Lab results after adjustments T3 and Iron

[bessygo]

My TSH dipped to .12 (range .40-4.50) after I started supplementing with Iron (because of low Ferritin 26 (range 20-288).

My other Iron panels were fine. I do not have fatigue, actually feel speedy although I am hypo thyroid with Hashi. I have some frontal hair loss and was told my Ferritin needed to be higher. I supplement with 15 mg of liquid iron a day and 15 mg iron tablets 3x's a week since I do not have anemia as far as any symptoms. I barely eat red meat, and do not eat fortified cereals (am gluten free). I have had horrible insomnia for years however, I know so many other women my age (65) who have the same problem.

I am currently on 2.5 mcg T3 daily (yes, only 2.5 mcg) and .75 Synthroid 6 days a week which computes to .64 Synthroid daily. I have no hypo symptoms, except sometimes feel a bit cold briefly in the a.m. (most likely poor circulation) but have very high anxiety mostly from mental health issues and can feel jittery at times. I don't eat a lot, however, my weight stays the same (I work out: 5'2" 125 lbs).

I, of course, fasted prior to blood labs. Below are my latest numbers. My B-12, Iron, TBIC, Folate and VItamin D were all great, so I was just re-tested for the following (on dosage of 2.5 mcg T3 and .64 mcg Synthroid):

TSH 1.95 (range .40-4.50)

Free T4 1.1 (range .8-1.8)

Free T3 2.7 (range 2.3-4.2)

Total T4 9.1 (range 5.1-11.9)

Total T3 99 (range 76-181)

Ferritin 38

Hashi Anitbodies 159

Since my Free T3 seems to be a bit low, and my Endo is fearful of changing my T3 (she wanted to do away with the T3 because of anxiety, but I am on such a low dosage, I asked instead to reduce my Synthroid a bit, so went from .70 mcg to .64 mcg).

I was going to see if I could just reduce my Synthroid from .64 to .50. I had to argue with Endo about how taking Iron would effect my Thyroid labs, and of course it did effect my labs). Any feedback before I go into see her again? I realize I am on such low dosages, but I am very sensitive to any meds. I am going by my lab numbers since I don't have hypo symptoms. Thanks, in advance!

[SlowDragon Administrator]

Sorry your post was missed

Insomnia can be low FT3

How do you take your T3

As divided dose?

Many find small dose T3 before bedtime improves sleep, but others find the reverse....

Anxiety can be due to under medication and in need of dose increase

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 .

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

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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?

[bessygo in reply to SlowDragon]

Thank you for your reply. My insomnia is deep seated, etc.

I take 1/2 of a 5 mcg of T3. It is almost impossible to cut it in half, so to divide the dosage is almost impossible. I'm only taking 2.5 mcg. Yes, I take my labs exactly as instructed here. I was just hoping for feedback on my levels.

[SlowDragon Administrator in reply to bessygo]

Well your results suggest you are under medicated

Perhaps try adding second 2.5mcg dose of T3 later in day

Retest in 6-8 weeks.

Then consider adding another and retesting 6-8 weeks later

Last dose of T3 8-12 hours prior to blood test

Last Levothyroxine 24 hours prior to blood test

Personally I need three doses T3 per day at 8 hour intervals - 7am, 3pm and 11pm

As you have Hashimoto's are you on strictly gluten free diet?

[bessygo in reply to SlowDragon]

Thank you. Since I have no symptoms, my functional dr said my levels were great. Why would I add more of a potent med as T3 if I dont have symptoms of hypothyroid, no fatigue, no weight, no brittle hair nor nails? I am seeing my endo today to see what she will say.

I am gluten free as I said. But over the past months while adjusting meds my Hashi antibodies went from 70 to 159. And when my antibody level was 70 I was eating gluten!

I do not have celiac disease and no digestive problems (I take clean supplements, eat organic, rarely meat, no sugar, lots of veggies, fruits, nuts, fish,etc). Had an extensive vitamin and mineral blood draw fom functional dr. and all levels were great so my intestines are absorbing all my nutrients.

The endo dr said going gluten doesn't always lowers hashi antibodies. Mine went up after going gluten free!

So sometimes I think these blanket diagnoses forget we are all different. My endo actually told me to stop reading the internet but I'm glad I did.

Adding a bit of iron to help my ferritin levels caused my TSH to plummet.

Back in April only on .75 Synthroid and before adding iron or T3 my levels were.

Only on .75 Synthroid:

TSH. 2.29

FreeT4, 1.3

FreeT3. 2.5

Total T3. 103

Antibodies. 69. (while eating gluten...not a lot but stilll.., )

After reading Health Unlocked I asked about adding T3.

Was put on .75 Synthroid and 2.5 mcg T3.

2 months later my levels :

TSH. 1.04

FreeT4, 1.3

FreeT3. 3.1

Total T3. 95

Antibodies 78

Ferritin 33. Iron 121, Folate 21

Because of frontal alopecia hair loss, low Ferritin level and since I barely eat red meat, I added 15 mg of iron daily. Just after adding iron my levels were:

TSH .12 (!)

FreeT4. 1.4

FreeT3. 3.5

Total T4. 9.8

Total T3 120

But iron levels went down (!)

Ferritin 26. Iron 57

2 months later, after lowering Synthroid from .75 to .70, still till taking 2.5 mcg T3 AND adding 18 mg iron every other day my levels were

TSH. 1.27

FreeT4, 1.1

FreeT3. 2.7

Total T4 7.5

Total T3. 96

Antibodies went UP from 78 to 151. After going gluten fee!

Ferritin 33. Iron 121, Folate 21

All my levels changed from just adding adding iron to help ferritin and because I rarely eat red meat.

Now on 2.5 mcg T3 and .64 Synthroid with 15 mg liquid iron daily and 18 mg iron every other day are:

TSH. 1.95 (range .40-4.50)

Free T4. 1.1 (range .8-1.8)

Free T3. 2.7 (range 2.3-4.2)

Total T4. 9.1 (range 5.1-11.9)

Total T3. 99 (range 76-181)

Ferritin 38 still a bit low .

All other iron labs were perfect.

Hashi Anitbodies 159. On gluten free. Higher than when I took gluten but before I supplemented with iron. Our bodies are mysterious and strange at times.

[SlowDragon Administrator in reply to bessygo]

With Hashimoto’s levels hop about a lot

I am strictly gluten free, generally my antibodies trend is to go down. But they also shoot up now and again

Improving and Maintaining optimal vitamin levels should help

Adding your tiny dose of T3 has increased FT3 a little. Many people would still find that level still too low

But if you feel ok, then it’s obviously ok for you