It’s been over 6 months where my weight has steadily been increasing.
I have always been borderline diabetic type 2. I’ve recently had a hbA1c test where my result was 64nmol/mol (18.0-41.0). This was no surprise really as I know when I get weight it affects my blood sugars massively.
I am in the same situation, technically still "only" insulin resistance as fasting insulin still in range but high in range; it came back at 18.4 and should be>6. Fasting blood glucose levels 110 (ref 70-105, should be <85 according to doctor).
I am on NDT (Thyroid-S) but have noticed in recent months that it's difficult for me to find the right balance between T3 and T4. On 3 grains daily, my FT3 ends up close to the upper normal limit but my FT4 levels are at the bottom of range. I will try adding a little T4 and see if it makes a difference. In the past, when feeling fine and being able to lose weight, my FT4 levels were around 1.1 (now 0.7; ref 0.7-1-.5).
I seem to need a certain amount of T4 as well to optimise metabolism.
Since you are on T3 only things are different for you, but the question is: why are you on T3 only? Do you feel better without T4?
I am thinking maybe you are one of those people who need some T4 as well.
According to the book and website "Tired thyroid", high T3 levels cause or worsen insulin resistance.
Quick question - is your free T4 really 2 pmol (range 11-22)? That seems very low.
Your folate and Vit D3 are low and could do with increasing, B12 is over the range but you mentioned you stopped.
Despite supplementing with T3, your free T3 is still on the low side. How do you feel with this?
There is actually a correlation between free T3 levels and HbA1c, low levels are indicative of increased blood sugar levels. You may need an increase in hormones for your glucose level to normalise. Both T4 and T3 have influence on your metabolism, if they are low, your metabolism is slow and you cannot remove sufficient glucose from your circulation. Usually you also see a high cholesterol levels, but interestingly your cholesterol seem fine.
I would say see an endocrinologist who is knowledgable about thyroid AND diabetes, but I guess this would be a real rarity.
Hi, I am not that familiar with t3 supplementation, so I am afraid I cannot comment on any increases.
Is there a particular reason why you are not on T4? Even if you are a bad converter you could get some benefit of having some t4 in your system and converting some of that to t3?
Are you sure you don't need some T4 with your T3? Did you go on T3 right away or try levo first? My impression is that most people on T3 only start on levo, then try levo + T3 and possibly even NDT before settling on T3 only. Far from everyone needs to be on T3 only, and the fact that you don't feel well on it suggests to me maybe you'd feel better with a mix of T3 and levo.
Yes, it's normal for your FT4 levels to fall that low if you take T3 only, especially with a suppressed TSH which means your own thyroid is no longer producing whatever it's capable of producing.
I haven't read your other posts so don't know your back story.
Why are you on T3 only?
I don’t take any T4 so is that a reason it’s very low ?
Yes, that's correct.
I feel absolutely awful on 50mcg t3. I feel really low, sad, I don’t have a lot of energy & my zest for life has disappeared.
Are you sure T3 only is right for you?
Have you tried a combination of Levo and T3?
We are all different where we need our FT4 and FT3.
Some people are fine on T3 only.
Some of us need a combination of Levo and T3.
If on a combination of Levo and T3 some of us need our FT4 to be quite high in range as well as FT3, others do well enough with FT4 low in range. It's a case of experimenting and finding what's right for us as an individual.
How can I increase my folate & vit D? Just by supplementing?
Vitamin D 56.2 nmol/L (22.8ng/ml)
Yes, you supplement.
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).
Unfortunately, the Vit D Council's website seems to unavailable at the moment so I can't check exactly how much you would need to reach their recommended level from you current level, but I would suggest you consider 4,000iu D3 daily for now and retest after 3 months.
Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking tablets/capsules/softgels, no necessity if using an oral spray.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking tablets/capsules, no necessity if using topical forms of magnesium.
Check out the other cofactors too (some of which can be obtained from food).
