T3 NDT TREATMENT - DRY EYE SYNDROME

[jeresavo]

Hi- new here. On 950 per week of levo, recently increased from 850. Also hav dry eye very gritty morning only. Suggestion this could be a thyroid issue. Quick relief is simply splash with warm water which immediately sorts for the day. Q. Should I take T3 or NDT or combination ? If so how much ? If I do take T3 or NDT what is position with T4 (levo)? Am advised that a treatment involving a mix of T4 & T3 has been ok for some. Finally is the TSH test an unreliable marker for thyroid problems, especially given that it doesnt test for T3. Sorry if this is a loaded post.

[Lalatoot]

We need to see recent blood results with TSH FT4 and FT3 to offer advice.

[SlowDragon Administrator]

Dry gritty eyes is extremely common symptom of thyroid disease

Hypromellose eyedrops can be helpful...can buy over the counter - ask at pharmacy

Bloods should be retested 6-8 weeks after any dose change in levothyroxine

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have Hashimoto’s

Ask GP to test vitamin levels

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?

Please add results and ranges if you have any

[jeresavo in reply to SlowDragon]

Thanks so much. Am back in 6 weeks & will certainly follow the guide above.

Very much obliged.

[SlowDragon Administrator in reply to jeresavo]

Post from yesterday about how eyes are frequently affected here

healthunlocked.com/thyroidu...

[shaws Administrator]

Welcome to our forum and am sorry you have a hypothyroidism.

The following is symptoms of hypo:-

thyroiduk.org/signs-symptom...

We don't get all of them, thankfully.

Some hints - if you don't already follow this method:-

All blood draw is to be at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between your last dose of levo and the test and take it afterwards.

Ask GP to also test B12, Vit D, iron, ferritin and folate - everything has to be optimal.

Always get a print-out of your results with the ranges (ranges are in brackets after the numbers). Ranges are important as labs differ and it enables members to respond if you post them.

The majority of us don't rely upon a TSH alone when we haven't yet reached an optimum dose of levothyroxine (T4). Optimum means that our symptoms have resolved and we feel much better.

A number of specialists have stated that a combination of T4/T3 might be suitable for some but unfortunately T3 is no longer prescribed in the UK - except if it is through an Endocrinologist because it is has become so expensive it is rarely prescribed.

Always get a print-out of your blood test results, with the ranges for your own records. You can post if you have a query.

NDT (natural dessicated thyroid hormones) have been withdrawn in the UK - through False Statements made about this product which has been in use since 1892 (in various forms).

[jeresavo in reply to shaws]

Thanks so much,

Beginning to build up a picture of the variables and looking forward to putting advice in to play,

Thanks again

J

[Huzat]

Hi, I have had most success with dry eyes using using high quality, high dose omega oil recommended by my ophthalmologist (which can be quite expensive). Just as effective and considerably cheaper is a table spoon of flaxseed oil a day. You should find it relieves your eyes quite quickly.

Just to add- in my experience Thyroid eye problems don’t run in tandem with your thyroid condition. They run on their own cycle. So your results may look good but your eyes are bad or results are bad but eyes are fine.

[jeresavo in reply to Huzat]

Thank you Huzat,

Can I ask a stupid question. Is the oil to be consumed ?

Cheers

Jero

[Hidden]

That´s a strange dose of levo you´re on...do you mean 85/95 micrograms per day? Which I´ve never heard of...that would more likely be 88 mcg daily or 100 mcg daily.

You should first try to optimise treatment on levo (by optimising vitamin and mineral levels) to see if that improves T4 to T3 conversion since hypo symptoms on levo are caused by low FT3 levels (in turned caused by insufficient conversion).

Despite what is sometimes claimed, NDT/T3 is not a panacea and should not be taken unless you have a confirmed decreased ability to convert T4 to T3. T3 can be difficult to dose, can result in hyper symptoms, plus will most likely result in a suppressed TSH which your doctor will be unhappy about.

This is not to say that some people don´t need T3 or shouldn´t take it, but that it´s not something you should try until you have tried to optimise your treatment on levo only. You cannot know if levo only works for you until you´ve reached a dose which keeps your TSH at 1 or lower, and have had both your free T3 and free T4 measured.

[shaws Administrator in reply to Hidden]

I don't agree that T3 is difficult to dose as it is what I take. As long as you don't rush in increasing and take time to gradually increase and always being aware of your symptoms and that they are being resolved.

For me, levothyroxine was intolerable with the result that I had to have many heart checks and cardiologist was just about to put an implant in my heart to try to 'see what was going on'. Lucky me, that T3 was added to T4 and I had no further severe palpitations which had meant visits to the A&E.

I eventually dropped T4 altogether and T3 is what suits me and restored my health.

[Hidden in reply to shaws]

Yes, but I imagine you tried other things first...my reply was meant to discourage the OP from rushing from levo to T3 only without proper guidance.

[shaws Administrator in reply to Hidden]

Levothyroxine was awful. An experience I wouldn't want to go through again.

Eventually the endocrinologist added some T3 to T4 and immediately it turned my health around.

I eventually took T3 alone.

Some people have 'Thyroid Hormone Resistance' which means they cannot convert levo (inactive hormone) properly into T3 (liothyronine) and have to take a larger doses of T3 than would be required by others.