".

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Or you can tag them by putting @ directly in front of their user name, leaving no space, then click on their name from the list that pops up.

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Either of these will automatically generate a notification to the person you are replying to.

By just using the "Reply to Jeppy" box at the bottom of the thread, you have in effect replied to your own first post.

[Cup-cake7 in reply to SeasideSusie]

I usually press the reply underneath the persons box?? Like this?

[SeasideSusie Remembering in reply to Cup-cake7]

Yes, you've replied directly to me and I have had notification.

[Cup-cake7]

Thanks for links - yes I do press reply under their comments box, why do you think I don't ?

[SeasideSusie Remembering in reply to Cup-cake7]

Jeppy

If you look at your 2 last replies

The first one says

"Jeppy - in reply to SeasideSusie"

and your message is indented directly beneath mine to you so you did press the reply beneath my comment and I got notification.

The second one doesn't say " Jeppy - in reply to....."

The comment isn't indented, so you didn't reply to me directly by pressing "Reply" under my message, you actually replied to the opening post in the thread.

[Cup-cake7 in reply to SeasideSusie]

Ah this is because I'm adding on a comment, yes I see this now

Thankyou

Well this will stop some frustration , when don't get a reply 🙃

[Cup-cake7 in reply to SeasideSusie]

Thankyou again

.....always in a rush so haven't actually read the Reply to......

As daft as it may sound

[Cup-cake7 in reply to SeasideSusie]

Hi again Seaside Susie

May I ask your opinion please

As I've struggled with levo 75 and have metavive here also, is there any harm in mixing the two? as appreciate the metavive is just 19 of t4 but has a little t3 in it obviously

....I don't know how but I must get to feel better than this, and hoping I can see what a tsh at one makes you feel

[SeasideSusie Remembering in reply to Cup-cake7]

There will be no harm in mixing the two, some people do add Levo to their NDT, and Metavive is another form of NDT.

However, with these results

Tsh. 4.8. (0.27-4.20)

T4. 16.2. (12 - 22)

Free t3. 4.52. (3.10 - 6.80)

even though your TSH is over range, your FT4 is 42% through range and your FT3 is 38% through range so they are quite well balanced and if the balance stays the same when your TSH is lower then you wouldn't have a conversion problem.