Looking for a T3 friendly endo

[judybee]

Suffering from severe lack of energy at the moment and prolonged spells of aggitation, altogether not a happy person. Last check my T4 was low 12.1 where 12 is the bottom of range. So levo has been increased. I would like to get this checked out with a sympathetic consultant, I would also like to get other hormones brought into line too as oestrogen, progesterone, testosterone and DHEA were all very low when last checked. If you know anyone please pm me I live in SE England but can travel. Failing that point me in the right direction of where to look please.

[SeasideSusie Remembering]

Judybee

Do you have full results, including reference ranges, for TSH, FT4 and FT3?

At the moment it won't be T3 that you need with FT4 so low. You need to get TSH down to 1 or below to get FT4 as high as possible, then you can see how well you convert T4 to T3 by looking at your FT4 and FT3 tested at the same time. Then you'll know whether T3 will be beneficial.

Also, it's important to test Vit D, B12, Folate and Ferritin and these need to be optimal before considering adding T3.

[SlowDragon Administrator]

Welcome to the forum

How much levothyroxine were you taking before this test?

How much has levothyroxine been increased to?

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Teva and Aristo are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Have you had vitamin levels tested recently?

Important to regularly retest vitamin D, folate, B12 and ferritin

These are frequently very low if you have been left under medicated

Ask GP to test now

Improving low vitamin levels can significantly improve symptoms

It will take 6-8 weeks for any dose increase in levothyroxine to have full effect

Bloods should be retested 6-8 weeks after any dose increase, or change in brand of levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

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)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin (doesn’t include folate)

medichecks.com/products/thy...

Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Meanwhile email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists

[e-mail]

[smilingjane]

Hi Judybee

Will private message you

Smilingjane 😊

[endomad]

Pm'd you x

[judybee]

Thank you all for your replies. Yes I am taking the Teva brand of levothyroxine, have never taken anything else, I need to get that altered to see if that helps. I have fished out my most recent test results, not all done at the same time so will include dates.

29th June 2020 TSH 0.12 mlU/L (0.3 - 3.94)

29th June 2020 freeT4 12.6pmol/L (12.3 - 20.2)

6th Feb 2020 TSH 0.03mlU/L (0.27 - 4.2) private test

6th Feb 2020 freeT4 13.3 pmol/L (12 - 22)

6th Feb 2020 free T3 5.1 pmol/L (3.1 - 6.8)

6th Feb 2020 Thyroglobulin antibody 16.0 IU/ml (0 -115)

6th Feb 2020 Thyroid Peroxidase antibodies 9.7 IU/ml ( 0 - 34)

29th June 2020 Serum Folate 17.5Ug/l

29th June 2020 Serum Vit B12 480ng/l (197 - 771)

29th June 2020 Serum Ferritin 159ug/l (30 - 400)

I don't seem to have a vit D reading, but i do supplement it.

Feb 2018 DHEA 0.14nmol/l (0.25 - 2.22) I have been taking Adrenavive to help with this

Feb 2018 progesterone <33pg/ml (51 - 210)

Feb 2018 oestrogen <0.68 pg/ml (1.01 - 2.56)

Feb 2018 testosterone <8.6 pg/ml (9.8 - 42.7)

I was not taking levo prior to this test, I was taking Metavive 2 twice daily as advised by Dr Petefield some time ago, unfortunately I only got to see him once before he became unwell. This did have a good effect on my T3 which was alwayes below range before this. Since the test in June 2020 i have been taking levothyroxine 50 and metavive. I am now planning to stop taking metavive and putting levo up to 75 since i have read on this forum that metavive is unreliable and my mood is variable and energy levels rock bottom.

Could anyone comment on whether they think the tiredness is down to Thyroid issues or the lack of the three sex hormones or even the low DHEA. I would be really grateful as I am at a loss and too tired to think about it.

[SlowDragon Administrator]

29th June 2020 TSH 0.12 mlU/L (0.3 - 3.94)

29th June 2020 freeT4 12.6pmol/L (12.3 - 20.2)

6th Feb 2020 TSH 0.03mlU/L (0.27 - 4.2) private test

6th Feb 2020 freeT4 13.3 pmol/L (12 - 22)

6th Feb 2020 free T3 5.1 pmol/L (3.1 - 6.8)

6th Feb 2020 Thyroglobulin antibody 16.0 IU/ml (0 -115)

6th Feb 2020 Thyroid Peroxidase antibodies 9.7 IU/ml ( 0 - 34)

29th June 2020 Serum Folate 17.5Ug/l

29th June 2020 Serum Vit B12 480ng/l (197 - 771)

29th June 2020 Serum Ferritin 159ug/l (30 - 400)

I don't seem to have a vit D reading, but i do supplement

So when you had these two tests you were ONLY taking 50mcg levothyroxine?

Clearly Ft4 is very low, showing you need 25mcg dose increase in levothyroxine

Bloods should be retested 6-8 weeks after each dose increase in levothyroxine

Have you ever had ultrasound scan of thyroid?

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Or ever had MRI of pituitary

How much vitamin D are you currently taking?

Suggest you get vitamin D test

vitamindtest.org.uk

What other vitamin supplements are you currently taking?

Are you on strictly gluten free diet?

[judybee]

Thank you, neither thyroid nor pituitary have been scanned.

I take 4000IU of D3 daily.

I take a lot of other supplements too as I think it is possible that what I get from my food is impaired as I unfortunately have been on high doses of antibiotics for the last 2.5 years and had a lot for the 7 years preceeding that as I have an embedded bladder infection.

So the other supplements are

vit C, Zinc, Fish oil, Vit E, reduced glutothyamine, Calcium and Magnesium. I also have on presciption Hipprex (an antibacterial) and flucanazole as well as my antibiotics.

No I am not strictly gluten free, but my gluten intake is very low I would say it is mainly from oats.

I will read the links and get vit D tested.