Hi, I have Hashimoto's and I was diagnosed over 6 years ago. I have been taking desiccated thyroid from Erfa Canada since my diagnoses. I still don't feel well even though my free T3 is up high. I took my medication 1 grain the day before my blood work at 9:00 pm and I did the blood work at 7:00 am the next morning. Blood work was done 10 hours from taking my medication. I am taking 1 1/2 grain at 6:00 am and 1 grain at 11:00 am. Am I taking too much medication? What about my folate, can I take a B-complex with 400 mcg of folate or no? How much vitamin D should I take daily? What number should I aim to get? Thanks in advance for everyone that responds.
RBC Folate 2132 >1186
deficient < 1187
Ferritin 19 5-272
TSH <0.01 0.32 -4.00
Free T4 13 9-19
Free T3 5.9 2.6-5.8
Reverse T3 17 8-25ng/dl
25-Hydroxyvitamin D 72 75-250
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dragonfly76
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As blood tests were introduced along with levothyroxine, T4 alone, when we add or take another thyrroid hormone such as NDT (which contains more than T4) we cannot really go by results but how we 'feel' on paticular doses. I shall give a link which may be helpful and this doctor only prescribed NDT or T3 alone for 'thyroid hormone resistant patients'. He took one initial blood test and thereafter doses were gradually increased until patient's symptoms were resolved,
You don't need to bother about RT3 as it is 'natural' way the hormones 'act' (the best word I can think of ).
Excerpt:-
No Effects of rT3 on Nuclear Thyroid Receptors
Since high rT3 is linked with conditions associated with slow metabolism, it has been claimed in internet articles, but not in peer-reviewed papers, that rT3 causes a slowing in metabolism by blocking or obstructing the nuclear thyroid receptors. These receptors are the target sites where the primary active thyroid hormone, T3, binds, triggering its actions to drive cellular metabolism and maintain body temperature. Yet there is no credible scientific evidence that rT3 even enters the nucleus of the cell. While rT3 does not bind to, and has no known transcriptional activity at, the thyroid receptor, it does have potent non-genomic activity, mediated by binding to a specific thyroid receptor in the cytoplasm, as an initiator of actin polymerization in astrocytes in the brain [8][9]. Actin polymerization is important to cell structure and motility, as well as to normal brain development.
When I went over from Levo to NDT I followed the instruction in the STTM book, stop one day then the following day start on half grain NDT but I can't remember with certainty how I continued as it's some time ago now. I do remember though once I got to 2 grains I wastold to continue in quarters though I didn't thing I was continuing to progress. I has started my thyroid journey though taking NDT which was imported from Canada but it was back in the day when your weren't tested on NDT. This time I was doing this on my own to start off with but knowing I had an appointment booked with an Endocrinologist if things didn't go to plan so I had backup in place. So I wasrealising that I was most probably over medicated when I went to be tested one week before my actual appointment.
Yes I was over medicated on three grain and was told to miss two days and restart of 1.75 grains which I thought was a huge drop although I had r actually felt over medicated either but suspected as increasing my medication wasn't making a significant difference. I'm now on slightly less medication as I've improved my general thyroid health by addressing my vitamins and minerals so I have dropped down to 1.5 grains one day in three.
The advice I got from my expert was that on taking NDT TSH should be suppressed, 0.01, FT4 can drop down its range but FT3 should be high in its range but never over!
So your FT3 reading is too high and you need to drop back. I also felt being over medicated felt very similar to being undermedicated so best to drop down asi was told to then see how you feel then when stable and then see if you feel you need to titrate up a little. My instructions had told me to go up in half grains to 2 but that's how I missed my sweet spot.
Sadly my new Endo hasn't a clue and wanted me to reduce my dose but I've said I'm happy with where it is as I feel good and no issues. I tried to tell her that taking any form of T3 then results are read differently but she didn't believe me although she did say I understood what I was doing but she sent her report to both me and my doctor saying we need to work at increasing my TSH-that's never going to happen!
