Are my meds sufficient ?

[LauraToadspa0080]

Hi

This is my first post , although I was diagnosed hypothyroid about 18 years ago . For quite a few years I was on Levothyroxine and it kept my symptoms under control . About 3 years ago I started feeling under medicated , saw a Endo and was put on T3 and T4 trial . I have been on both since . When I started on 75 mg Levo and 10 mg the difference in my health was amazing . Suddenly I could concentrate and get on with projects . For the first time in years I could produce paintings !

Later I started feeling tired again and my T 3 was upped to 15 mg .

I have recently started feeling exhausted again

With short periods of energy so had blood test.

Tsh-0.10

Serum free T4-13.4(11.0-24)

Free T3-3.9-(3.9-6.8)

Serum cholesterol 5.8-(<5.0) above range

B12–622–(189-2000)

Folate9.48-(3.1-18.3)

Ferritin-87(13.0-150)

Sodium-147-(133-146) above range

I’ve been told to wait 3-6 months for another test !

Also have HRT patches

Thanks for any help

I am 64 - nearly 65 and getting desperate !!

[Wetsuiter]

I know nothing. But your T3 seems low

[LauraToadspa0080 in reply to Wetsuiter]

Thank you - I thought that

[SlowDragon Administrator]

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

You need vitamin D tested

Ask GP to test or test via NHS postal kit

vitamindtest.org.uk

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water . 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).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

How long have you been on HRT?

[LauraToadspa0080 in reply to SlowDragon]

I’ve been on hrt for over a year and had been on it previously but a new doctor had stopped it for 6 months saying I’m too old to take it ! I got tired and other symptoms so my own doctor reinstated it

[vocalEK in reply to LauraToadspa0080]

I wonder when Diabetics get too old to take medication that controls their glucose levels.

[LauraToadspa0080 in reply to SlowDragon]

I did my test this way

I’ll contact my doctor about the other tests

[LauraToadspa0080 in reply to SlowDragon]

Btw- thank you for your response

[SlowDragon Administrator in reply to LauraToadspa0080]

When on HRT it's common to need increase in replacement thyroid hormones

[Batty1 in reply to SlowDragon]

Slow Dragon, does HRT interfere with thyroid meds no matter when you take the HRT I take my Estridol tab 6 hours after my last thyroid meds?

[SeasideSusie Remembering]

Laura

You are undermedicated, pure and simple. For someone taking T3 one would expect to see FT3 in the upper part of the range for them to be optimally medicated, yours is right at the bottom of the range.

One expects FT4 to be low when taking T3 (it's what T3 does) and some of us are fine with it as low as yours, others need it higher in range.

Your cholesterol is most likely high due to being undermedicated - high cholesterol is a symptom of hypothyroidism.

I think the first thing you should do is get your nutrient levels checked:

Vit D

B12

Folate

Ferritin

as these need to be optimal for thyroid hormone to work.

Also, oral HRT can affect absorption of thyroid medication, and this article suggests that oestradiol patches can. Obviously I don't know what your patches contain so you might want to check it out

drugs.com/drug-interactions...

levothyroxine < > estradiol

Applies to: levothyroxine and Estradiol Patch (estradiol)

Before taking estradiol, tell your doctor if you also use levothyroxine. You may need dose adjustments or special tests in order to safely take both medications together. If you are already taking estradiol and levothyroxine, your thyroid levels may need to be measured if your dose of estradiol is changed or stopped. You should notify your doctor if you have symptoms of low thyroid such as tiredness, feeling cold, constipation, unexplained weight gain, depression, joint or muscle pain, thinning hair or hair loss, dry skin, hoarseness, and abnormal menstrual periods. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

[LauraToadspa0080 in reply to SeasideSusie]

Hello - thank you for your quick response I will get a test for bit D

I have posted results for ciliate , B 12 and ferritin

I’m not sure if they were optimum/ reasonable results ?

[SeasideSusie Remembering in reply to LauraToadspa0080]

B12–622–(189-2000)

That is a very wide range. What is the unit of measurement? If it's ng/L or pg/ml (they are the same) then the following applies:

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."

Folate9.48-(3.1-18.3)

Folate should be at least half way through range, which would be 11+ with your range.

Although these two results aren't bad, you might want to consider supplementing with a good B Complex as that will help support thyroid and adrenals and nudge your levels up. Consider Thorne Basic B or Igennus Super B or one that contains methylfolate (not folic acid) and methylcobalamin (not cyanocobalamin). You don't need mega doses of ingredients so stay away from B100s, B50s, etc, as they aren't balanced.

Ferritin-87(13.0-150)

It's said that for thyroid hormone to work properly (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. I have seen that 100-130 is a good level for females. Your level is not a problem but it wouldn't hurt to eat liver occasionally, or liver pate, black pudding and other iron rich foods to maintain a decent level.

[LauraToadspa0080 in reply to SeasideSusie]

Thank you susie - the B12 is ng/L

[GardenerSue]

I’m no expert but it would appear to me that your T4 and T3 are low and that you possibly need an increase in medication. My TSH remains suppressed so I would ‘t worry about yours. Blood can be repeated after six weeks, so not sure why you’ve been told to wait so long. I was diagnosed about 18 years ago also and am in my 60’s. Functioned pretty well on LT4 but started having issues a few years ago. Unfortunately I was never put on a combination of T3 and T4 by the endocrinologist I’ve now seen three times. Currently trying to go to see a private Dr as am struggling. It would appear that I am a poor converter of T4 to T3. I have my fingers crossed that I will be sorted as can’t carry on as I am.

[LauraToadspa0080 in reply to GardenerSue]

I’m sorry to hear that you are having so much trouble getting help. It certainly made a large quick improvement to me .

I am fortunate to have been referred by my doctor to be seen by a particular Endo who would give a trial - I think I am a bad converter too

[loridlee]

Levothyroxine doesn't work for me. I had a problem similar to your current problem when I was put on Levothyroxine despite my requests for T3, and I gained 16 pounds. Now I'm doing much better with a different doctor, who has me on T3 compound, and she's prescribed NP Thyroid.

[LauraToadspa0080]

That’s interesting - I would like to know more about that