Do I need Liothyroxine

[Day-skipper]

I'm new here! I have just been made aware of liothyroxine, and wonder if I could benefit. My thyroid packed up while I was having herceptin injections. So having lost 38lbs due to the chemo, it was a bit disconcerting to put on half a stone in a week. I'm now on 75 mcg Levothyroxine daily, but cannot shift weight. I also feel lethargic and fluctuate with feeling cold or sweaty! What's the easiest way to get tested for T3 to see if liothyroxine would be of benefit.

[SeasideSusie Remembering]

Day-skipper

It's liothyronine

It's not a weight loss drug.

When hypo, weight loss is difficult if we're not optimally medicated.

To know if we need T3 (liothyronine) we need to test TSH, FT4 and FT3 at the same time.

It's also useful to know if your hypothyroidism is autoimmune (Hashimoto's) and testing Thyroid antibodies tell us that.

Also, for any thyroid hormone to work properly, we need optimal nutrient levels so testing Vit D, B12, Folate and Ferritin is also important.

If you can post your latest test results, with reference ranges, eg TSH: 2.5 (0.2-4.2) we can comment.

[Day-skipper in reply to SeasideSusie]

Hi, it seems my T4 and T3 were not recorded separately but in Nov 2018 my TSH was 1.33 and prior to that in August 2017 the TSH was 1.06.

I don't eat junk food, and cook from scratch, I regularly get out in the sun to top up my vitamin D including finding the sun in January, when I joke that a Caribbean cruise is for medicinal purposes.

Should I now request that I get a reading for T3 and T4?

[SeasideSusie Remembering in reply to Day-skipper]

Should I now request that I get a reading for T3 and T4?

You can request them but whether they will be done is another matter. Many areas only test TSH and nothing else if TSH is in range. This is why hundreds of us here do our own private testing to get the full picture.

I regularly get out in the sun to top up my vitamin D including finding the sun in January

Not everyone can make Vit D naturally from the sun, this is why it's important to test. Our member who lives in Crete needs to take D3.

[Day-skipper in reply to SeasideSusie]

Thanks, I have just sent off for the full range of tests, and will update when I get this done and the results are in. Just to confirm, my blood tests to date have been first thing in the morning, after an overnight fast.

[SeasideSusie Remembering in reply to Day-skipper]

Just to confirm, my blood tests to date have been first thing in the morning, after an overnight fast

Yes that's right, early morning, fasting from evening meal or supper the night before - you can drink water, last dose of Levo 24 hours before test (it's 8-12 hours for T3 and NDT.

[Day-skipper in reply to SeasideSusie]

HI,

I have my results back, but not sure what to make of them. My TSH / T3 /T4 all seem to be in the normal range at 1.12 range 0.27 - 4.2

4.84 range 3.1 - 6.8

20.3 range 12 - 22

as are Folate / B12 / Vitamin D being 9.99 / 86.5 / 63.3 repectively.

But my ferritin is 161 range 13 - 150 (I don't take a supplement)

Thyroglobin antibodies 401 range 115 -

Thyroid peroxidase 44.9 range 0 - 34

is this something that can be improved, or do I just have to live with it?

[SeasideSusie Remembering in reply to Day-skipper]

Day-skipper

as are Folate / B12 / Vitamin D being 9.99 / 86.5 / 63.3 repectively.

Can you please list these with their reference ranges so they can be interpreted properly, also is your B12 serum or Active (serum has a wide range of about 140-700), Active has a narrow range of about 37-180), and what is the unit of measurement for Vit D - nmol/L or ng/ml? eg.

Folate 9.99 (xx bottom of range - yy top of range)

B12 86.5 (xx - yy)

**

Thyroglobin antibodies 401 range 115 -

Thyroid peroxidase 44.9 range 0 - 34

Both antibodies are raised which means that you are positive for autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed. Fluctuations in symptoms and test results are common with Hashi's.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

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.

**

But my ferritin is 161 range 13 - 150 (I don't take a supplement)

Ferritin can be raised due to infection or inflammation, it can be raised where Hashi's is present.

**

TSH: 1.12 range 0.27 - 4.2

FT3: 4.84 range 3.1 - 6.8

FT4: 20.3 range 12 - 22

These aren't too bad at the moment, although FT3 is only 47% through range with FT4 at 83% through range so not particularly well balanced. Optimal nutrient levels will help, so let's see the ranges as requested. Also selenium can help with conversion.

[Day-skipper in reply to SeasideSusie]

Folate 9.99 range 3.89 -19.45

B12 86.5 range 37.5 - 188

Vit D 63.3 range 50 - 175 nmol/L

[Day-skipper in reply to Day-skipper]

B12 is pmol/L

[SeasideSusie Remembering in reply to Day-skipper]

Folate 9.99 range 3.89 -19.45

Folate is recommended to be at least half way through range, so 12+ with that range.

B12 86.5 range 37.5 - 188

This is over the limit where B12 deficiency might be suggested (that would be <70) but personally I would want this 100+.

A good B Complex will raise your B12 and your folate level. Consider Thorne Basic B or Igennus Super B, both are good quality and contain the bioactive forms of ingredients.

When taking a B Complex containing Biotin (B7), remember to leave it off for 7 days before any blood tests as it can cause false results if biotin is used in the testing procedure.

Vit D 63.3 range 50 - 175 nmol/L = 25.32ng/ml

This is low. 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).

To reach the recommended level from your current level the Vit D Council suggests supplementing with 3,700iu D3 daily

vitamindcouncil.org/i-teste...

As you have Hashi's, for best absorption an oral spray is recommended, eg BetterYou, or sublingual drops, eg Vitabay Organics, as these bypass the gut.

Retest in 3 months.

When you've reached the recommended level then you'll need a maintenance dose to keep it there, which 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/

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).

Don't start all supplements at the same time. Start with one, leave it 1-2 weeks and if no adverse reaction then add the second one. Continue like this. If you have any reaction then you will know what caused it.

[SlowDragon Administrator]

75mcg is only one step up from starter dose of Levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised or if left under medicated

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html

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

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

Add your most recent blood test results and ranges....if you have them

Or come back with new post once you get results and members can advise on next steps

[Kalamaki]

Sorry, but this is the first I have heard about liothyroxine. The symptoms you have described seem to me that you are not on the correct dose of levothyroxine.