Help with test results and meds dosage - Thyroid UK

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Help with test results and meds dosage

Jushkie profile image
8 Replies

Hi,

I currently take 100mcg of T4 (NHS prescribed) plus half a tablet/12.5mcg of T3 (bought abroad), both around 4-5am, no caffeine until 6:30am, no supplements until 11am. I also take 210mg ferrous fumarate, 75ųg vitamin D with 75ųg vitamin K in oral spray, and B12 in an injection once every 3 months. Plus other vitamins and minerals I'm not listing as they weren't included in the test.

I feel considerably better than I did before I started taking T3, but I still have days with extreme tiredness, lack of concentration, muscle and joint pain etc.

Should I increase either T3 or T4, or possibly both, and if so at what dosage?

Medichecks test results done 21/1/20, ranges in brackets:

TSH - 0.258 mlU/L (0.27-4.2)

Free T3 - 4.78 pmol/L (3.1-6.8)

Free T4 - 15.5 pmol/L (12-22)

Ferritin 55.3 ug/L (13-150)

Folate 14.17 ug/L (>3.89)

B12 >150 pmol/L (>37.5)

Vitamin D 75 nmol/L (50-175)

Many thanks :)

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Jushkie
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SeasideSusie profile image
SeasideSusieRemembering

Jushkie

Vitamin D 75 nmol/L (50-175)

75ųg vitamin D with 75ųg vitamin K in oral spray

Is that BetterYou DLux in the red box where 3 x sprays give 75mcg/3,000iu D3 and 75mcg K2?

If so then I'd increase your dose for now.

The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.

Maybe increase to 5,000iu, or at the least 4,000iu, for 3 months then retest. Once you reach the recommended level then you'll need to find your maintenance dose by trial and error, retesting twice a year to keep it there.

Do you also take Magnesium as an important cofactor of D3? It's needed for the body to convert D3 into it's usable form.

Ferritin 55.3 ug/L (13-150)

Ferritin is recommended to be half way through range so this could be improved. I'm not going to suggest you increase your iron tablets because iron is very complicated and you may not need more, you would need an iron panel to check your serum iron first. But you can improve your ferritin level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

apjcn.nhri.org.tw/server/in...

Optimal ferritin level is needed for thyroid hormone to work properly, so by improving your ferritin level your thyroid levels may improve.

TSH - 0.258 mlU/L (0.27-4.2)

Free T3 - 4.78 pmol/L (3.1-6.8)

Free T4 - 15.5 pmol/L (12-22)

Should I increase either T3 or T4, or possibly both, and if so at what dosage?

It's trial and error to find out where you need your levels to suit you as an individual. Some of us on combination therapy need both FT4 and FT3 higher up in range, some are fine with a lowish FT4 and higher FT3, so it's all about experimenting but changing only one thing at a time.

You could start with an extra 1/4 of a tablet of T3, leave it 6-8 weeks then reassess.

Are you taking a B complex or biotin? If so then remember to leave this off for 7 days before any blood tests as it can give false results if biotin is used in the testing procedure (which most labs do).

Jushkie profile image
Jushkie in reply toSeasideSusie

SeasideSusie,

Many thanks for your reply :)

Yes, it is the BetterYou DLux one, I will increase the dosage by 1 spray.

I did take magnesium up until recently as a part of a hair growth supplement, but I've just noticed that the new one I've changed to doesn't have it, so will look for an alternative.

I've always had a problem with ferritin levels, but usually managed to keep the levels closer to 70ug/L, I will eat liver once a week and see if that helps :)

And yes, I do take biotin, haven't taken any for 5 days prior testing.

With the additional T3, should I take the whole dosage first thing in the morning, or take the quarter tablet around 2-3pm when I usually have a serious dip in energy levels? Is T3 absorption also affected by caffeine as is T4?

Many thanks again :)

SeasideSusie profile image
SeasideSusieRemembering in reply toJushkie

Magnesium as part of another supplement may not contain enough.

Here are some links so that you can see which form of magnesium is best for your own needs, take at the dose recommended on the pack:

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

With the additional T3, should I take the whole dosage first thing in the morning, or take the quarter tablet around 2-3pm when I usually have a serious dip in energy levels?

You'll need to experiment really, some people take it all in one dose in the morning, others split into 2 and take the second dose either afternoon or bedtime, some split into 3 doses.

Is T3 absorption also affected by caffeine as is T4?

To ensure that nothing affects any form of thyroid hormone replacement, I would treat them all the same as Levo - empty stomach, water only for an hour each side, etc.

Jushkie profile image
Jushkie in reply toSeasideSusie

Great, thank you for all the info, and I'll get some decent magnesium 👍:)

SlowDragon profile image
SlowDragonAdministrator

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?

If you left longer than 12 hours between last dose T3 and testing this is a false low result

How long before blood test was last dose levothyroxine?

Jushkie profile image
Jushkie in reply toSlowDragon

Slow Dragon,

Thank you for your reply :)

Test was done at 10:30am, only water for breakfast, couldn't get an earlier appointment unfortunately.

Last levothyroxine taken 28 hours before the test, last T3 15hours.

SlowDragon profile image
SlowDragonAdministrator in reply toJushkie

Ok .....so pretty accurate

How do you feel?

Personally I split my T3 into 3 doses at 8 hour intervals

7am, 3pm and 11pm

Jushkie profile image
Jushkie in reply toSlowDragon

Mostly ok, since taking T3 I manage to do 3-4 cardio and weight training a week without feeling dead afterwards, so that's a massive improvement from my pre-T3 days!

I do get bad days, but not half as many as I used to.

I'll try to follow your schedule and take a quarter tablet of T3 3x a day, fingers crossed it will help me cope with full time job and evenings with the kids better, I'm often asleep before they are :)

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