Saw endo today: So after booking appt back in May... - Thyroid UK

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Saw endo today

bluejoppo profile image
12 Replies

So after booking appt back in May I've finally been to see endocrinologist today. (Bear in mind I live in germany)

She said ft4 and ft3 are not as important as tsh. Facepalm. But has changed me from just levo to novothyral 75 of which I'm to take 1/2 tablet per day plus a 25mcg levo so my levo dose works out to 62.5 per day plus 7.5 t3 as she said that should be equivalent to the 100mcg Levo I'm currently taking. Start tomorrow, back in 6 weeks for bloods and results from today.

Had scan of thyroid done - measures 4.1ml and clearly hashimotos But no hot or cold spots.

Also testing my vit d.

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bluejoppo
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shaws profile image
shawsAdministrator

"She said ft4 and ft3 are not as important as tsh"

Rubbish - I am sorry to say but that's how they seemed to be trained worldwide nowadays. i.e. TSH is a moneymaker and is it less important than the Frees. For instance TSH is highest early a.m. and drops throughout the day.

You are being prescribed a T4/T3 combination product, i.e. novothyral 75.

You should give it a trial as scientists have proven that a T4/T3 product can give better results and relieve symptoms better than levo only.

Dose should also be increased until TSH is 1 or lower and both frees (FT3/FT4) are in the upper part of the ranges.

I hope you feel better soon.

bluejoppo profile image
bluejoppo in reply to shaws

That's what I thought! At least she did listen to me, I told her I had read a lot about how they were important and pointed out that taking 100mcg meaning my tsh is over 1 makes me feel rubbish. I felt better when I was on the 125mcg dose but my tsh was below the range.

We shall see how it goes, back in 6 weeks for bloods again. Hopefully I'll be able to start shifting some of the weight I've gained since diagnosis. I need to visit my gp though as my bp was too high.

Thanks for replying.

shaws profile image
shawsAdministrator in reply to bluejoppo

A couple of links:-

hormonerestoration.com/

thyroiduk.org.uk/tuk/thyroi...

beh1 profile image
beh1

I think you might well find yourself underdosed on 62.5levo and 7.5 t3. I’m not convinced it’s equivalent to 100mcg levo ( I take both). I think we usually say t3 is approx 3x as potent as t4 at cellular level, but even working at 4x you’re less than 100mcg levo. Keep a close eye on symptoms to report back to endo.

bluejoppo profile image
bluejoppo in reply to beh1

Thanks, I did suggest taking 100mcg levo and 1/4 tablet t3 but she didnt like that idea. At least by giving me some 25levo I can increase that up if I feel I need to. Any idea how long before I will have an idea of it it is working or not?

SlowDragon profile image
SlowDragonAdministrator in reply to bluejoppo

What were your results on current dose?

TSH, FT3 and FT4

bluejoppo profile image
bluejoppo in reply to SlowDragon

Tsh was 0.22 on 125mcg (doc thought I was taking 100mcg like he told me too) he didn't test ft3 or ft4. That was on 22nd oct. Been on just the 100mcg since and had bloods taken today but they will be skewed as they hadn't told me i'd be having blood (appt was at 11) so I'd taken my levo this morning and had a coffee.

Before that on 125mcg on 22nd feb my tsh was 0.27, ft3 was 3.2 and ft4 was 15.9. Reduced to 100mcg an follow-up bloods in May tsh 1.08, ft3 2.6 and ft4 11.7. Ranges ft3 2.0-4.4, ft4 8.0-17.0 and tsh 0.35-4.5.

SlowDragon profile image
SlowDragonAdministrator in reply to bluejoppo

So in Feb on 125mcg

FT4 88% through range

FT3 only 50% through range

In May on 100mcg

FT4 41% through range

FT3 only 25% through range

chorobytarczycy.eu/kalkulator

bluejoppo profile image
bluejoppo in reply to SlowDragon

Yep, that's how I explained it to her, that I felt better when tsh was lower but my ft3 and ft4 were higher. Not 100% but not so tired, had more lust for doing things and with a 5yr old, I have to function! I told her that I'd done a lot of reading and research and that they should both be in the upper 3rd of the range to be optimum.

SlowDragon profile image
SlowDragonAdministrator

At least you got some T3 .....see how it goes

You also need B12, folate and ferritin tested

Have you had coeliac blood test?

Are you on strictly gluten free diet?

bluejoppo profile image
bluejoppo in reply to SlowDragon

No I'm not gluten free at all. Never tried or had a celiac test done. I don't appear to have any problems with gluten which is a good thing as I like my bread and pasta!

B12 was tested in the summer and I'm waiting for a new test to arrive to check it again. I need to order an iron test but with Christmas approaching it may have to wait.

SlowDragon profile image
SlowDragonAdministrator in reply to bluejoppo

Many Hashimoto's patients don't appear to have any gut symptoms....but gluten is frequently a completely hidden issue

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

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