TIROMEL

[Rah12]

Hi

Can anyone PM me a online supplier of Tiromel (Abdi Ibrahim) please? I'm in the UK.

Thank you

[RedApple Administrator]

Rah12, members are wary of giving supplier information to new members who have no posting history that explains or discusses their thyroid journey.

Please tell us more about your thyroid diagnosis, medications you are currently taking and why you want to obtain Tiromel.

[Rah12 in reply to RedApple]

I have recently been diagnosed with hashimoto. I have been very unwell. GP said there's nothing they can do. Other then wait and retest me again in a years time! Since then I went to a functional doctor and he put me levothyroxine and LDN. And told me I need to have T3 aswell. I'm so thankful to the functional doctor as I have seen lots of improvements and I've only been on it for about 3 months. But I have a long way to go. He said its very important to have t4 and t3. But I am finding it hard to find a genuine supplier. I'm worried, I don't want to get dodgy medicines.

[RedApple Administrator in reply to Rah12]

Rah12, How much levothyroxine are you on at the moment? It's good that you're seeing improvements, but it takes quite a long time to build up to the correct dose. Three months on levothyroxine is really not long enough to be thinking about adding T3, and the functional doctor should not be pushing you down that route yet.

What are your most recent full thyroid test results on this dose of levothyroxine (TSH, FT4, FT3)? This information is needed in order to assess whether or not you need T3.

[SlowDragon Administrator]

Many people manage fine on just levothyroxine......if they are on high enough dose levothyroxine and if vitamin D, folate, ferritin and B12 levels are optimal

How much levothyroxine are you currently taking

Do you always get same brand of levothyroxine

What vitamin supplements are you currently taking

Please add latest results and ranges

As you have Hashimoto’s have you had coeliac blood test

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)

If/when also on T3, make sure to take last third or quarter 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?

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 vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

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...

[Rah12]

Thanks for replying.

My results are

Serum tsh level 2.32

Serum free t3 4.1

Serum t4 12.9

Thyroid peroxidase 284.0 u/ml

My hasimoto went undiagnosed for a long time and I have been very unwell with it. I was so ill i could barely function. No amount of sleep was enough for me and just wanted to curl up and die!And my whole nody was in so much pain. Some days i could barely walk as it was too painful. Since going to the private doctor...I've noticed some improvements which i never imagined i would see! The private doctor is treating me as whole. So a complete diet change - no gluten, no soy, no dairy, no eggs, no processed meats, no processed oil, and no sugar! He believes in t4/t3 combination and I am happy to follow this as he explained to me the reasoning behind it. And i have also looked into this a lot. And i believe it will help me. He explained how i need to be very careful and titrate up very slowly.

Since being on levothyroxine my fatigue has increased, inceased hair loss, and my weight increased. Also feel cold and weak and extremely tired all the time.

I've had the cortisol test and i am taking supplements for this called ps100 and ace thorne.

I'm taking 50mcg levothyroxine.

I am also taking selenuim, zinc, magnesuim, blackseed oil, vitamin d, apple cider vinegar, iron.

Thanks for your help.

[SeasideSusie Remembering in reply to Rah12]

Rah12

Do you have the reference ranges for those thyroid results? Ranges vary from lab to lab so we need the ranges that come with results. At a guess it would seem that you are undermedicated to have such a high TSH and I'm guessing your FT4 is low in range. You need to get TSH below 1 with FT4 as high as possible to see how well you convert T4 to T3 before you can know if you need to add T3. And before adding T3 you need optimal nutrient levels so you'd need current results for Vit D, B12, Folate and Ferritin.

[Rah12 in reply to SeasideSusie]

Hi thanks for replying.

Serum free t3 level 4.1pmo1/l (3.1-6.8)

Serum tsh level 2.32 mu/l (0.27-4.20)

Serum t4 level 12.9 pmo1/l (11.0- 25.0)

Serum vitamin b12 489 ng/l (180-900)

Serum ferritin 84 ug/l (15-300)

Serum folate 8.8 ug/l (>3.0)

Vitamin d 50 nmol (i think)

Just had vitamin d test today so will have the results next week hopefully and that will be more accurate.