I'm not an expert at juggling with vits etc so will leave that for others to comment but just be aware that when you get those optimal it may well have an impact of you thyroid meds and you may need to lower the dose even further.
I started off splitting it but kept missing my second dose! I even bought a key ring with a pill holder on it-still forgot to take it so I thought I would try it all at once. I decided my body had had its introduction to T3 so it wasa try it and see! No adverse effects whatsoever and started to feel much better. Just recently within a couple of days I saw mentioned that Thyroid S is slow release-hence the 'S' and I feel that's probably true. I never have a dip in how I feel plus feel good so I feel that the suggestion is correct and I have my dose spot on so alls well with the world! So pleased about that! Always a worry as you are getting older as to what issues are caused by! But I've always respected what my body is trying to tell me and try to treat it right!
Thank you for getting back to me. I don't know what to do, you said I am taking too much medication but I left 10 hours after taking medication and blood work not 12 hours. Stop the thyroid recommend 15 hors or over. How many hours do you usually leave? What's your TSH. So you are taking thyroid S and not Erfa?
I started my thyroid journey back in 1986 I think and doctor and I both started on NDT. I didn't know where it came from then. I just got it in a little brown bottle. withva label stuck on with my name and instructions and I did as I was told. I didn't even know they were grains then! Not sure when my supplement stopped but a few years later and thatswhen I found out where it came from as there wasa strike in Canada. Waited three months without medication and as I had three young energetic boys I was really stuffing so asked to go onto Levo and to be fair I wasfine with that! Post menopause thinks went haywire so I spent the next 5 years researching, asking questions and not knowing what I was going to do but then found something about Levo not working long term for everyone so finally decided to look into NDT again. I had no chance of getting anything locally as where I live no one ever got an alternative so I asked for a referral elsewhere. Superb testing of everything once I did that but told let's see how you go on Levo first. That doctor who would have given me T3 has he thought it needed was leaving so I took the plunge and asked to bectold no! Apparently my T3 had risen and was now just under half way to were it should have been so hecthought it would keep rising. I wasn't convinced then found his replacement was coming from a country where NDT was accepted so I started self medicating and he helped me get my dose sorted. Sadly he was only there for a year so I've carried on!
"Thyrotoxicosis due to exogenous thyroid hormone intake and endogenous hyperthyroidism have different physiological roots. This traditional distinction should be noted because the interrelationships between TSH and thyroid hormones differ on LT4 treatment from those in thyroid health [24, 56, 57, 59, 69]. This may explain why a prospective study measuring surrogate markers of thyroid tissue effects in athyreotic patients found a slightly suppressed TSH to be optimum for these patients rather than constituting overtreatment [57]."
Thanks for your time. I am going to start taking once in the morning because its too much work and I stay so long without eating and I don't feel any difference from taking once or dividing it. I will reduce it too. I don't want to be taking too much or too little. I wish I knew when I am taking the right dose. You are lucky that you feel good and found your sweet spot. I took years to just be diagnose because my doctor was useless.
Your vitamin D and ferritin are both too low, which won't help. Do you have a B12 result. That's a seriously odd folate range - what country are you in?
Ferritin around 70 - vit D depends on units but yours isn't even in range: probably about 100.
Hey dragonfly76. I would agree with silverfox on this - you are overmedicated by labs, you are going over on ft3, while your ft4 is around mid-range. Since you take it twice a day, that definitely is too much. I had a similar story, high ft3 on 3 grains of NDT taken three times daily. I stopped sleeping, I was incredibly tired, swollen, dry skin etc. Symptoms of over and under are so similar.
Do you take any vit D? I supplement 8,000 units a day, but that is because if I don't, I'm insufficient...you need to work on your ferritin too
That's something I am not sure of as I had the same issue when splitting...you need try and see what suits you the best..I take one dose, because it works better for me, but some people can't do it, so it's really up to your body
Your Vitamin D needs addressing. Do you take a D3/K2 supplement? it needs to be towards the top of that range. Don't aim for the same with ferritin though, that needs increasing a little.
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