My daughter would appreciate your help!

[Deb59]

Hi, I would very much appreciate your expert help for my daughter.

She has hypothyroidism and pernicious anemia and has struggled with her health for many years. We have experimented over the years with various doses and mixture of T3/ Levothyroxine, Nature Throid and a mixture of NT and Levothyroxine and she has settled for the past year on:

Nature Throid 1.5 grains x 7 days per week

Levothyroxine 125 mgs x 3 days per week and 120 mgs x 4 days per week

Multi vitamins

b12 injections every 3 months.

She feels much better on the above, however she has trouble losing weight and is quite breathless. Her hair is very dry and breaks easily and is thinning.

Her latest blood tests were: (From GP Surgery who do not test T3 - her last T3 result from a private test carried out 3 months ago was in a good high range - she was getting a good dose of T3 from the NT and I am presuming that this has not changed).

T4 - 12.1 (12. - 22) pmol/L

TSH - 2.03 (0.27-4.20) mU/L

She is on a high mixture of thyroid meds. Her Doctor, who is supportive, but is not a thyroid expert leaves it to my daughter and how she feels to experiment with the NP and thyroxine. I do worry about her taking this mixture as I can tell by her hair/weight gain that something is not right. (She came of the T3 medication as it was too potent for her and she finds the NT a better option) .

I think she is concerned that if she changes/reduces the meds, then she will be going back to the days when she could hardly get out of bed.

Many Thanks in advance.

[jimh111]

Her blood test especially the TSH shows she is not on too high a dose and is perhaps not absorbing very well. T3 is much more easily absorbed than T4, it's a smaller molecule and passes through the gut wall quicker. Perhaps this is one reason why she found T3 to potent. Perhaps her pernicious anaemia is linked to poor abosorption, I'm speculating here.

Food, particularly bran and coffee can affect absorption. Most people are OK taking thyroid hormone with a little food but some are not. If she doesn't take her medication on an empty stomach then it's worth trying to, she could take the levothyroxine at bedtime if that's easier.

The important point is how much hormone gets into her blood, if she has poor absorption then she just needs more than average. It's difficult to assess fT3 levels if she is taking T3 but her T3 level will be reflected in her TSH and this fine, in fact she might feel better with a slightly higher dose and lower TSH.

[Deb59 in reply to jimh111]

Many thanks for your reply jimh111, I shall pass your message onto my daughter. You mention that she may feel better with a slightly higher dose. Should she increase her thyroxine or her Nature Throid?

[Gismo333]

Hi, firstly if your daughter has been diagnosed with pernicious anaemia then an injection every 3 months is not nearly enough. Some clinics advocate that at the outset an injection every day for 10 days is the initial dosage then every other day then twice a week until symptoms abate. It is widely known that B12 cannot be overdosed. I obtain the B12 myself and self inject, there are a lot of doctors advising this now. I would just like to add B12 testing is not accurate unless you have a test done which shows cellular uptake of the B12.

As for thyroid medication it is not of any benefit to change thyroid medication as it takes 3 months to totally adjust in the tissues. You must keep to the same medication and not swap as you are doing as you will never find balance. It is the amount of T3 that enters the cells that counts, not in the blood, hence the TSH, FT4 and FT3 are inaccurate.

If your daughter is not tolerating T4, she may have an adrenal problem, it would be advisable to have her adrenals tested by Genova. If you go onto their UK website you will find a practitioner that will carry out the test for her. Once the results are back then you can see if there is an adrenal problem. If this hypothyroidism is of long standing then it may well be the case. Nutri Adrenal Extra is a good supplement to take to lift the adrenals, only then will the body be able to convert the T4 into T3 which is essential.

If the adrenals are low then T4 will just sit in the blood.

Blood testing for hypothyroidism is very inaccurate, pulse, temperature and symptoms are the way to go.

If she is struggling with natural thyroid hormone I would suggest trying a different approach. Some people do well on T3 only, some on T4 and T3 but a different combination from natural thyroid hormone but never T4 only. It is always unadvisable to take T4 on it's own as it can stay in the blood and cause toxicity.

I hope this information helps your daughter but if you need anymore help then please let me know. I really don't mind if you want to dm me.

Kind regards

[Deb59 in reply to Gismo333]

Many thanks Linda for your informative reply. We shall take your advice and look into everything you have suggested. I will pm when we get the adrenal tests done if you don’t mind. Many thanks again.