Any input would be much appreciated! 5 weeks ago my dose increased from 125 mcg/day to 137 mcg/day of synthroid and my blood tests from yesterday are below:
Free T3 (range 2.3-4.2) 2.8
Free T4 (range .9-1.8) 1.4
TSH (range .27-4.2) .54
I'm a bit concerned that my TSH is bordering on too low and my free T3 is also on the low end. I'm wondering if it would make more sense to lower my synthroid and start a low dose of a T3 medication?
I've had horrible air hunger (feeling like I can't get a satisfying breath) for nearly a year, which seems to get worse when my TSH is too low. I also have mast cell activation disorder and POTS (postural orthostatic tachycardia syndrome), so it's hard to tell what symptoms are related to my thyroid and which symptoms are related to the other disorders, such as the breathing issue. Thank you in advance for any insight you may have!
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SarahLou30
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If you are concerned about your TSH being low now, if you start adding T3 then it will go even lower, that's what T3 does, it tends to lower, even suppress TSH.
Before you consider T3, what are your vitamins and minerals like? They need to be optimal for any thyroid hormone to work, and you need to check them, and optimise any low levels, before starting T3.
Your ferritin is dire, it's below range. You should really see your doctor and ask for an iron panel and full blood count. Low ferritin can indicate iron deficiency anaemia, and with yours below range that's a very real possibility.
For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.
You may need an iron infusion which will raise your level within 24-48 hours, tablets will take many months.
Vit D is 44 (range >=30 ng/mL) - the Vit D Council recommends a level of 50ng/ml
B12 564 pg/mL (range 211 - 911 pg/mL) - this isn't too bad. An extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Folate 16.67 ng/mL (range 4.78 - 24.20 ng/mL) - this is OK, recommended is at least half way through range.
So with your disastrous ferritin result, there's no way you can consider adding T3 at the moment.
Thank you so so much. I did just have a complete blood count which was normal, so that didn't show anemia, but I will definitely start iron supplements. I'm hesitant to try an infusion because I'm hypersensitive to drugs and excipients and I've heard infusions can cause serious allergic reactions in people with mast cell activation disorder.
OK, so be prepared for iron tablets to take a long time to raise your level. But I would still ask for an iron panel, because if your serum iron is high, with a low ferritin, then iron tablets aren't necessarily the answer. Iron is complicated.
Have a look at the iron panel tests chart here to see the other tests involved and what their results mean
Do you think this means I would benefit from iron supplements? Thanks so much again for your help. My doctor insists my iron is fine when I've been suspecting that's the issue the whole time....
Serum iron: 55 to 70% of the range, higher end for men - yours is 38% so although it is range, it's on the low side
TIBC: Low in range indicates lack of capacity for additional iron, high in range indicates body's need for supplemental iron - yours is very high in it's range
Saturation: 35 to 45%, higher end for men - yours is just 18%
Ferritin: Low level virtually always indicates need for iron supplementation - you can't get much lower than yours, I still think it's so low that your doctor should be doing something, even referring you to a haematologist, I think he is being negligent if he doesn't.
I'm afraid iron is too complicated for me to suggest to anyone that they take iron supplements, which is why with results like yours I suggest discussing with the GP. Yours do tend to suggest iron supplementation is required but I think your doctor should be sorting this out and monitoring you, I don't think it's a DIY job. As I keep saying, your ferritin is absolutely dire and should be ringing alarm bells with your GP.
Thank you. Yes, it's very frustrating because I don't feel like my concerns are being taken seriously about my iron. I did see a hematologist after much insisting, and all of the many tests he did were normal, and the hematologist wasn't even concerned about my ferritin! Ugh, so frustrating.
I will go ahead and start supplementing and get it rechecked in a few months. This may be too much information, but I do have rather heavy periods, so I'm wondering if that in combination with the fact I rarely eat meat is leading to the low ferritin. I'll definitely work on adding more beans and taking vitamin C with the iron supplement. Thanks again for your advice!!
I forgot to say, take iron tablets 4 hours away from your thyroid meds and 2 hours away from any other supplements and medication as it affects their asbsorption.
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