New thyroid test results, better but still having symptoms?

[Zazbag]

Hello everyone,

I posted before with my background and previous results, the post is here: healthunlocked.com/thyroidu...

I had my dose increased to 150 mcg about 5 weeks ago, these are my results from today (morning sample, fasted and I took my levothyroxine for the day after my test):

TSH: 0.03 (0.27 – 4.20) (down from last result)

T4: 19.4 (12.00 – 22.00) (74% through range by my calculation, up from last result)

T3: 5.2 (3.10 – 6.80) (57% through range by my calculation, up from last result)

Ferritin: 53.1 (22 – 275) 6th July: 43.3 (up from last result)

Haemoglobin estimation: 121 (120 – 150) 6th July: 130 (down from last result)

Red blood cell count: 3.80*10^12 (3.80 – 5.30*10^12) 6th July: 4.03*10^12 (down from last result)

Mean corpuscular volume: 98.4 (83 – 100) 6th July: 100.7 (down from last result, which was abnormal)

Mean corpuscular haemoglobin: 31.8 (27 – 32) 6th July: 32.2 (down from last result, which was abnormal)

At my last blood test my folate, vitamin D and B12 were all optimal so not a concern.

I generally feel better now I'm on 150 mcg, my feet are usually nice and warm which is a completely new sensation for me, and I'm a bit more clear headed, my periods don't last 8 days anymore, and I only have one day of heavy bleeding now as opposed to 4 days of heavy bleeding but I'm still losing so much hair (it's been falling out excessively since March) and I really struggle to recover from exercise. I am still suffering from brain fog quite often as well and my mood is quite low most of the time.

I don't understand why my ferritin has gone up but haemoglobin has gone down. Also don't understand why my red blood cell count has gone down again (I have had a low/close to low RBC from 2018 until earlier this year when I started taking 420 mg ferrous fumarate/day and it became "normal" again, but now it is borderline low again. I'm still taking the ferrous fumarate (have been since February/March because I'm trying to increase my ferritin and recently started eating red meat again to try to help.

I'm taking:

150 mcg lactose free levothyroxine (Teva, same brand I've always used)

2.5 mg low dose naltrexone (have been taking since June, slowly titrating up dose by 0.5 mg every two weeks. I started on 0.5 mg)

420 mg ferrous fumarate

Methylfolate

Zinc

Vitamin D

Methyl B12

Magnesium glycinate

Selenium

N-acetyl cysteine

Please can anyone advise on why I'm still having thyroid-related symptoms despite T3 57% through range? And why I'm losing so much hair? I also had a few white eyebrow hairs but since the dose increase to 150 mcg I can see those white hairs have started to grow brown again. So so weird, I'm only 33, who gets white eyebrow hairs at 33?

[Lalatoot]

The full effects of a dose increase take longer than 5 weeks to appear so things may improve.

[Zazbag in reply to Lalatoot]

Hi Lalatoot, thanks for replying. 2/3 months ago I was on 100 mcg, they increased my dose by two levels, but it has made absolutely no difference to my hair loss...

[Lalatoot in reply to Zazbag]

Yes but it is early days yet 8 to 12 weeks are when we expect to see improvements after increases.

[Zazbag in reply to Lalatoot]

Sorry, I wasn't clear. 2/3 months ago they increased my dose to 125 mcg, then 5 weeks ago to 150 mcg. I could expect to see some improvement to the hair loss even if not complete in that length of time, surely? Could it be because of something else? My hair is so much thinner now, I've not let myself get upset all this time but now I can see such a dramatic difference and tbh I am really upset about it.

[Lalatoot in reply to Zazbag]

type hairless into the search box as I think that vitamins may also play a part. My hairless has been bad but has reduced greatly now I am better medicated. My hair colour has come back too.

[SlowDragon Administrator]

Low red blood count can be due to low B12 or low folate

When were these last tested?

Vitamin D needs testing too

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and also improve B12 levels

You may find you can cut back and eventually stop separate B12 supplement

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

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.

Thyroid disease is as much about optimising vitamins as thyroid hormones

[Zazbag in reply to SlowDragon]

Hi SD, thanks for replying.

Last test 1st June:

Serum folate: 18.40 (2.5 – 19.5)

Serum B12: 548.2 (180 – 900)

Vitamin D: 96

I've continued to supplement them all since then so don't imagine they would have decreased.

I know ferritin is associated with hair loss/growth but I have had pretty low ferritin for a long time and still had very thick hair...