[SeasideSusie Remembering in reply to Rah12]

Rah12

I absolutely endorse everything that RedApple has said below.

The aim of a Hypo patient on levothyroxine is for TSH to be 1 or below with FT4 and FT3 in the upper parts of their reference ranges. Your FT4 is only 13.57% through it's range with FT3 at 27.03% through range. Your body is doing it's best to make as much T3 as possible at the moment as this is the hormone that every cell in our bodies need.

So you need more Levothyroxine at this stage, an increase of 25mcg now, retest in 6-8 weeks, a further increase of 25mcg and another retest after 6-8 weeks. This should continue until your levels are where they need to be for you to feel well.

If your TSH gets to bottom of range with FT4 at the top of range and your FT3 is still low, that is the time to consider adding T3 if all your nutrient levels are optimal.

Those results for your nutrients are all low. Please come back with your new results/ranges when you have them for further comment. Optimal levels are:

Vit D - 100-150nmol/L

B12 - minimum 550pg/ml, nearer 1000pg/ml is better

Folate - at least half way through range

Ferritin - half way through range

Taken from reply below:

He said being t4 only will keep me hypo.

He's wrong. Keeping you on such a low dose of Levothyroxine will keep you hypo. There are hundreds of thousands of hypothyroid patients worldwide who do very well on Levo alone. Those that don't you'll find on forums like this and very often they don't do well because their doctors are ignorant about treating hypothyroidism and are keeping them undermedicated or aren't aware of how important optimal nutrient levels are for thyroid hormone to work properly.

[RedApple Administrator in reply to Rah12]

Rah12, Your FT4 and FT3 are both low, which is to be expected on just 50mcg levo dose. Increase in fatigue, hair loss and weight is also unsurprising as you're obviously still quite undermedicated. It's good that your private doc is happy with the idea of including T3, but it's too soon to start down this route. Not everyone actually does need or benefit from adding T3, so it would not be sensible to try this regime until your levo dose has been increased to further raise your FT4 and lower your TSH to around 1.

[Rah12]

Thanks for replying. He said he will not be raising the t4 anymore as he believes combining t3 and t4 will help me with my symptoms. He said being t4 only will keep me hypo.

[RedApple Administrator in reply to Rah12]

Well in that case, I'm decidedly unimpressed with your private doctor. Presumably you are paying a lot of money for his services. For him to pre-judge and dictate your treatment is not appropriate. Your relationship with your doctor should be a partnership in which you both discuss and agree how your treatment will progress.

[Rah12 in reply to RedApple]

Ok. I'll speak to him again and see what he says.

Thanks for your help.

[DJR1 in reply to Rah12]

I agree with Red Apple on this. This initial approach from the functional doctor is raising a red flag with me. I wonder what qualifications the functional doctor has. I know people who have thought functional doctors are very specialised and then find they are GP doing a bit of extra work in the private sector but have little expert training in thyroid issues. Please be careful. If you respond well to the correct dose of T4 and convert to T3 appropriately you can be treated in the NHS. You risk paying fees in the private sector needlessly. If your GP is being difficult try to change to another one.

Sorry my reply should come after Red Apples....

[Rah12]

Thanks guys for your responses. Appreciate it a lot. Gp has been absolutely no help. Changed 3 times. They told me they do not treat hashimoto. Its wait and see approach!

[LAHs]

Rah123, test your Selenium (Se) level. You need optimal Se to convert your T4 to T3. Although your T4 needs increasing, it cannot be dragging along at the bottom of the range to have any effect. Just increase your own dose (of T4) first and see if your T3 increases proportionately. If it does not, start taking Se either as a supplement or by eating Brazil nuts or any other food which contains Se. Measure again. If your T3 has risen, all well and good. If T3 is still dragging then continue to try to find T3 tablets. Try getting a prescription(from your alternative doc) then e-mail the manufacturer (in the US) See if you can get it via that route.

[Rah12 in reply to LAHs]

Thank you 😊

[jacobite33]

Hi just noticed your old post Wondering how you got on with your Tiromel? (Abdi Ibrahim)

I have just received them and it also looks as if I have Hashimotos going by past blood results.Noticed they contain lactose.Did you have any problems?