Serum folate level 4.0 ug/L (3.0-14.4)
Serum vitamin b12 1607ng/L (211-911.0) I was supplementing occasionally with methyl b12 but stopped
Were you taking a B Complex when supplementing with B12? This is necessary to balane all the B vitamins. Looking at your folate level I'm guessing you weren't taking a B Complex.
You need a good quality B Complex containing methylfolate, eg Thorne Basic B or Igennus Super B. These both also contain a fair amount of B12. As you don't really need any B12 you could consider a Whole Food B Complex such as Naturelo or Garden of Life Raw B Complex, both contain the same amount of methylfolate as Thorne or Igennus at the recommended doses, but the B12 included is minimal so that may be a better choice for you. Our B12 store is generally good for about 2 years.
Serum iron level 11.0 umol/L (9.0-30.4)
Serum ferritin level 124 ug/L (10.0-291.0)
Transferring level 2.0 g/L (2.5-3.8)
Mean cell volume 75.8 fL (80.0-99.0)
Mean cell haemoglobin level 23.8 pg (27.5-32.5)
I take bluebonnet 27mcg high strength iron capsules 3 every 2-3 days
Although your ferritin level isn't bad, your Serum Iron level is low at just 9% through it's range when the optimal level is 55% - 70% (higher end for men).
As for Transferrin, low in range indicates lack of capacity for additional iron, high in range indicates body's need for supplemental iron, and yours is below range.
Your low Mean Cell Volume and Mean Cell Haemoglobin, coupled with your low in range serum iron, could suggest iron deficiency, so I think you should be discussing this with your doctor. Iron is complicated and I can't help you other than point that out.
I tried Levo for 2 years before switching to natural desiccated thyroid. I was doing very well on ndt but after a few months my hypo symptoms returned which suggested I wasn’t converting well & would probably have high reverse t3.
Do you think I should increase my t3 to get in to the optimal range or should I try going back to ndt - thyrogold
"I was doing very well on NDT but after a few months my hypo symptoms returned which suggested I wasn’t converting well & would probably have high reverse t3."
Why do you think your hypo symptoms returned?
Did you need an increase in dose?
Were your nutrient levels optimal?
There are many, many reasons for high rT3, only one of which is thyroid related. If it is thyroid related it would be because FT4 is high and making rT3 instead of free T3. You were taking T3 in your NDT so it's very unlikely you would have high rT3, and you wouldn't know unless you tested.
"Do you think I should increase my t3 to get in to the optimal range or should I try going back to ndt - Thyrogold"
How did you feel on Thyrogold. Better than on T3 only?
Did you ever try adding T3 to Levo? That can give the flexibility of finding what ratio of T4 to T3 suits you best.
Sounds like time to consider a low carb diet if you are not already. T3 can raise blood sugar, but your T3 is still too low in range. Do you split your dose into 3 or 4? Your folate is rather low.
I agree with the other poster, and recommend you try a low carb diet. dietdoctor.com is the best free resource out there.
Is there a reason you don't take the iron capsules every day, do you have side effects from them?
Yes with your levels you need to supplement with vitamin D and folate. One of the admin team will probably be along with more details of supplementing and testing. If they don't see this and reply, then best to post again asking about supplementation.
As SeasideSusie said above, iron is complicated, so it's best to talk to your GP about it if you can, especially as several of your markers are low.
Personally if I was taking iron, which I have in the past, I would take some every day, with vitamin C to help absorption. If you are taking more than one a day, I would split that over the day too if you can (but I appreciate that can be complicated with timing). You probably know already you need to take it 4 hours away from thyroid meds generally, but I remember it being said on here that T3 isn't as fussy generally.
Don't take your iron pills with milk, caffeine, foods with high fiber, or antacids. as these interfere with absorption. You can take them on an empty stomach if that doesn't give you any digestive issues, it does with some people. I used to take mine in the middle of the night when I got up for the loo, then I knew it was away from everything else and on an empty stomach.
