Latest results not good...

[birkie]

Hello everyone merry Christmas 🎄🎄

I've just received my latest blood results today,

Serum T3.. 4.3...pmol/L...range.. 3.10-6.80pmol/L

Serum T4.. 2.6pmol/L..range 11.00-22-00pmol/L..(Being treated)hypothyroid results

Serum TSH.. 19.32 mU/L.. Range.. 0.30-4.50mU/L..being treated? Therapy - please give details,

Folate.. Normal 3.9 ug/L.. >2.50 ug/L

Serum vitamin B12 normal 352 ng/L range.. 197.00- 77.00 ng/L

VitaminsD.. 52..nmol/L..range 50.00-150.00 nmol/L

Serum Calcium 2.47 mmol/L.. Range.. 2.10-2.60..mmol/L

Serum albumin 46 g/L.. Range.. 35.00-50.00 g/L

Serum adjusted calcium conc.. 2.42 mmol/L.. Range 2.10-2.60 mmol/L

The GPS recommendation is to up the T3, by 5mg.. I'm currently on 10mg split in to 5mg in the morning 5mg in the evening, would this increase help with my T4?? Would adding some be better To balance the T4 out..? I've been very unwell and mostly in bed lately, any help would be grateful

Thanks 💖💖💖

[SlowDragon Administrator]

How on earth do they rethink you can manage on just 10mcg T3 with no thyroid

On just T3 you are likely to need somewhere between 40-60mcg per day as 3 divided doses.

But should only increase by 5mcg at a time

Suggest you Add 3rd 5mcg dose mid afternoon

In few weeks increase T3 in morning to 10mcg

Why was T3 reduced?

You don’t seem to be able to tolerate any levothyroxine

What happened when you tried liquid levothyroxine?

Vitamin levels not brilliant because you are under medicated

What vitamin supplements are you currently taking

[birkie in reply to SlowDragon]

Hi Slowdragon ♥️I'm Struggling really badly with meds, I was on 125mg T3 but suffered from hyper symptoms, my endo told me to start lower so put me on 10mg split I've done that now for 6wks..i knew my bloods would be bad as I feel rotten but was told to keep on it until the next 6wks blood work.. So would you say I should add another 5mg to the 10mg.? Should I do that fot 6wks, I'm totally lost, 😭

[SlowDragon Administrator in reply to birkie]

You weren’t on 125mcg T3

That was levothyroxine (T4)

Your now taking T3 only and on far too small a dose

[birkie in reply to SlowDragon]

Hi slowdragonYes it was thyroxine I was on.. I'm going to do as you suggested and add the extra 5mg,to my 10mg and split it in to 3, then start 10mg in the morning,

Thank slowdragon

Much appreciated 👍

[SlowDragon Administrator in reply to birkie]

Yes add 5mcg as a separate dose mid afternoon

See how that goes....you’re so hypothyroid that you probably want to add another 5mcg sooner than waiting 6 weeks

Perhaps after 2-3 weeks on 3 x 5mcg .....assuming you find that tolerated

Increase morning dose to 10mcg. - so that would be 20mcg in total per day

Then retest in 3-4 weeks

Likely to need to eventually be on 40mcg - 60mcg be day

Hopefully Marz greygoose DippyDame or others on just T3 may comment too

[birkie in reply to SlowDragon]

My only fear is the hyper symptoms, when I was put on 125mg that was thyroxine lactose free I had bad hyper symptoms, 😭

[birkie in reply to SlowDragon]

Hi slowdragon ❤️Sorry didn't say the only vitamin gp has given me is vitamin D.. I'm on my second month my vitamin D is 52.00..nmol/L range.. 50.00...150.00nmol/L.....has the vitamin D range changed I thought it was 60.00..to 150.00..🤷‍♀️... I related this to the practice nurse I was seeing she did agree that 800iU was not a big dose.. But reinforced that it was normal I did say do you think my body will be OK with that amount?.. No reply,, can I ask you a question, as you know my TSH was 19.32..range..0.3..4.50...only on T3 at 10mg...now uped to 15mg split 3 ways.. Been on this since I message you a few days ago... I've since had sweats, electric shocks down my arms and head, no tremor yet.. Going on loo more especially after eating, I noticed I had none of these symptoms when on 10mg split in to 2..do you think this will ease as the week goes on?? I'm just bothered about going hyper again as I have with T4, and T3... It frightens me that my body won't take enough T3 or T4.. To make me well again.. Also would u say my vitamin B12 needs an increase its 352 ng/L.. Ranges 197.00..771.00..ng/L.

Thank you slowdragon ❤️❤️

[SlowDragon Administrator in reply to birkie]

The minimum recommended vitamin D level is 75nmol. But many CCG health areas will only prescribe to 50nmol

On levothyroxine we need vitamin D at least around 80nmol and around 100nmol maybe better. So keep going. Perhaps top up with vitamin D mouth spray by Better You. It’s very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7 - one spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Yes I would say your B12 is rather low.

