New Endocrinologist - Dexa Scan and Thyroid Test in PM?

[Welchy1]

Hi all,

My Dr has asked me to re-test my Thyroid in the afternoon after medication and has also asked me to have a Dexa scan... Can you let me know your thoughts?

Does anyone have any conventional evidence to say this is a bad idea (testing after taking thyroid hormone) and does anyone know where I can find literature that disproves the osteoperosis myth? (I'm a 44 year old male who weight trains).

My current labs look like this:

Vit D 132 nmol/L (75-200)

FT4 15.4 pmol/L (9-24.00)

FT3 4.8 pmol/L (3.5-6.5)

Ferritin 218 ug/L 15:00 -300)

Serum Folate 7.9 ug/L (2.00-17.00)

TSH 0.05 (0.35-5.00)

I'm on 125Mcg of Levo and 20Mcg of T3. The Endo also asked me if I split the T3 dose and I told him; No. He seemed to be concerned about this and suggested that it was so 'fast acting' that perhaps my T3 would have worn off by the afternoon/evening.

I still have symptoms (including change in hair texture and hairloss but not in the typical of male pattern baldness).

Anyway, looking for help and feedback... I'm thinking of asking him to up my T4 and reduce my T3 to 150mcg and 10mcg respectively...

Welchy

[SlowDragon Administrator]

Why not try dividing T3 dose FIRST ?

10mcg waking, 5mcg 8 hours later, mid afternoon and 8 hours later, 5mcg at bedtime (can really help improve sleep)

Yes it's slightly inconvenient to take divided dose, but it can give significantly better results

Blood test as early as possible in morning and fasting. Last dose of T3 should be 8-12 hours before blood test, and Levothyroxine 24 hours before test

Is this how you did this test?

No B12 test?

[Welchy1 in reply to SlowDragon]

So I had my B12 tested by for some reason they were missing from the blood test results. I do need to follow up on that.

My concern about splitting the dose is ge advice to 'wait 4 hours before taking any foods with calcium or iron'... so it massively impact what I can eat on a daily basis

[SlowDragon Administrator in reply to Welchy1]

It's only necessary to wait an hour before and after food apart from water (two hours after large meal)

Waking dose is easy

Mid afternoon dose just means waiting for tea/coffee etc

Last dose at bedtime, obviously very easy to miss food and drink before and after

[Welchy1 in reply to SlowDragon]

Thanks SlowDragon, but what about the advice from Isabella Wentz and other Thyroid experts who say medication should be taken 4 hours apart from calcium and iron rich foods (milk, whey, and red meat)? Is this unecessary?

[SlowDragon Administrator in reply to Welchy1]

Main Levothyroxine dose, ideally yes (I take at bedtime for that reason)

T3, it's a compromise. If the best way for you as an individual is to take a divided dose, (personally it's the ONLY way I can tolerate it) then being sensible about leaving as much gap as possible

Eg I take 10mcg T3 at 6am. Breakfast including small amount of kefir at 8.30.

3pm - T3 dose. I make sure to eat lunch by 12.30-1pm. Nothing apart from water until 4pm

Evening dose T3 and Levothyroxine combined. Very good reason not to snack in the evening

supplements I take about 9.30am, apart from magnesium about 6pm

[Welchy1 in reply to SlowDragon]

Thanks Slowdragon.. I think the Endo wants to see if it will resolve my remaining symptoms... but I seem to tolerate T3 20mcg all in one go in respect of my heart rate anyway... my resting pulse is always around 52 bpm... never changes with T3...

[SlowDragon Administrator in reply to Welchy1]

Yes my resting heart rate is usually 55-58

[Nanaedake]

What reason were you given for having a DEXA scan? Have you had a thyroidectomy? Have you got symptoms consistent with metabolic bone disease?

If you've had a thyroidectomy it could be a good idea to get a base line for bone density since the loss of parathyroid glands or calcitonin or some other factor related to loss of thyroid tissue might affect how you maintain bone.

[Welchy1 in reply to Nanaedake]

Supressed TSH was the reason he gave

[ollymummy in reply to Nanaedake]

I have dexa scans as my TSH is suppressed putting me at more risk of OP

[Welchy1 in reply to ollymummy]

Have they ever shared the full print out of your Dexa scan?

[ollymummy in reply to Welchy1]

I had to cancel my last Endo appt and couldn’t get another one until June so I will get my results then - they are more than happy to share them

[greygoose]

He seemed to be concerned about this and suggested that it was so 'fast acting' that perhaps my T3 would have worn off by the afternoon/evening.

Oh, dear. You've got to laugh, although it's really not funny. They seem to think that T3 is like ibuprofen or something. T3 is not necessarily fast acting and doesn't wear off. It stays in the blood for 24 hours, but the T3 that gets into the cells stays there for about three days.

Some people need to take all their T3 in one go, in order to saturate the receptors. Some people have thyroid hormone resistance that requires high doses in one go to make sure some gets into the cells. And, if he thinks that all your 20 mcg T3 has 'worn off' by the evening, he's as good as admitting that you're not on a high enough dose.

[Welchy1 in reply to greygoose]

Thanks Greygoose, can you point me in the direction of any literature or links that I can use to support yiur argument when I see him?

[greygoose in reply to Welchy1]

Sorry, I'm afraid I can't. But, you might find something useful if you sift through the post and replies of diogenes:

healthunlocked.com/user/dio...