Medichecks Results - what now?

[Bramble83]

Would love some input on my results please

I started on Levo 5 weeks ago (50mg a day) after a slightly elevated TSH of 3.1 was detected by our IVF clinic, following a miscarriage.

These are my latest results from Medichecks, I also had the standard TSH and FT4 done at my GP, which came back almost exactly the same values as the Medichecks

My GP has just increased my Levo to 75mg based on the TSH and FT4 result

I have Addison’s disease and take daily hydrocortisone but have no other medical conditions.

I am always quite tired but have always put that down to the Addisons and been grateful that I am so well with it.

Only other symptoms are inability to lose weight despite eating no more than 1200-1500 calories a day and running 3-4 times a week plus lots (!!) of walking with hubby and our dogs at the weekends.

TSH 2.0 (0.27-4.2)

FT4 19.3 (12-22)

FT3 3.9 (3.1-6.8)

Folate 19.8 (>3.89)

Active B12 146 (37.5-188)

Vitamin D 60.9 (50-175)

Ferritin 65.3 (13-150)

Iron 17.64 (5.8-34.5)

In terms of supplements i’ve been taking:

A daily prenatal with 800mcg methyl folate for a good 18 months

195g ferrous sulphate a day for last 12 months, which doesn’t seem to have improved my ferritin at all from my Medichecks 12 months ago.

BetterYou vit D + K2 oral spray daily at 3000IU for 12 months which has actually resulted in my Vit D going down from 68 to 60.

All advice and comments very much appreciated.

[SlowDragon Administrator]

Can see from previous posts that you don't appear to have Hashimoto's....but have you actually had ultrasound scan of your thyroid?

It's possible to have Hashimoto's and never have raised antibodies

50mcg was only a starter dose. Obviously you have to be careful on increasing dose slowly with Addison's

Have you had coeliac blood test?

Of tried strictly gluten free diet?

You need to increase vitamin D supplement. Perhaps Try double dose on alternate days

[Bramble83 in reply to SlowDragon]

My antibodies came back at 16 (<34) from the IVF lab but annoyingly I seem to have picked a Medichecks one this time that didn’t check antibodies!

Never had a scan.

I was tested for celiac before Addisons and it was negative. I also don’t really eat any carbs or sugar at all (except those in vegetables) as steroids and carbs aren’t a good mix, so by default i’m pretty much gluten free.

The IVF clinic ideally want my FT3 above 4.9 they’ve said but it doesn’t seem to be going up much, even though my FT4 has increased.

Do you think based on these results that increasing my Levo from 50mg to 75mg is the right thing to do? My FT4 seems quite good in the range?

Any idea on the ferritin result? I’ve been on that high dose for 12 months and it’s made absolutely no difference.

I will try upping the Vitamin D for the next 4 weeks until my next bloods.

[SlowDragon Administrator in reply to Bramble83]

50mcg is only a starter dose

Guidelines suggests around 1.6mcg Levothyroxine per kilo of weight

So someone weighing around 9st 8lbs that's around 100mcg

Obviously you have to increase Levothyroxine very very carefully with Addison's

Ferritin and being hypothyroid is common

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption

Obviously, these days, if pregnant, no longer allowed to eat liver

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...

[Bramble83 in reply to SlowDragon]

Thank you! I am about 9st 10lbs so I guess 50mg is still quite low.

I was worried that as my FT4 is already at 19 (12-22) that increasing my dose of Levothyroxine would put it over range? I’m guessing that’s probably not the case if my TSH is still 2?

The weird thing about the iron is I eat at least 3 huge bags of spinach a week, king prawns for my lunch at least 4 times a week and snack on pumpkin seeds. It just doesn’t seem to want to go up! I will try some of the other suggestions- thank you!

Is there anything specific I can do to try and increase my FT3 closer to the level they’d like it to be for the IVF?

Do you think it could be at the lower end even though my FT4 is at the higher end, because my adrenal glands don’t work?

[SlowDragon Administrator in reply to Bramble83]

Increasing dose of Levothyroxine should increase FT3

Getting vitamins optimal definitely helps and then Levothyroxine dose can get increased slowly and steadily

[Nessy50 in reply to SlowDragon]

Not an expert but wouldn't taking T3 increase FT3? Didn't know T4 would increase it, I've gone into T4 only so you think that will increase T3 even if don't convert? Taking folate before testing B12 can mask B12d. I know serum test not great are you in range for that & why you did Active? Low B12 can cause problems with fertility too. I'm coeliac & anti body test is never positive mine showed on biopsies. Hope you manage to get your levels up. X

[lidoplace in reply to Nessy50]

Why have you gone onto T4 only? If you don’t convert you need T3

[Bramble83 in reply to lidoplace]

Appreciate the question isn’t aimed at me, but interested to know what determines that you don’t convert?