We recommend maintaining B12 over 500.

Have you had folate level tested?

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 will help improve B12 levels too

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 is another option that contain folate, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

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

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

With such low B12 result taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

cytoplan.co.uk/shop-by-prod...

[birkie in reply to SlowDragon]

Hi slowdragon and thank you for the reply, ❤️My folate level was 3.9..ug/L..ranges.. >2.50ug/L...i wanted to ask my surgery for B12 injections.. Because of my bowle ( colitis) problem but as you see they say its in range.. Can you pay for B12 injections, I was just wondering

Thanks again ❤️❤️

[SlowDragon Administrator in reply to birkie]

Suggest you perhaps try

Jarrow sublingual B12 tablets.....they absorb in mouth and avoid gut

amazon.co.uk/Jarrow-Methylc...

Ingredients: Xylitol, cellulose, stearic acid (vegetable source), natural lemon flavour, magnesium stearate (vegetable source), citric acid and silicon dioxide.

Or

B12 mouth spray- by Better You absorbs in mouth Suggest you start with one spray initially .....

Ingredients:

Purified water, xylitol, natural apricot, flavour, citric acid, methylcobalamin (b12), preservative: potassium sorbate, green tea extract, chromium chloride.

You can get B12 injections ....perhaps put up a post asking members...but probably expensive

[SlowDragon Administrator in reply to birkie]

You can’t possibly go hyper with TSH of 19

On just T3 most people will need somewhere between 40-60mcg T3 per day ....but we have to increase very very slowly

It’s common to feel rough as dose increases and this should slowly improve after 4-6 weeks on a constant unchanging dose

Personally I always feel terrible during any dose increase. It took me a long time to realise this wasn’t because dose was too high....but because rest of the endocrine system was trying to catch up

[birkie in reply to SlowDragon]

Ho that's so good to know slowdragon thanks for that, I'm hoping my TSH starts to improve after this next 6wks 🤞🤞🤞

[SlowDragon Administrator]

On just T3 your Ft4 will be extremely low. It’s irrelevant

But on T3 your Ft3 should be at least around 5.5-6

And TSH should be under 2, often on adequate dose T3 TSH will be well under 1, or completely suppressed

Last 5mcg dose T3 taken 8-12 hours before blood test

[Dr_Fun]

Please just try levothyroxine again. Start at 25cmg daily and gradually build up the dose. You won’t sleep for a week having been so hypo for long but you will soon readjust after that. Have faith. I’m a GP and I take it. It works!

[birkie in reply to Dr_Fun]

Hi Dr _ funThank you for the reply especially on Christmas day❤️..

I've been on T4, which made me very hyper, I don't like hyper symptoms, I was hyperthyroidism for sometime before diagnosis, eventually going into thyroid crisis then having the whole thyroid removed, some blood tests showed my calcium was raised and my PTH, its been like that for some time looking through my records raised calcium but no pth was done on those occasions one was done just recently as I said and my endo said it was probably hyperparathyroidism, my calcium has returned to normal but pth has not, I've also been diagnosed with ostiopea in my spine and just recived results on my knees yesterday I have osteoporosis in both knees and ankles... I'm not good with synthetic meds, I could not take the anti thyroid meds, cannot stomach, antibiotics, or anti inflammatory drugs or aspirin.... Unfortunately, I feel like I've been left to get on with these conditions on my own and have been told to seek my own painkillers, because I'm lactose intolorent my gp gave me codeine phosphate which flared up my bowles I was in agony for 5 days, I was bemused as to why I was feeling so bad, I'd keep to my diet of course I then checked the painkillers ingredients and lactose was their in bold lettering.... Feeling a bit better in the bowles now thank goodness, I'm also going threw the menupause when I took the T4 it seemed to assabate the menupausal symptoms too.... As I say I'm left to go this alone until the holidays are over then I've to find a painkiller which I don't want to be antidepressant.....

Again thank you for you reply

Have a lovely day... 💖

[Dr_Fun in reply to birkie]

Hmm, tricky. It seems you have lots of problems with lots of medications. There is a substance in the human body called DHEA - dihydroepiadosterone. It is the most abundant steroid hormone in the body and is produced by the adrenal glands. Levels peak at the age of 26 then steadily decline thereafter. Following the menopause, it is the main sources of oestrogen and it is also metabolised, as per the body’s requirements into progesterone, testosterone plus a few other things, can’t right remember exactly. One of the metabolites of DHEA is 7 Keto DHEA which Speeds up metabolism, probably through an action on the thyroid gland. Both DHEA and 7 keto DHEA are classed as orphan drugs ie not owned by any pharmaceutical so sadly there has been little research in the way of placebo controlled trials. They have been approved by the FDA as a food supplement but are class c drugs in the U.K. so not available in the IK (DHEA is a weak anabolic steroid and could therefore improve sports performance). The whole topic of endocrinology is fascinating and there is still a lot we don’t know. Merry Christmas! Hope you get your problems sorted!

