Could anyone please interpret my new labs? Eight weeks ago I discontinued Levothyroxine 50mg. I decided to discontinue because it was making me worse. I was suffering from anxiety and major fatigue. I started taking half a grain of thyroid Amour which is 30mg. Along with this I started supplementing with b complex 100mg alternate days, iron 50mg daily, vitamin d 125mcg alternate days. Currently I have low to no anxiety 😊. Fatigue has improved tremendously, but during late afternoon I start feeling sluggish.
Iron total range: 40-190 mcg/dL result 105
Iron binding range: 250-450 mcg/dL result 264
Iron saturation: range 16-45% result 40
Hemoglobin: range 11.7-15.5 g/dL result 13.3
Ferritin: range 16-154 ng/ml result 31
Free t3: range 2.3- 4.2 pg/ml result 3.1
Free t4: range 0.8-1.8 ng/dL result 1.0
Vitamin D 25-OH, total: range 30-100 ng/ml result 61
Vitamin B 12: range 200-1100 pg/ml result 798
Folate: range >5.4 result 15.2
Still waiting for results for reverse t3
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Hi, I'm still learning since I started self treatment in August. However, from what I can see, you need more armour, your TSH is still high and there there is room in t3 for more, you meant to raise your dose every two weeks until you 'feel' optimal. On the other hand, you may not feel optimal even once you reach the right dose of armour until your ferritin is between 70-90, you are already supplementing with iron, so it should help 😊. Also, try adding 500mg of vitamin b1 daily on top of you b complex. I take b complex 50 and adding b1 500 on top. B1 is for fatigue etc.. And you should notice improvements fairly quick, within 3-5 days (izabella wenz blog). You are on the right path. Increase armour and optimise ferritin. Also supplement with vitamin d 5000 daily for couple of months then drop to 2000.
No thyroid hormone replacement works well if ferritin . folate, B12 and vitamin D are not maintained at optimal levels and not just somewhere in a range.
Did you take bench readings of T3 and T4 before starting NDT and if so has your T3 improved ?
I think until you get your ferritin up to over 70/80 your results will be marginal :
NDT contains around 9 T3 and 38 T4 per grain :
The T4 still needs to be converted into T3 by your body and if your vitamins and minerals are not optimal if follows that you'll not be fully utilising this thyroid hormone replacement as well as you might.
The less well you convert the NDT the more medication you will need as you are reliant on just the T3 element rather than the T3 and T4 to support you.
It takes around 6-8 weeks for the Levothyroxine to fully leave your body and it is during this period that you build up your NDT dose and it is recommended that you start on a 1/4 grain for a week and build up by 1/4 grains weekly until, if, you reach 2 grains.
At 2 grains you hold that dose for 6-8 weeks allowing it to bed in and then have a blood test to see if your levels of T3 and T4 have moved from your bench mark numbers.
If your T3 has improved and you have no symptoms of hyperthyroidism you continue adding a 1/4 grains weekly until one week you will find you feel a bit anxious, irritable, and not you, just drop back down to the dose you were on the previous week and that is your dose on NDT at that point in time.
Allow that dose to bed in for 6-8 weeks and then take a blood test to see where your T3 and T4 levels are : depending on timing / dose your T4 maybe low in range - and your T3 much higher in range and your TSH suppressed.
I switched from 125 mcg Levothyroxine to NDT overnight and started on 1/2 grain as I haven't a thyroid : I monitored my blood pressure and temperature daily : my blood pressure remained constant and my temperature went from around 35.4 to 36.6 .
I got to 1 + 3/4 grains and experienced symptoms of overmedication so I dropped back down to where I have stayed for around the past 18 months - my TSH is suppressed - but it always was for me to feel well, even when on Levothyroxine, and depending on the blood draw timing / dose / food intake - my T4 is low in the range and my T3 very high or slightly over the range and I feel well and if anything run myself slightly hypo :
I hope that helps a bit and know I need my ferritin up at around 100 to feel really well and I guess for optimal conversion of NDT .
P.S. I'm with Graves Disease and following RAI thyroid ablation in 2005 now manage lingering Graves, thyroid eye disease and hypothyroidism.
Just an additional thought on the low ferritin level :
Asda sell little pots of frozen chicken livers - they are very clean and mild to taste ;
Why not try 1 pot a week as an addition to the tablets ?
Defrost and flash fry down in a little olive oil, and then whizz down into a pate and store in the fridge in an old jam jar. Add a little mayo. if the mixture is too dry to you, and take a spoonful each morning to help this medicine go down.
I think so - I did when my ferritin was down at 22 and that was all the information I was given by the doctor and I don't know if a full iron panel breakdown was done.
My prescription was 3 x ferrous fumarate x 210 tablets - ( 68 mcg iron per tablet ) :
Maybe ask your doctor - no point being anxious and also confirm when you should go back for a second blood test to check that the ferritin level is rising.
If you were taking Amour Thyroid would you increase the 1/2 grain to 1 grain with my blood results ? I’m a bit confused I was under the impression when taking NDT you shouldn’t pay attention to TSH but instead Ft3 and Ft4.
The average/normal /optimal dose for NDT is around 3-4 grains. pd. With FT3 at the high end of range and FT4 mid/high on testing. ( withold taking pills at least 12 hrs + before any test). Most people find taking grains over the day ie 7am/11am/4pm helps. Increase very slowly. Also check your cortisol levels if no improvement as Adrenals play an important part in feeling optimal.
Vitamin D 25-OH, total: range 30-100 ng/ml result 61
You have been given this advice in a reply by goskaigorek above:
Also supplement with vitamin d 5000 daily for couple of months then drop to 2000.
I dispute that.
The Vit D Council, Vit D Society and Grassroots Health all recommend a level between 40-60ng/ml. If you take the suggested dose you are going to send your Vit D level way over the recommended range.
You might find the article by Chris Kresser linked to in this post yesterday helpful:
Thank you SeasideSusie ! Do you think I need to take the entire grain or stay at half a grain? My Free t3 only went up from 3.0 to 3.1. I’ve been taking that dose since mid September.
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New to Hypo..Advice on test results :)
New Blood Results after changing from Levothyroxine to Armour
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New Test Results