I presume that my numbers eliminate that for me?

FT3 3.9 (3.1-6.8)

FT4 19.3 (12-22)

TSH 2.0 (0.27-4.2)

[Nessy50 in reply to lidoplace]

I know Drs advice so can get tests done & it paid off, first time TSH went over range although often too high. I’m waiting on Endo referral so finally diagnosed now but I’ve told her my T3 is always low. Thought maybe NDT & T4 might work or T4 & T3.

[Bramble83 in reply to Nessy50]

Thanks for your reply 😀

I don’t know about the whole taking T3 versus taking T4, this is all very new to me.

The test I did with Medichecks only does the active B12 which came back at Active B12 146 (37.5-188)

Oh wow, didn’t know that about celiac? What type of biopsy did you have to show it?

[Nessy50 in reply to Bramble83]

They take a few biopsies from small bowel & my villi was flat it's improved now on B12 injections but was getting lot worse & symptoms were awful too without B12. X

[Bramble83 in reply to SlowDragon]

Thank you, I will keep going with the increased Levothyroxin and see what the numbers look like in another 4 weeks 😀

[SlowDragon Administrator in reply to Bramble83]

Retesting ideally 6-8 weeks after any dose increase

[Bramble83 in reply to SlowDragon]

Thank you, realise that’s what you would usually do.

The GP and the IVF clinic want it doing every 4 weeks as we are doing my frozen transfer in 5 weeks and they want it checked again before that 😀

Thanks for all your help!

[DippyDame in reply to Bramble83]

You might find this helpful re spinach

nutritics.com/p/news_Why-Mo...

I don't tolerate iron well, tried lots. Liver and red meats a no-no, I feel ill Now trying Spatone and even find that a challenge.

Your FT3 is far too low, you may not be adequately converting FT4 to FT3. You may benefit from the addition of T3

Good luck

[Bramble83 in reply to DippyDame]

Thank you, that’s really kind of you.

I’ve actually had another set of results since the above, just yesterday- here’s the post

healthunlocked.com/thyroidu...

Thankfully have managed to get my ferritin up, by taking a high dose iron tablet with vitamin C 😀

Unfortunately my fT3 now looks even worse and is below range, having increased my Levo from 50mg to 75mg.

Am about to increase it again to 100mg to try and get my FT3 into range 😞

[Catsnkayaks]

Just to add to all the good advice already given that I consulted with a reproductive endo last year and was told that FT4 is fine right at the top of the range or even just beyond in pursuit of good FT3 levels. I tried that first but still had conversion problems so now on T3 and T4. Good luck.

[Bramble83 in reply to Catsnkayaks]

Thank you, that’s good to know. I guess I just need to wait and see what the increase to 75mg does to my FT4 and whether my FT3 ‘catches up’ in terms of where it is within the range.

I think I would be less concerned/ curious if I didn’t have Addison’s, as unsure what part adrenals play in conversion from T4 to T3.

I will definitely be posting my results again in 4 weeks when I have them 😀

[Catsnkayaks in reply to Bramble83]

Fingers crossed for a good improvement over the next month.

[magsyh]

Magnesium glycate made a big difference to my vitamin D since taking it my Vit D has risen higher than ever before. Selenium will also help your T4 to T3 conversion

[Bramble83 in reply to magsyh]

Thanks for the tip. At the moment I take the BetterYou Vit d and K oral spray.

Is there a dose and brand of the magnesium glycate you could recommend?

Likewise for the selenium- what’s the optimum dose to try and improve conversion?

Thanks so much for the advice 😀

[Bramble83 in reply to magsyh]

Just had a quick look on Amazon- quick question is Magnesium Glycinate different to Magnesium Glycate?

[magsyh in reply to Bramble83]

Yes, it's the same thing I use the "nested" brand and 2 to 3 tablets over the evening as I have such a problem swallowing tablets it's comical.

For some reason I'm a very good converter so I take 200mcg selenium now and again some people do it daily.

[syrahrose in reply to magsyh]

Try taking pills with fizzy water. The bubbles seem to help move them along!