Hypothyroid: Please can somebody help with these... - Thyroid UK

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Hypothyroid

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Please can somebody help with these results i currently take 50 t4, 25 t3 at 3am 25 at 9am 12.5 t3 at 2 and 12.5 t2 at 7pm my doctor does not know about the t3 and prescribes 100 levo i went to see the doctor as i am still getting bad lower leg pain and have a feeling like air hunger, lightheaded,i feel puffy have dizzy spells and fatigue, the doctor did a bloodtest and called me in said she had a call from the lab about bloodtest and asked me to stop taking all herbal supplements as she did not know what dose of meds i should be on as it was making my bloodtests wrong

Tsh suppressed

Free T4 <3

Free T3 6.6

She said i should not have a low tsh and low Free T4 and i need another blood test in 6 weeks after i have stopped taking supplements and increased levo to 125 i dont know how to stop taking T3 and dont want to as i feel this helps me more than levo doctor is going to test ferritin.

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SlowDragon profile image
SlowDragonAdministrator

Just looking through previous posts

Can't see you have ever had folate, ferritin or B12 tested

Add results and ranges if you have them

One post showed extremely high vitamin D, have you significantly reduced dose of vitamin D

Have you ever had both TPO and TG thyroid antibodies tested?

You will have to tell GP you are taking T3

You may need to take more Levothyroxine and less T3. Very low FT4 can cause symptoms

This change needs to be done very slowly and carefully

About 80-90% of primary hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's

If your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

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

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

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying 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...

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printer in reply to SlowDragon

Thankyou for your reply if i increase the levo and reduce the T3 can you tell me how i would do this please?

SlowDragon profile image
SlowDragonAdministrator in reply to printer

It takes 5 days for Levothyroxine to be available after taking it.

Suggest you add 12.5mcg Levothyroxine and, after a 5 days cautiously reduce T3 by 6.25mcg

See how that goes and a week or so later, increase Levothyroxine to and extra 12.5 mcg (25mcg in total extra per day) and 5 days later reduce T3 another 6.25mcg

Keeping 3 doses of T3 per day. So cutting doses down, not cutting one dose out.

Remain on this for minimum of 6-8 weeks and retest bloods before considering any further changes

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printer in reply to SlowDragon

Thankyou would my blood results show a higher T4 to keep the doctor off my back and would my tsh still be suppressed?

SlowDragon profile image
SlowDragonAdministrator in reply to printer

You may need to increase Levothyroxine further,

but we can only change slowly waiting to retest bloods after six to eight weeks

You can't rush it

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printer in reply to SlowDragon

Thankyou would the small increase raise the T4 as i have to have bloodtest in 6 weeks and worried this will not be any different if i am still taking T3.

SlowDragon profile image
SlowDragonAdministrator in reply to printer

Yes it will increase your FT4.

How much it's difficult to say .

It might also help improve some symptoms

SlowDragon profile image
SlowDragonAdministrator

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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/when also on T3, make sure to take last dose 8-12 hours prior to test

Is this how you do your tests?

CarmenML profile image
CarmenML in reply to SlowDragon

QUESTION, why don't you want to tell Dr. about last dose of T4 being 24 hours before?

printer profile image
printer in reply to CarmenML

Sorry i am not sure what you mean?

CarmenML profile image
CarmenML in reply to printer

SlowDragon always posts not to tell Dr/ phlebotomist about the last dose of T4 medication. I have always wondered why.

printer profile image
printer in reply to CarmenML

Sorry i thought the question was for me 🤣

CarmenML profile image
CarmenML in reply to printer

Sorry Printer!😘😘

SlowDragon profile image
SlowDragonAdministrator in reply to CarmenML

Because most medics either think it irrelevant or incorrect or only look at TSH.

There is ridiculous over reliance on just TSH, which is completely inadequate

Yet specialist thyroid endocrinologists will advise this is correct. Last Levothyroxine dose 24 hours before and last T3 dose 8-12 hours

Even the new NHS Liothyronine guidelines state that bloods should be in morning BEFORE daily Levothyroxine dose

The fasting aspect is somewhat controversial.....but as you want to take delayed dose immediately after blood draw, it needs to be on empty stomach

And fasting.....just may help raise TSH

CarmenML profile image
CarmenML in reply to SlowDragon

What's your opinion on the timing of t4 v t3? And do you advise taking them together?

SlowDragon profile image
SlowDragonAdministrator in reply to CarmenML

Some people can take T3 once a day

Others need it 2 or 3 times a day

Always on empty stomach and then nothing apart from water for at least an hour after

Personally I can only take T3 as split dose 3 x per day. Each dose 8 hours apart. 7am, 3pm and 11pm

Currently experimenting with also splitting my Levothyroxine, majority (100mcg) at 11pm with T3 but small amount (25mcg) with T3 in morning

silverfox7 profile image
silverfox7

If you are taking T3 in any form then your readings should be read differently as the readings will be different which the lab have realised. You need to tell the doctor why as he isn't going to be able to understand why. When taking any form of T3 your TSH should be suppressed, your FT4 can fall in its range but your FT3 should be high in its range. You can no longer use your readings to test if you have a conversion issue either. That issue needs to be addressed first.

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