I have been taking an NDT of 120mg for the past 6 months and T3 of 12.5ug. I had a follow up apt with the Endocrinologist who I was referred to by my Gp. In the last apt he said I was in danger of overtreatment and atrial fibrillation due to the above treatment. He suggested I have another blood test done 3 months after the last one which I did and the results were as follows.
TSH. 0.02. - (0.27 - 4.2 mU/L)
FT4 11.2 - (12 - 22 pmol/L)
Ft3 3.7 - (3.1 - 6.8 pmol/L)
I also see a Naturopath and we work on keeping vitamin/mineral levels optimal.
In the Endo's letter to my GP he says the results suggest slow recovery from levothyroxine overtreatment. I have requested the TRAb and TPO AB results as they were just labelled as 'normal' with no figures/levels available.
Please could anyone give me some feedback on these levels? I'm struggling daily with very little energy and a feeling that I'm completely deplete of any stores and that I'm not making enough energy to fill them back up...
Many thanks for any responses.
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Sishey1
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In the Endo's letter to my GP he says the results suggest slow recovery from levothyroxine overtreatment.
I would love to know how he worked that out! Were you over-treated with levo? What were your blood test results from levo only?
Seems to me that your FT3 is very low for someone taking 30 mcg T3. How do you take your hormone? Do you take it on an empty stomach, leaving at least one hour before eating or drinking anything other than water? Do you take any other medication/supplements at the same time as your thyroid hormone?
In the last apt he said I was in danger of overtreatment and atrial fibrillation due to the above treatment.
What exactly did he mean by that? That taking any amount of T3 causes AF? If so, he's wrong. You don't want to over-dose on T3, obviously, but with that result, the danger is a loooong way off!
Problem is, 99.9% of endos are diabetes specialist, and know next to nothing about thyroid.
Hi Greygoose - I've never been treated with medication from the Endo - My Gp knew I was seeing a private practitioner and wanted to do a Thyroid check - hence how the Endo got involved. He is an odious man and very patronising sadly.
Just to confirm I take 12.5ug of T3 a day but I'm struggling with such a lack of energy and I ache constantly. I don't have any blood test results from levo alone - he just came to that conclusion after I mentioned I was seeing a private practitioner. I had mentioned I was getting quite a lot of heart palpitations particularly when walking upstairs.
There has been a lot of having to work it out for myself but I do take t3 first thing away from any other meds/food etc. But I'd welcome any further information in relation to the taking of NDT and thyroid med alongside vits and minerals. I do think the levels are very low too and perhaps I should be upping them? The thing I struggle with most is the feeling I'm constantly dragging myself around and that my legs are made of concrete.
Yes, but you also get 18 mcg (µg) T3 from your NDT, so that adds up to a total of 30.5 mcg.
but I'm struggling with such a lack of energy and I ache constantly.
Because your FT3 is so low. It's T3 that causes symptoms when it's too high or too low.
I don't have any blood test results from levo alone - he just came to that conclusion after I mentioned I was seeing a private practitioner.
Well, he's a pretty silly man, then, isn't he! lol
I had mentioned I was getting quite a lot of heart palpitations particularly when walking upstairs.
Once again, that's due to the low FT3. Palpitations can be a hypo symptom.
But I'd welcome any further information in relation to the taking of NDT and thyroid med alongside vits and minerals.
To be certain of getting maximum absorption of thyroid hormones - T4, T3, NDT - it's best to take them all on an empty stomach, at least one hour before food and any drink other than water - especially coffee. Or two to three hours after food etc. Most supplements/medication should be taken two hours away from thyroid hormone, but calcium, vit d, iron, magnesium and oestrogen should be four hours away from thyroid hormone.
I do think the levels are very low too and perhaps I should be upping them?
Before increasing anything, make sure you're taking your hormone correctly. If you are, then I think that an increase in T3 is certainly called for.
My Gp knew I was seeing a private practitioner and wanted to do a Thyroid check - hence how the Endo got involved. He is an odious man and very patronising sadly.
Oh, I had one of those back in 2003.
No need to put up with it, bin him off. If your thyroid is being treated by a private practioner and you are happy with how everything is, then no need for your GP to get involved, and certainly not such an unpleasant endo.
TSH. 0.02. - (0.27 - 4.2 mU/L)
FT4 11.2 - (12 - 22 pmol/L)
Ft3 3.7 - (3.1 - 6.8 pmol/L)
You are taking NDT and T3, of course your TSH is going to be low, it's just what those two hormone replacements do, lowers or even suppresses TSH.
Your FT4 is below range and your FT3 has barely scraped into range.
As has been said, make sure you are taking your thyroid meds correctly. Also test your vitamins, they need to be optimal. If everything is correct with those two then you are undermedicated.
I take a combination of Levo and T3 and your FT4 level would very likely have me bedbound. I need both FT4 and FT3 around 60-70% through range. We all have to find our own sweet spot but your results are nowhere near optimal for anyone.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
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 .
when on T3, and NDT make sure to take last third or half of daily 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?
Your results seem to suggest under medicated....assuming you took last third of NDT and T3 8-12 hours before test
On NDT, Ft4 is often low, but Ft3 should be higher in range than these results
TSH is almost always suppressed on NDT or T3, even if on inadequate dose
Hi SlowDragon - yes I followed the protocol you mentioned. I will be having retesting vitamins again - thanks for the information. I also thought undermedicated particularly with how I'm feeling.
From looking at your previous post's you don t seem to have ever been on Levothyroxine ?
Is this an indication of how much attention this Endo has given to your case? if so ,not a good start !
The reference to risks of A Fib and over treatment is probably based only on looking at your TSH, unless you did previously have over range FT4/FT3 results.
There are some statistical risks associated with TSH below 0.04 in patient's taking levo only, but these are relative( ie. the same risks are greater for TSH above 4 ). You should do your own research on here to understand these for yourself, as Endo's and GP's have often only been fed the 'headlines' and not the detail, which tells a different story.
I think TSH will be lowered simply because of the T3 you are taking, regardless of how much you take. so you need to look at the FT4/FT3 levels first before the TSH
These results posted above have FT4 below range and FT3 low in range, so absolutely no danger of over medication on the dose these results apply to. In fact the opposite... looks like you need them higher, most people would feel dreadfully undermedicated with those numbers.
Thanks for replying tattybogle..I’ve been taking NDT and T3 For a while now under a private practitioner ..
the Endo In question is notoriously rude. I struggle to speak up because I feel like I don’t have enough info to counteract his arguments - but I’ll do more research on this site. I appreciate your feedback.
I would sack your Endocrinologist ... I ditched mine 10 years ago and it was the best thing I ever did. He was odious as well and offered me counseling for feeling ill with a TSH of 9.
I had mentioned I was getting quite a lot of heart palpitations particularly when walking upstairs.
A common cause of heart palpitations is low iron and/or low ferritin (iron stores). Both of these things are common in woman and even more common in hypothyroid women.
Low nutrient levels are very, very common in thyroid disease. If you can get vitamin B12, vitamin D, folate, and ferritin measured and then post the results and ranges in a new post on the forum we can suggest what to do and what to take to improve them (if they need improvement which they often do).
I'm not suggesting that you need to deal with low nutrients instead of poor thyroid results. I'm suggesting that to feel better you need to deal with both.
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