Advice on taking T3 (I think this is my last ch... - Thyroid UK

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Advice on taking T3 (I think this is my last chance of feeling better!)

Leeb1972 profile image
12 Replies

Hi everyone my name is Lee and i'm a Hashimoto sufferer !

My problems started in 2012 and it took until 2015 for me to be dignosed with Hypothroidism when my TSH level test came back as 18.3. Since 2012 ive had muscle contractions in my limbs, muscle aches, memory fatigue, low sex drive, and hot and cold sweats etc (i think you all know the symptoms). The symptoms have eased since taking Levothyroxine, gabapentin and Tramadol, but they still persist to the point i just exist on the couch and work.

My GP did a lot of tests on me since the diagnosis. But they came back mostly "normal". I argued to see an endocronologist due to my symptoms persisting, and he initially refused saying the Levothyroxine had brought my levels back to "normal" and nothing more could be done. He finally caved in and an appointment was made. When i got to see the endocronologist i explained that i still felt unwell, and had read many forums on taking T3 as well as T4. She was not convinced it would help but we made a deal which was that she would prescribe it if i had a short synacthen test and it came back normal. It was normal, but she has now left the hospital and im waiting to see someone new which is in April. I got desperate a few months ago and bought some T3 (Tiromel) online from a prescription free site, but they did not do a thing (i know i was really stupid and my wife made sure that i knew i was stupid). It was probably baking powder.....

But I want as much ammo as possible to take with me to try and get the T3 when i go to the new one, and thought i would ask this forum for advice, as i think its the best one!! Below are my blood test results. Some are 2017 and some 2018, but any advice would be great as i am a novice in comparison when trying to decipher them. Many thanks in advance.

July 2018 results:-

Cortisol level 229

Serum testosterone 6.8

Serum sodium 139 mmol/L

Serum creatinine 82

FSH Level 7.5

Serum potassium 4.2 mmol/L

Calprotectin level normal range

Luteinising hormone 2.8

Calcium adjusted level 2.1

24 hour urine metadrenaline ouput normal

October 2017 tests:-

Thyroid peroxidase 111.0/ml (ABNORMAL)

TPO interpretation normal

Plasma fasting glucose 4.7 mmol/L

Serum free T4 21.8 (ABNORMAL)

Seru 25-Ho vit D3 70.9nmol/L

eGFR creat (ckd-epi)/1.73*2 90ml/min/1.73*2

Serum vitamin B12 227 NG/L

25-OH-vitamin D 25.2nmol/L (ABNORMAL I WAS PUT ON VITAMIN D TABLETS)

Serum folate 4.8

GFR calculated abreviated MDRD 60ml/min/1.73*2

In a biochemistry profile in sept 2017 my serum adjusted calcium conc was 2.1mmol/l which said was abnormal.

This is about all I have. I have never asked about or shown my results on a forum before so i do appreciate any feedback and thankyou.

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SeasideSusie profile image
SeasideSusieRemembering

Leeb1972

I got desperate a few months ago and bought some T3 (Tiromel) online from a prescription free site, but they did not do a thing (i know i was really stupid and my wife made sure that i knew i was stupid). It was probably baking powder.....

To be honest, it may not be fake. It's so cheap (except for what the NHS are charged) that it's not worth faking. But........... you never know, I've always wondered about body building sites myself.

If you can add the reference ranges to your above results we will be able to interpret them (ranges vary from lab to lab). You can edit the post:

support.healthunlocked.com/...

**

Thyroid peroxidase 111.0/ml (ABNORMAL)

TPO interpretation normal

Oh dear :(

First of all, I would ask your doctor why the comments there are contradictory. One says abnormal, the other says normal. We can tell you that your TPO (thyroid peroxidase) antibodies are definitely abnormal and they confirm autoimmune thyroid disease aka Hashimoto's. Has anyone ever told you this? This is where the immune system attacks the thyroid and gradually destroys it. Hashi's causes fluctuations in test results and symptoms and you can swing from hypo to "hyper" and back to hypo.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

You can possibly help reduce the antibodies by adopting a strict gluten free diet which has helped many members here.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies and you do have some problems there.

**

Seru 25-Ho vit D3 70.9nmol/L

25-OH-vitamin D 25.2nmol/L (ABNORMAL I WAS PUT ON VITAMIN D TABLETS)

You have conflicting results here, can you clarify why one is much higher than the other? Your 25.2nmol/L results show Vit D Deficiency. Did you have loading doses of D3 totalling 300,000iu over a few weeks and your current level is now 70.9nmol/L?

What is the current dose of D3 you are taking? Is it still prescribed?

The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.

Your GP won't know, because they're not taught nutrition, but there are important cofactors needed when taking D3 as recommended by the Vit D Council -

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking tablets/capsules/softgels, no necessity if using an oral spray

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

Check out the other cofactors too (some of which can be obtained from food).

