Hello all, I have had Graves’ disease for many years and had a total thyroidectomy in Feb 2020.
As per my previous post I was advised it would be beneficial to get private bloods done. Here are my results :
31 (75-175) : 25 oh Vit D LOW
31 (13 - 150) : Ferritin
75.0 (37.5 - 188) : Active B12
6.6 (8.83 - 60.8) : Folate Serum LOW
2.43 (0.270-4.2) : TSH
3.5 (3.1 - 6.8) : Free T3
19.0 (12 - 22) : Free Thyroxine FT4
134 (0-115) : Thyroglobulin Anti Bodies HIGH
143.7 (0-34) : Thyroid Peroxidose Anti Bodies HIGH
134.00 (59-154) Total Thyroxine T4
Any advice would be much appreciated I still feel awful after thyroid removal.
I take 100 mcg levo, 12.5 propranolol twice daily (i’m very slowly reducing this) also calcium supplements since Total Thyroidectomy 2mcg alphacalcidol and 2 500mg x 4 times daily calcichew d3. Last three calcium checks all in range.
Thank you Sally x
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elsaldo
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I think she might need to wean herself off propranolol you cannot just stop it just like that. That is one of the reasons I did not take it when I was first diagnosed.
Your TSH is too high and should be 1 or lower. Also 100mcg is a low dose and you need an increase and you might have to add T3. A lot people without a thyroid do well on NDT because it contains T3. You also need to have optimal vitamin levels and some of yours are too low.
Thanks Lora I will speak to GP again. I did ask for a rise in levo but was told no as I am in “range”. However my last tsh result was 1.27 so maybe now it’s higher I will get an increase x
So your T3 is at around 11% through and your T4 is at around 70% through the range.
Ideally these need to be balanced at roughly the same % through the ranges with most people feeling better when both T3 and T4 are in the upper quadrants of their ranges.
Most people feel well when their conversion ratio is between 1/ 3.5 - 1 / 4.5 with 1 / 4 being around the common medium : and currently your ratio is coming in at 1 / 5.4 : and to find the ratio you just divide your T3 into your T4 :
I think your Propranolol may have something to do with this low ratio but I have never been on this, though read you must come off this Beta Blocker very very slowly.
Your vitamins and minerals all look much too low in the range detailed and you need to be aiming for at least 50% + through - though find the folate range a little odd but this is not my area of expertise and hope someone will come along and offer you a more in depth reply:
However if these are all maintained at optimal levels, your conversion of the T4 into T3 will improve and there is the option of increasing your T4 as you have room to manoeuvre up in the range.
No thyroid hormone replacement works effectively if your vitamins and minerals are not maintained at optimal levels and I know for myself I need my ferritin up at around 100, for maximum support and conversion.
However in all honesty after putting all these factors into a better place, I believe the most sensible suggestion has to be that of supplementing a little T3 alongside your T4 :
As previously explained, you have lost your own natural T3 thyroid production and you would definitely benefit from a combination of T3 and T4 thyroid hormone replacement so both vital hormones can be dosed and monitored independently of each other.
The other option is to take Natural Desiccated Thyroid which contains a fixed ratio of T3 and T4 and I read some people have to add a little T3 or T4 to their NDT to find that fine ratio balance unique to them.
P.S. Forgot to mention your antibodies which seem a little high but am not able to offer any advice on this - sorry.
thank you so much pennyannie your insights are very helpful and it gives me a very good idea on what i am aiming for as it’s all very new to me. thanks again x
Ideally GP should do full iron panel test for anaemia...but they probably won’t agree to do so
You may need to test privately
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Suggest you get FULL Thyroid And Vitamin testing again in 2-3 months...see how much vitamins have improved
Hopefully by then you will be off propranolol completely
Personally I couldn’t get off propranolol until strictly gluten free
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
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
Just one quick question SlowDragon ... do you have any opinion to share on my thyroid antibody test results ? They are high but i’m not sure why. Thank you x
Thanks again for replying ... No I didn’t ever have an ultrasound. I will prioritise getting my vitamin levels in order first and then see how my anti bodies are, Sally x
Improving vitamin D levels will naturally increase calcium levels...so you will need to keep an eye on calcium. You may need to reduce calcium supplements
Do you still live in Scotland as I believe T3 is meant to be easier to get prescribe if you wear a kilt ??? No this isn't a joke, but was trying for a smile. and some positivity.
If you email Dionne at Thyroid uk - ( and join the charity if you haven't already ) there is a list of friendly endos - sympathetic to hypothyroid patients -
You can be referred anywhere in the country that obviously makes sense for you :
Professor Toft the famous endocrinologist who recently retired from the NHS worked out of Edinburgh and would like to think his students would be amongst the " enlightened " ??
Obviously you'll need to work on the vitamins and minerals in the meantime but there's a plan there and something to work towards :
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