Advice on latest results please..

[Tabitha6]

TT 15 years ago. Thyroid cancer.

These results are from my annual appointment with my oncologist - I would be grateful for advice or comments please..

FT4 21.06 pmol/L 12-22

TSH 0.042 mlU/L 0.27-4.20

FT3 4.4 pmol/L 3.1-6.8

Thyroglobulin 0.5 <l ug/L post ablation

Anti thyroglobulin antibodies <20.0 KU/L range <20

B12 363.1 pg/ml 197-771

Serum folate. 8.14 ng/ml 3.89-26.80

Ferritin 93.73 ug/l 13-150

Vitamin D 50 (Low). 75-200 nook/L

I had a Vit D loading dose in past and have been using Better You Vitamin D K2 Spray.

B12 Igennis super B complex

Better You magnesium oil spray.

Thank you.

[SeasideSusie Remembering]

Tabitha6

Thyroid-wise, FT4 is high in range (91%) and FT3 is low in range (35%) which shows poor conversion and that you may benefit from a bit less Levo and the addition of some T3.

B12 is a bit low. 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 is a bit low, it should be at least half way through range so 15.5+ with that range. How many Igennus Super B do you take daily? I imagine increasing your dose would improve both B12 and Folate.

Ferritin is fine.

Vit D is low and the Vit D Council recommends a level of 125nmol/L [50ng/ml] and the Vit D Society recommends a level between 100-150nmol/L [40-60ng/ml]. For your current level the Vit D Council recommends supplementing with 4,900iu D3 daily (you'd need to buy 5,000iu). If you're already taking that amount I'd increase it and retest in 3 months.

[Tabitha6 in reply to SeasideSusie]

Thank you for advice. Will up the B12 and Vit D. I saw an endocrinologist last year for first time and my results then were FT4 25.32 pmol/L 12-22 FT3 5.1 pmol/L 3.1-6.8. He said he was open to T3 but as I was in range for FT3 I didn’t need it. Advice from a few on this site at the time said I was just on edge of being a poor converter. Do you think it’s worth another appointment with endo?

[SeasideSusie Remembering in reply to Tabitha6]

Tabitha

My own experience of seeing an endo was catastrophic. Most are diabetes specialists and know very little about treating hypothyroidism, or even knowing the difference between hyperthyroidism and Hashimoto's. I personally don't have a good word to say about them. But others do occasionally manage to find a good one.

FT4 25.32 pmol/L (12-22) - 133% of range

FT3 5.1 pmol/L (3.1-6.8) - 54% through range

Similar to my results 3 years ago, although my FT4 was 28.59

Your T4:T3 ratio is 4.91 : 1 so your conversion isn't good.

I think your endo at the time should have looked at how much over range your FT4 was to achieve a FT3 result only half way through range and I think he should have lowered your Levo and started you on T3.

I also had severe Vit D deficiency, low folate and low ferritin, plus very low sex hormones plus "low adrenal reserve" (according to my then practioner).

I added self-sourced T3 to my Levo, optimised my nutrient levels and adrenals are being sorted. I am in a better place now than when I saw the dreadful endo, no thanks to him. Self help is sometimes the only way.

[Tabitha6 in reply to SeasideSusie]

Thank you so much for advice. I have requested list from Dionne and also received other recommendations... and will be making an appointment with new endo ASAP.

[SlowDragon Administrator in reply to Tabitha6]

Yes

[Tabitha6 in reply to SlowDragon]

Thank you so much for advice. Will be making appointment ASAP with different endo.

[SlowDragon Administrator]

Low vitamins are likely due to you being under medicated and FT3 being too low

Professor Toft recent article saying, T3 may be necessary for many

rcpe.ac.uk/sites/default/fi...

Email Thyroid UK for list of recommended thyroid specialists, who will prescribe T3, some are NHS

please email Dionne at

[e-mail]

It is possible, with luck and determination to get T3 prescribed on NHS

New NHS England Liothyronine guidelines November 2018

sps.nhs.uk/wp-content/uploa...

Dossier presented to Lord O'Shaughnessy November 26th

drive.google.com/file/d/1c2...

[Tabitha6 in reply to SlowDragon]

Thank you for advice. I am considering another appointment with a hopefully sympathetic endocrinologist with regard to T3,otherwise perhaps I’ll be brave and go it alone!

[SlowDragon Administrator in reply to Tabitha6]

Roughly where in the UK are you?

Some of us have found very pro T3 endocrinologists, but they are few and far between

[Tabitha6 in reply to SlowDragon]

I’m in West Sussex.

[SlowDragon Administrator in reply to Tabitha6]

There are a few on Thyroid UK list not too far from you

NHS (currently a very long wait) or private as initial option

[pennyannie]

Hello Tabitha6

I too am without a thyroid - ablated in 2005.

A fully functioning thyroid would give you, on a daily basis, 100 T4 + 10 T3 - approx. :

I believe that people who do not have a healthy, fully functioning thyroid, through medical intervention, should at least have the option of the replacement of both these essential hormone as a given - from which to work with, in an attempt to rebalance these thyroid hormones to a level of wellness acceptable to the patient.

Patients with an autoimmune condition of Graves and or Hasimotos need a specialist in this field of endocrinology but these consultants seem to be very few and far apart.

The current Nhs treatment of TSH only blood tests and patients being palmed off with anti depressants, and, or, a chronic fatigue ( dustbin ) diagnosis is not acceptable is it -

This site is amazing, it has helped equip me but sadly, I've resorted to self medication

but am happy with my progress and continue to get back my health, stamina, stability and confidence.

Take good care

Penny

[Tabitha6]

Thank you pennyannie. I agree this site is amazing and been very helpful.