As you have Hashi's, for best absorption an oral spray form of D3 is recommended, eg BetterYou. They do D3 alone or a combination of D3/K2.

**

Serum vitamin B12 227 NG/L (ng/L is the same as pg/ml mentioned below)

This is in range but it is low. According to 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."

You can check for signs of B12 deficiency here:

b12deficiency.info/signs-an...

If you have any then list them to discuss with your GP and ask for further testing for B12 deficiency/pernicious anaemia. Plenty of people with a level in the 300s have been found to need B12 injections.

If no symptoms you could supplement with methylcobalamin sublingual lozenges.

Serum folate 4.8

Without the range it's difficult to say but this looks low. Maybe not low enough for your GP to prescribe folic acid, but B12 and folate work together so not surprising it's low. You could supplement with a good quality B Complex containing melthylfolate (eg Thorne Basic B) but don't start taking that, or methylcobalamin lozenges, until further testing of B12 has been carried out if necessary, it will mask signs of deficiency and skew results.

**

Your calcium is low but that should improve, hopefully, when Vit D is optimal. But important to keep a check on the level, if it stays low then your GP should address it.

**

I can't see a ferritin result. This is essential as low ferritin causes many problems. It's said that it should be at least 70 for thyroid hormone to work properly and T4:T3 conversion to take place, and I've seen it said that for males around 150 is recommended.

**

Serum free T4 21.8 (ABNORMAL)

That was obviously over range to say abnormal.

You need current results for your thyroid, you need

TSH

FT4

FT3

This will then tell us how well (or not) you convert T4 to T3 and whether you need to add T3 to your Levo, and whether you would need to reduce your dose of Levo.

However, before adding T3 it's essential that vitamin levels are optimal.

So for the moment, forget T3, let's see your current results (with reference ranges) for thyroid and vitamins and we can move forward from there.

Leeb1972 profile image
Leeb1972 in reply toSeasideSusie

Wow that is some reply and thankyou!!! No i did not get a confirmation on Hashimoto fom my GP. I had to beg for the antibody test and work it out for myself! And yes the i was put on the loading vit D which put it back to normal levels. I am to see my endocronologist in a couple of weeks time, so should i ask him to check ferritin levels, vit D levels and other vitamin levels? Is there any other tests i should ask for? Free t3? I am definately going on a gluten free diet now!

SeasideSusie profile image
SeasideSusieRemembering in reply toLeeb1972

Leeb1972

You really need your current levels for Vit D, B12, Folate and Ferritin. If your doctor wont do them then I would definitely do them with one of our recommended labs. They all need to be optimal, so you need to know where they currently are and if they need supplementing. I think they do.

You should also ask for FT3 to be tested at the same time as FT4 and TSH. This is going to show how well you convert and whether T3 is something to consider once your nutrient levels are optimal. Again, if your doctor wont do this test, then you can get a full thyroid/vitamin bundle with one of the private labs. Come back after your next appointment, tell us what's happening, and we can give you details of which test and where to get it from if necessary.

Gluten free is worth a try for a few months, there's no guarantee but you wont know unless you try it.

Leeb1972 profile image
Leeb1972 in reply toSeasideSusie

Indeed i wont know unless i try. I have thought about it for a while, and now u have mentioned gluten free i will try it. I will also get the tests done. Many thanks...

Leeb1972 profile image
Leeb1972 in reply toSeasideSusie

Hi, you advised me a couple of weeks ago to get some up to date checks. So I had Medichecks do my tests which are below. I am seeing my Endocronologist in 2 days time so any advice on what to say would be great! I haven't changed anything dietry as yet as I've just had the blood tests done.

CRP HS 6.05 MG/L

FERRETIN 91.5 UG/L

FOLATE SERUM 19.8 UG/L

VIT B12 48 pmol/L

VIT D 99.8 nmol/L

TSH 2.56 mlu/L

FREE T3 4.94 pmol/L

FREE THYROXING 19.4 pmol/L

THYROGLOBIN ANTI BODS 550 ku/L

THYROID PEROXIDASE ANTIBODS 93.8 klu/l

Many thanks

SlowDragon profile image
SlowDragonAdministrator in reply toLeeb1972

Suggest you also put this on a new post so more people can see it

Please add ranges (figures in brackets after each result) on new post

So Ferritin, folate and vitamin D are OK

B12 is very low. Should be over 70 on active B12 test. Ask GP or endocrinologist for testing for Pernicious Anaemia

Low B12 very common when under medicated.

Improving B12 may help improve conversion of FT4 to FT3. But important to test further before starting any B vitamins

Your TSH is too high, but FT4 is near top of range. FT3 likely too low

How's the gluten free diet going?

Noticed any improvements?

