New and need help with thyroid levels

[Evie7851]

In March my T s h was 5.64 now it is 3.64 range is 0.7-1.5

Free t4-March 0.5 now 0.8 range 0.7-1.5

Free t3-March 2.1 now 2.5 range 2.2-4.0

B12 -616 range 211-911

Vitamin D

-43.5 range30-100

Ferritin 73 range 8-252 last year it was 150

Folate 18.1 range >5.4

I’m taking Np thyroid 1 3/4 grain it seems when I try to raise it I start sweating and my blood pressure goes up I’m at a loss I’ve gained a lot of weight and can’t seem to loose it also achy and some days I just don’t feel well I also have Addison’s disease so my adrenal glands don’t function I take hydrocortisone for that I have had it for 30 years along with the hypothyroidism My endo will prescribe ndt and t3 I have tried taking t3 along with the ndt but then I have the sweating and higher blood pressure Thank you for your help

[SeasideSusie Remembering]

Evie7851

Those ranges aren't typical of ones we normally see here in the UK.

Please check the ranges, you've put the same range for both TSH and FT4.

At a quick glance it seems that TSH is over range, FT4 and FT3 very low in range. When one takes NDT one would expect to see a low or suppressed TSH, lowish FT4, and FT3 in the upper part of it's range if that is where you feel well.

Is Vit D nmol/L or ng/ml?

Ferritin is OK, although I've seen it said that for females 100-130 is good.

B12 appears to be OK, although that is a Serum B12 test and it's the Active B12 test that tells us what is available to be used by the cells.

Folate is OK.

Have you had thyroid antibodies tested, were they raised, do you have autoimmune thyroid disease aka Hashimoto's?

[Evie7851 in reply to SeasideSusie]

Hi the TSh is supposed to be 0.35-4.94 ulu-ml the vitamin D is ng/ml Thank you for your help

[SeasideSusie Remembering in reply to Evie7851]

TSH: 3.64 (0.35-4.94)

FT4: 0.8 (0.7-1.5)

FT3: 2.5 (2.2-4.0)

So these results do suggest you are very undermedicated.

I don't know how Addisons disease and taking hydrocortisone affects anything.

Are you taking your NDT on it's own, a couple of hours away from any other medication?

When we're on NDT or a combination of Levo and synthetic T3, we all are different as to where we need our FT4 and FT3 levels. I take Levo plus T3 and need FT4/FT3 both at around 75% through range. Maybe the balance of T4:T3 in NDT isn't right for you.

Have you ever had a period when you've felt well, if so what were your results and what thyroid meds were you taking at the time?

Vitamin D:

43.5ng/ml

The Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends a level of 100-150nmol/L (40-60ng/ml). So you are just about OK. Some people feel better when their level is at the top of the recommended range.

The only thing missing from your thyroid results is thyroid antibodies, if these are postive then your hypothyroidism is autoimmune and with Hashimoto's you can have symptoms of both hypo and hyper and swing between the two.

[Evie7851 in reply to SeasideSusie]

I have never had my Antibodies tested but she says I have Hashimoto I will ask her for that Up until a year ago I was on Levo but I wanted to try ndt When I felt the best I was on 13/4 grain plus 3 cytomel but then she lowered it and my blood pressure went up again I guess I’ve never been at a point where I felt optimal

[SeasideSusie Remembering in reply to Evie7851]

I have never had my Antibodies tested but she says I have Hashimoto

So how was Hashi's confirmed then if antibodies weren't tested?

What advice were you given about Hashi's?

[Evie7851 in reply to SeasideSusie]

I guess because my Addisons is an autoimmune disease she said Hashi’s and didn’t tell me anything else about it so should I continue to try to raise my medicine every couple of weeks it seems I get sweating if I raise it too much but maybe I doing it too fast or it’s the ndt

[Evie7851 in reply to Evie7851]

Also I do take my thyroid medicine with the hydrocortisone because I need it to wake up because my body doesn’t produce it what would be a better time to take the thyroid medicine

[SeasideSusie Remembering in reply to Evie7851]

With Hashi's, the immune system attacks and gradually destroys the thyroid gland. Symptoms and test results can fluctuate and you can have symptoms of both hypo and hyper so adjusting dose of thyroid meds when you swing from one to the other can help.

Some people have found that a gluten free diet can help but there is no guarantee.

There is a chance that any other medication could affect absorption of Levo so it's advised to leave 2 hours between Levo and other medication (and supplements), some need 4 hours. Finding the right time will be down to when you take your other meds. I regularly need the bathroom in the early hours of the morning so I take my thyroid meds then and it keeps it away from everything else and my stomach will be empty too.

[Evie7851 in reply to SeasideSusie]

That’s a good idea I will try that