[Timetraveler67 in reply to birkie]

You poor thing I really do feel for you having to go through all this with not much help from your Drs. I take codene and they bung me up terrible I have been looking into natural painkillers Myself and I’ll let you know if I find one that works. I really do wish you well it sounds like you have been through so much. It took me 3 years Of slow increase to get to 75mg of levo which is we’re I am now all because of intolerance to it. I get angry when Drs don’t believe how ill even a small amount of levo made me one endo even laughed at me and I broke down crying. I’d like to put them in our shoes for a week them maybe they’d be more sympathetic. God bless you sweetheart stay strong xx

[Thyb in reply to Timetraveler67]

Timetraveler67 Have you tried liquid levothyroxine? I could not tolerate any of the many brands/generics of levothyroxine tablets....But, amazingly, I can tolerate the liquid!! 🙂❄️

[birkie in reply to Thyb]

Hi.. ❤️Yes I did try the liquid levo.. But I'm sure it contained lactose, as it messed my intestinal tract up along with the pill levo, (I have colitis to).. But the endo put me on T3 LACTOSE free.. My bowles seemed ok on the 10mg..I was on 125mg of T3 first but that was to much as I suffered hyper symptoms so endo and gp put me on 10mg for six weeks hence the blood work being off.... 😠😠

[helvella in reply to birkie]

But I'm sure it contained lactose,

I think the likelihood of a medicine such as a levothyroxine oral solution containing lactose is very low.

Last I checked, none of the levothyroxine oral solution formulations contained any lactose.

Some people cannot tolerate the considerable quantity of glycerol in these levothyroxine oral solutions. Which would appear to be a more likely cause of any issues.

However, if you had ANY problems, howsoever caused, I hope you filed a Yellow Card report:

healthunlocked.com/thyroidu...

It is perfectly reasonable to do this even if it is a side effect noted on the Patient Information Leaflet. Or if the doctor was wrong in prescribing the product.

[birkie in reply to helvella]

Hi.. Helvella..I was on levo thyroxine oral solution 25micrograms/5ml..creo phama ..yeah I can't see lactose in the ingredients but their is glycerol.. I had bad bowle problems bloating, cramping pain mucus runny stools, my blood work was not good so I was taken off it, I've been on T4 at 175mg..after thyroidectomy (lactose) took about 4/5 months they discovered I was lactose intolerant I had a skin prick test.. They put me on oral liquid but just the same, took me off then put me on T3 but I had hyper symptoms as I did on T4 🙄 new endo took me off T3, put me on T4, at 125mg but hyper again... Could only stand it for 4 weeks it was unbearable, taken off put back on T3, but at 10mg split in to 5mg morning and early evening, I knew it was bad because I felt bad but as my gp said I needed to keep on that amount for 6 wks... Now just uped the dose by 5mg so I'm taking 15mg split 3 times... I just know the more I go up I can bet I go hyper again🙄

[Thyb in reply to birkie]

birkie I have the Teva liquid levothyroxine and it doesn't contain any lactose. I have many allergies to excipients/fillers so that's why I mentioned the liquid levothyroxine as it doesn't contain the 'same' excipients as the tablets. I also have 'diverticular disease', know it's not same as yours but 'possibly' a connection!! ❤️❤️🙏👏👏👍😀

[birkie in reply to Timetraveler67]

Hi.. Timetravler67❤️I feel for you to... Its a discrace how where treated by so called professional people, but I won't stand for this much longer my gp has a lot to answer for it took over 2 years to get my diagnosis of hyperthyroidism (graves) I blame him for the Los of my thyroid, and now he seems to be fiddling with the thyroid meds, not looking in to the reason why when I go up I go hyper even just a small increase, its so sole distroying, after the hols I'm going bk to see the doc...., 👍

[Timetraveler67]

Hi I’m in London uk I asked my endo for this last year and she refused saying it’s Far too expensive and also in her opinion my problem is In my brain. I can not afford to buy it myself so have no option but to stay on levo tablets

[birkie in reply to Timetraveler67]

This way of treating patients is discusting don't they want their patients to get better? Are they not their to help not to keep you ill? I've found in this last 2 years they couldn't give a toss as long as your stuffing your face with the pill they give you,,, all wrong... 😠😠😠

[Thyb in reply to Timetraveler67]

I have the Teva liquid levothyroxine and it doesn't contain any lactose. I have many allergies to excipients/fillers so that's why I mentioned the liquid levothyroxine as it doesn't contain the 'same' excipients as the tablets. You NEED to DEMAND the liquid levothyroxine as I had to ❤️❤️🙏👏👏👍😀

Timetraveler67