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Leeb1972 profile image
Leeb1972 in reply toSlowDragon

CRP HS 6.05 MG/L < 5

FERRETIN 91.5 UG/L 30 - 400

FOLATE SERUM 19.8 UG/L > 3.89

VIT B12 48 pmol/L 37.5 - 188

VIT D 99.8 nmol/L 50 - 175

TSH 2.56 mlu/L 0.2 - 4.2

FREE T3 4.94 pmol/L 3.1 - 6.8

FREE THYROXING 19.4 pmol/L 12 - 22

THYROGLOBIN ANTI BODS 550 ku/L <115

THYROID PEROXIDASE

ANTIBODS 93.8 klu/l <35

I haven't started gluten free yet as I had to do the blood test 1st to get a true picture and wasn't sure if it would point to this problem.

I took my last levothyroxine (100mg) 24 hours prior to taking my blood sample at 10am.

I will start a new post with results as suggested.

Many thanks

SeasideSusie profile image
SeasideSusieRemembering in reply toLeeb1972

Leeb1972

As mentioned before, reference ranges are needed to interpret results. I know some of Medichecks ranges so can comment where possible.

CRP HS 6.05 MG/L

This may be high due to Hashi's , your antibodies were quite high at the time of the test.

FERRETIN 91.5 UG/L

This is good, assuming the range is around 13-150.

FOLATE SERUM 19.8 UG/L

This depends on the range. Sometimes they have a range going up to 60, in which case this might be a bit low. If you can add the range I can be more specific.

VIT B12 48 pmol/L

I think Medichecks include Active B12 with their UltraVit test so this is low. Below 70 suggests testing for B12 deficiency. You can check for signs and symptoms here

b12deficiency.info/signs-an...

List any that you have to discuss with your GP and ask for testing for B12 deficiency/pernicious anaemia. Don't supplement any B12 or B Complex/Biotin before further testing.

VIT D 99.8 nmol/L

As mentioned previously, the Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L, so you're just about there. You didn't answer the question about your current dose of D3, you now need to maintain this level and you'll have to find your maintenance dose by trial and error, it may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Cofactors mentioned above are still important and need to be taken when taking D3.

TSH 2.56 mlu/L

FREE T3 4.94 pmol/L

FREE THYROXING 19.4 pmol/L

Did you do this test under the conditions we always advise here:

When booking thyroid tests, we advise:

* Book the first appointment of the morning. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* Leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

If so then TSH is too high - when on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. If you did your test later in the day, ate beforehand or drank anything containing coffee, then your TSH is higher than it would be if done early morning, fasting and drinking water only.

You may need an increase in dose but if you feel well with this level of FT4 and FT3 there's no need to change anything.

Leeb1972 profile image
Leeb1972 in reply toSeasideSusie

CRP HS 6.05 MG/L < 5

FERRETIN 91.5 UG/L 30 - 400

FOLATE SERUM 19.8 UG/L > 3.89

VIT B12 48 pmol/L 37.5 - 188

VIT D 99.8 nmol/L 50 - 175

TSH 2.56 mlu/L 0.2 - 4.2

FREE T3 4.94 pmol/L 3.1 - 6.8

FREE THYROXING 19.4 pmol/L 12 - 22

THYROGLOBIN ANTI BODS 550 ku/L <115

THYROID PEROXIDASE

ANTIBODS 93.8 klu/l <35

I haven't started gluten free yet as I had to do the blood test 1st to get a true picture and wasn't sure if it would point to this problem.

I took my last levothyroxine (100mg) 24 hours prior to taking my blood sample at 10am.

I will start a new post with results as suggested by slow dragon.

Many thanks

SlowDragon profile image
SlowDragonAdministrator

Autoimmune thyroid disease diagnosed by high TPO antibodies, almost always leads to leaky gut and food intolerances and low vitamins

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

We need vitamins OPTIMAL before even considering T3. This is most likely why the Timorel "didn't work"

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

Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Trying STRICTLY gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

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

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

restartmed.com/hashimotos-g...

Masses of gluten free options available these days, including loads if great beers

Leeb1972 profile image
Leeb1972 in reply toSlowDragon

Many thanks for the great reply!!! I will do all of the above.

Leeb1972 profile image
Leeb1972 in reply toSlowDragon

Hi, you advised me a couple of weeks ago to get some up to date checks. So I had Medichecks do my tests which are below. I am seeing my Endocronologist in 2 days time so any advice on what to say would be great! I haven't changed anything dietry as yet as I've just had the blood tests done.

CRP HS 6.05 MG/L

FERRETIN 91.5 UG/L

FOLATE SERUM 19.8 UG/L

VIT B12 48 pmol/L

VIT D 99.8 nmol/L

TSH 2.56 mlu/L

FREE T3 4.94 pmol/L

FREE THYROXING 19.4 pmol/L

THYROGLOBIN ANTI BODS 550 ku/L

THYROID PEROXIDASE ANTIBODS 93.8 klu/l

Many thanks

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