But keep in mind if taking iron for an extended period of time you need to have your iron levels monitored as too much can be harmful, it's not like a lot of other vitamins and minerals where we just pee out excess, hence the need for caution.
I am just curious as so many people here recommend Dietdoctor.com:
What is so special about him???
I used to follow his blog in Swedish years before he went all international and changed his name to Dietdoctor, and I cannot see how anything he says deviates from what Atkins and other low carb proponents have said before him. I am constantly surprised to see how often he is hailed as some kind of saviour here whereas he does not say anything that has not been said before. Whether or not you believe in low carb diets, Dietdoctor does not tell you anything new.
dietdoctor.com as it exists currently is not one doctor as such, although it was originally founded by Swedish doctor, Andreas Eenfeldt, and he is the CEO. He was a family doctor, found that low carb helped his patients and wanted to help more people.
It is the best resource I have found so far on the low carb lifestyle with lots of information all in one place. There is a lot of input from various medical professionals with links to research on low carb and videos by them. It is the largest low carb website in the world.
Much of the information is free, with an optional membership, which funds the website. I am not a member but find the website thorough and easy to use. It is the first place I look for reviews, by medical professionals, of any new research papers issued on low carb.
It is ad free, they don't sell products and don't take sponsorship from any industry.
Dr Eenfeldt would probably be one of the first to praise Dr Robert Atkins for his pioneering work in low carb.
I recommend the website to anyone who is interested in looking into a low carb lifestyle. If you know of a better resource for a low carb beginner out there I would love to hear about it.
I see this movement as a sect, where members viciously attack everyone who does not agree with them. In the forums they attack WW and doctors performing gastric bypass surgery and drug companies manufacturing diabetes drugs as well as other doctors who do not advocate their way of eating. One member claimed that WW's business idea is to make people lose weight only to regain it with a high-carb lifestyle , making members come back time and time again. One doctor who said in a newspaper article that newer drugs such as Victoza and Saxenda can help overweight people with diabetes lose weight was accused of being "attention-seeking"...at the same time, Andreas Eenfeldt is more than happy to be interviewed by newspapers to get his message across. I stopped visiting this site for those reasons.
As I said I am not a member, and have never frequented the member forums so can't comment on that, but yes I have found the wide array of information available on the website extremely helpful in many ways.
I do believe low carb should be offered as an option before resorting to drugs or surgery, as practised by Dr David Unwin at his NHS surgery. He has said all of his patients so far have opted to try a low carb lifestyle first when given the choice.
I recommend DietDoctor and I really like the website and the wealth of information that it supplies. I do look at other keto / low carb sites too. I've never been on the forum though. I think it is on Facebook, and I don't have an FB account. I rarely read the comments on the website itself, so I miss the things that you mention. I read the comments when I want to check them for individual recipes, just in case there are traps for the unwary.
I started getting fat as puberty approached. My teens were made miserable by just about every type of person I came into contact with - pupils at schools, family, the medical profession, people on the street. I was told by doctors, slimming magazines, the TV I just needed to eat less and move more, and every single time I caved in and ate something I shouldn't do based on the diet I was following the feelings of abject failure were really terrible. And this went on for years, destroying my self-confidence and encouraging depression and social anxiety.
I'm still not good at dieting, but since discovering DietDoctor I have at least found healthy meals that actually help to keep me satiated, something that never happened on the WW type of diet.
One of the biggest things I like about DietDoctor is that it helped me to discover that at least some of my brain fog was actually caused by a diet which had too little fat and protein in it. I have far less brain fog now than I used to have. That in itself is enough to make me recommend DietDoctor because I thought I was developing early-onset dementia - but as it turns out I'm probably not (yet).
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Test results from 2 years ago
TSH 4.5 Doctor refused to discuss my thyroid function as a possible cause for my symptoms
Vitamins and minerals
new, seeking advice re test results
Carbimazone /Gums/Full blood
