Ive been diagnosed since autumn 2017 with UAT and Hashi, and have had a very rocking road since. As well as the usual fatigue etc my mental health has taken a nosedive. The depression and anxiety has been very bad, especially through the first half of 2018. Ive seen Harley street Endos, local Endos as well as psychologists and therapists to try and tackle the problem but its still an ongoing daily battle. I had my last results in November which my local Edno advised to stay as I am on 75mcg Levo and 25mcg Thyronine (split at 12.5 twice a day). I had been on this dose for approx 3 months but still felt some fatigue in the afternoons.
Nov results:
TSH 0.78 (0.25-4)
Free T4 10 (11-22)
Free T3 4.3 (3.1 -6.8)
I have just done my full Thyroid check Ultravit through medichecks and the results have jumped. I also need some advice on my Vit D and Folate as these were flagged by the Medichcecks doctor. Regarding supplements Im already taken 3000ui Vit D, B12 1000mcg. Im also on 80mgs slow release Propanalol for migraine prevention and 40mgs Citalopram for the depression and anxiety. My latest results are below, bloods were taken 3 hours after my dose of Levo and T3.
The medichecks doctor flagged low folate, high T3, low TSH and low Vit D. What would you guys suggest, obviously some kind of folate supplement and maybe up the dose of Vit D but considering I'm on 3000ui already what should I up to?
Thanks in advance and sorry for the sprawling post.
Best
Jamie
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jamiebgp
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Supplementing a daily good quality vitamin B complex, one with folate in not folic acid likely to be beneficial
B vitamins best taken in the morning after breakfast
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
Recommended ones are Igennus Super B or Jarrow B right
Vitamin D, try 2 x 3000iu alternate days. Very common with Hashimoto's to need high dose
But vitamin D around 100nmol is likely good level, you are almost there
Are you on strictly gluten free diet?
If not then you need to consider trying it
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. Dairy is second most common.
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
propranolol is used to treat hyperthyroid patients and affects thyroid uptake/conversion
I was stuck on propranolol for 20 years (more on my profile). Couldn't get off it until strictly gluten free
You must NOT just stop taking propranolol. It has to be reduced incredibly slowly. I found maximum could tolerate was 5mcg and wait at least ten to fourteen days. Last 5mcg incredibly difficult. None One day a week. Wait a fortnight. Then none Two days a week etc
Oncecyou start vitamin B complex, you could look at reducing B12 dose, as there's high B12 in B complex
Propranolol - you will most likely need to change to 4 x 20mcg tablets initially. Slow release propranolol probably can't easily be cut down
Lastly, have you tried splitting T3 into 3 doses per day - 8 hour gap. Waking, mid afternoon and bedtime. Some of us find it much better. Again more on my profile
Only make one change at a time or add one supplement at a time
Propranolol tends to lower magnesium according to Carolyn Dean in great book "The Magnesium Micacle"
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If also on T3, make sure to take last dose exactly 12 hours prior to test
Many thanks Slowdragon, a huge wealth of information there and so appreciated. I did read about not taking my morning T3 before test but Endo said I need to, probably why the spike as you mentioned. I really need to get my meds in order and times as Im struggling to keep on top of them and remember what I've taken ( brain fog). At the moment Im doing:
7am - Levo and T3 on waking apex
11am - B1 and Vit D with snack
2pm - T3
9pm - Magnesium, Selenium, Propanalol, Citalopram
Any advice on compounding some of these so Im not taking tablets every other hour or so?
You probably need higher dose of Levothyroxine. But improving folate first. Then retest TSH, FT3 and FT4 6-8 weeks later
Perhaps Trying strictly gluten free diet next step, get coeliac blood test first
Adding daily vitamin C to support adrenals might be good too
Personally I find Levothyroxine at night works better. But you would have to change other nighttime medication to morning, probably don't try at moment.
Only ever change one thing at a time
T3 - I take 20mcg (NHS prescribed) - 10mcg waking 7am, 5mcg 3pm and 5mcg at 11pm with Levothyroxine
Personally I tried 2 x 10mcg T3 and it doesn't work for me, upsets adrenals. I have to take 3 doses and changing to 8 hours apart gave significant improvement
After breakfast, vitamin C, B complex, and vitamin K2 Mk7. Twice week, ( on different days) vitamin E with selenium and zinc picollante
Vitamin D mouth spray by Better You is good as you don't have to leave four hour gap between it and Levothyroxine/T3
Magnesium I take midday or early evening
My endo always says "no Levo 24 hours before and no T3 in 12 hours before".
So I take T3 at 9pm night before blood test at 9am
All thyroid tests as early as possible in morning and fasting. Take T3 and Levothyroxine immediately after blood draw. Wait an hour for breakfast
Thanks Slowdragon, Ive ordered the Vit D mouth spray and B complex, hopefully I will get these into some kind of order now so Im not taking tablets all day.
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