Central hypothyroidism and T3 levels ignored by endo. Do I need T3? Help!

[Teresamarie]

Hi to all on this site!

I’ve been diagnosed with central hypothyroidism (secondary) in August 2018. I had a pituitary tumor removed in 2001and developed diAbetes insipidus, adrenal insufficiency and now central hypothyroidism.

My endo has prescribed levo (generic) in small increments of 12.5. In June I was at 88.5 mcg if levo. Wow! I couldn’t sleep, sweating, jittery feeling. Lowered levo to 75 mcg. Still had terrible symptoms. Very ill. I asked for brand name Synthroid in early August 2019. Big difference ! Sweating stopped almost immediately and now able to sleep at least a few hours.

I will meet with endo this week. What should o say about T3? Do I need that supplemented?

Here are my levels as I have them.

T4 Free (.9-1.7)

8/19/2019. 1.2 md/dl

8/9/2019 .9

6/19/2019 1.0

TSH (.3-4.2)

8/23/2018 0.3

8/26/2018 .5

Magnesium 2.2(1.7-2.3)

B12 588 ng/L. 242-1245) >60 mL/min/BSA/

25 Hydroxy D2 <4 no bounds indicated

25 Hydroxy D3 43 ng/mL

25 Hydroxy Total 47 ng/mL

Thank you! 😊

[Teresamarie]

Also Here is a like to a very good article about CH

ncbi.nlm.nih.gov/pmc/articl...

Accurate diagnosis and surveillance of patients being treated for central hypothyroidism is of great importance. Measuring only TSH levels is not sufficient, and can lead to incorrect treatment decisions. One must also monitor free T3 and T4 levels, and pay special attention to clinical signs and symptoms of hypothyroidism or hyperthyroidism.

What do you think about T3 not addressed?

[SeasideSusie Remembering]

As your Free T3 has not been tested at the same time as TSH and FT4, we can't tell how well you convert T4 to T3 so there's no way of telling if you need T3.

And before considering the addition of T3, all nutrient levels need to be optimal.

B12 588 (242-1245)

You don't say what the unit of measurement is. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Yours isn't deficient but could probably be better as it's only 34.5% through it's range.

25 Hydroxy Total 47

What's the unit of measurement? 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).

You also need Folate and Ferritin tested.

Folate is recommended to be at least half way through range and Ferritin half way through range with a minimum of 70ug/L (ng/ml) for thyroid hormone to work properly.

[Teresamarie in reply to SeasideSusie]

I’ve changed results above to reflect values. Thanks for your help!

[SeasideSusie Remembering in reply to Teresamarie]

B12 588 ng/L. 242-1245) >60 mL/min/BSA/

ng/L is the same as pg/ml so the above quote from Sally Pacholok is relevant.

25 Hydroxy Total 47 ng/mL

That is within the recommended range.

[Teresamarie in reply to SeasideSusie]

Thank you for replying to my post. I’ll ask for the vitamins to be tested along with a full thyroid cascade. I’ll post results when I get them.