I would be very grateful for any thoughts on this as have been feeling really horrible recently and can't work out if it's a lupus/sjogrens flare, or if it's a thyroid issue...or a combination. So, I had an appointment with my rheumy who has done some blood tests and asked me to start on methotrexate, and got a Blue Horizon finger prick test to check my thyroid and vitamin levels. I 'think' they look ok, apart from vitamin D, but I have put on quite a lot of weight recently without eating any more than normal and am sluggish, foggy and lots of other low thyroid issues. I am prescribed 50mcg of T3 daily.
TSH 0.36 (0.27-4.20)
Total T4 7.8 (66-181)
Free T4 0.6 (12.0 - 22.0)
Free T3 4.61 (3.1 - 6.8)
Antithyroidperoxidase abs 311 (less than 34)
Antithyroglobulin abs 23 (less than 115)
vit D 41 (50-175)
B12 434
Folate 31.50 (8.83 - 60.8)
I would be incredibly grateful for any advise.
Lx
Written by
puffyface
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Yes, your vit D is still very low - although I appreciate it's an improvement on last year - but it's summer and sunny so should be higher than this!
Your free T4 is very low because you only take lio, but despite taking quite a hefty amount of lio, your free T3 is only 40% through range. I need it much higher than that - and also like my free T4 to be high, so combination therapy works very well for me.
Is there any reason you just take lio?
Hopefully SeasideSusie will be along in a bit to add her wisdom x
Thank you so much for replying. I didn’t get on well with Levo, I blew up and felt awful, and that was on low dose...I might have moved from 25 to 50 (I can’t remember). Endo put me on T3...and I knew nothing at that stage (not that I know much now) so just did what I was told and as gp prescribed it, I didn’t question it. Maybe I need to try combination...I’ve never done that. Am terrified of feeling worse...particularly as I’m supposed to be starting methotrexate, although I’m going to delay until children go back to school in case of side effects. Thank you very much for your help...all of this and hideous hormones (am 50) which make all symptoms much worse, is making me desperate.
As fuchsia-pink says, your FT3 is quite low for someone on 50mcg T3 only. When did you take your last dose before this test?
Your raised TPO antibodies confirm autoimmune thyroid disease (Hashimoto's), did you know this?
Your Vit D is very low, the recommended level is 100-150nmol/L. Are you supplementing?
B12: 434 - is this pg/ml, ng/L or pmol/L? If pg/ml or ng/L (they are the same) then it is low. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Folate is pretty good, it's recommended to be at least half way through range so that wuld be 35+ with that range.
So sorry...I think I keep half replying. On my phone, rather than computer, so trying to remember numbers. Ferritin is 93 (13-150)...normally anaemic on gp numbers. I took my T3 at 6pm the night before 8am bloods (but do a 20/10/20 split throughout the day). I will go back to b12 and check...but it looked pretty well in range. Am wondering whether I’m either not absorbing enough...need more... or need to combine. Will go back to endo to ask...but it’s all so expensive!
I do know I have hashis...but not sure how to help myself other than to read, ask you and try to eat properly/take the right vitamins.
That's a nice ferritin level (I wish mine was that good!).
For Hashi's, some members have found a gluten free diet helps, but there's no guarantee. It may be worth a try and if you don't feel any benefit after 4-6 months then probably not worth continuing. Also, supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Thank you for really good advice. I will check my T3 levels and start some selenium. Honestly, looking at my face, I think I’m probably in a Sjögrens/lupus flare...although I find the hashis stuff more of an unreliable problem.
Are you ok? If your ferritin is very low, , and with hashis, how does that manifest for you?
I was put on methotrexate tablets at first by rheumatologist but gave me a really bad stomach but then went on to weekly injections and had no problems with them they helped my symptoms a bit while I was on them but then they took me off them just before lockdown as my blood count went too low so not been out back on it yet until I can see the consultant
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