HELP PLEASE! MEDICHECKS THYROID RESULTS BACK - TSH IS 9 (and I'm very hypo)

[Redlester]

THYROID ULTRAVIT 22 FEB 21 : 8.20AM

CRP HS 1.07 mg/L (Range: < 5)

Ferritin 16.4 ug/L (Range: 13 - 150)

Vitamin B12 - Active >150 pmol/L (Range: 37.5 – 187.5)

Vitamin D 86.2 (Range 50-175 nmol/L )

Thyroid Hormones

TSH 9.05 mIU/L (Range: 0.27 - 4.2)

Free T3 3.75 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 11.3 pmol/L (Range: 12 - 22)

Thyroglobulin Antibodies 21.7 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies 9.53 kIU/L (Range: < 34)

Doctor’s Comments:

"I understand that you stopped your T3 treatment on the 11th of January due to an adverse reaction and at the time of this test you were not taking any thyroid replacement therapy.

Your thyroid stimulating hormone level has increased whilst your free thyroxine is now low. This suggests that your thyroid is becoming underactive and should be reviewed by your doctor as you may benefit from thyroid medication. This may require input from a specialist if you are unable to take both levothyroxine and liothyronine therefore I advise discussing this further with your GP.

Your thyroid antibodies are normal revealing no evidence of autoimmune thyroid disease.

Your vitamin D and vitamin B12 level is normal.

Your ferritin, which is a good measure of your iron stores, is normal but towards the lower end of the normal range. I understand you have only been able to increase this in the past by improving your thyroid health. I advise discussing this further with your doctor. There is scope to improve it by increasing your dietary iron intake (beans, lentils, tofu, dark green veg, and chicken & lean beef if you eat meat). Orange juice will help you absorb dietary iron better. Over the counter lysine supplements can also help with this.

If you are feeling very tired you may wish to have a check of your full blood count to see whether you are anaemic.

Your CRP level is normal, suggesting no significant inflammation within the body."

I should explain, I was on 68.75 in early January and dropped down to 62.5mcg T3 on 11 January when I had a severe “pooling” reaction and I had to suspend my T3 dose in its entirety and since then I have not reintroduced it. I am currently unmedicated and was not on any medication when I did my testing. My test was done at 8.20am under fasting conditions. I have been taking Igennus Super B complex [2 per day] since the summer but stopped it for a week prior to testing; not taking the B complex reduced me to a state of non-functioning. I have the full range of hypo symptoms - too many to list here - and am getting progressively worse. I also tested cortisol in early December and it came back low which, along with too low ferritin, could have contributed to the "pooling" episode in January. I posted my results for that test here: healthunlocked.com/thyroidu...

My ferritin was 28 in early December 2020, while I was still on T3. I had to stop T3 in January after the “pooling” reaction and have not re-introduced it. My ferritin has reverted to the levels I formerly had before taking T3, of just below the bottom of the range (previous levels were in the 13-16 bracket). 28 (December 2020) is the highest I have ever managed to get it and obviously I only achieved that because I was taking T3. Since I stopped taking T3 my consumption of iron rich food has been higher than ever but for whatever reason my body cannot absorb or use it and record a decent ferritin score.

I posted the results of my iron panel in December here: healthunlocked.com/thyroidu....

My CRP remains stable from the 1.07 value which I recorded in a test in December 2020.

My Vitamin D status has improved – I take 2000iu per day [along with vitamin K2] and plan to continue with this.

My TGB has gone up slightly from 16 to 21.7 and my TPO has gone down slightly from 10 to 9.53.

My T4 and T3 figures have also dropped.

I take vitamin C, magnesium at night, and additional vitamin B1 and choline/inositol and taurine.

In an ideal [non pandemic] world I would book an appointment with my GP but I can tell you how that would play out. I would have to wait 3 weeks to get to speak to her on the phone (she only works on a Tuesday), she wouldn't accept the medichecks results, would insist she runs more NHS tests (this was what happened last time), so I'd need to wait for a nurse appointment for that, then I'd need to wait for them to come back, then make another appointment with her which would take another 3 weeks and only at that point would she be prepared to get her prescription pad out - so a wait of 8 weeks if I am lucky (I'm not overstating that timeline) and then would only get a script for T4. Meanwhile I have T3 in my drawer at home .... to those of you who have continued reading to this point of what is a long post, I say thank you and apologise but felt it was important to include as much detail as possible. Things are getting worse for me with each day that passes and my brain really isn't working so if anyone has any advice I would be very grateful.

[tattybogle]

Hi Redlester, my first thought is you may have to rethink you 'pooling' theory as the reason you needed to stop T3. My understanding is that 'pooling' is an outdated idea, it was once thought that rT3 used the same receptors as t3 inside the cells, but it's now known that it doesn't.

rT3 does use the thyroid hormone receptors on the outside of the cells, but that doesn't stop T3 attaching to the receptors inside the cells... so it's not blocked , and therefore it's not 'pooling'.... or at least that is my current understanding , gained with the aid of diagrams on the ThyroidpatientsCanada site from Tania Smith. I can find the page if you are interested.

thyroidpatients.ca/2019/09/...

thyroidpatients.ca/2020/07/...

thyroidpatients.ca/2019/11/...

My second thought is that according to your TSH and your fT4/3 results , you really need you be taking some form of thyroid hormone.

And unfortunately that's where my understanding finishes i'm afraid... sorry to be no actual help with your situation.

[SlowDragon Administrator]

You obviously have some thyroid function looking at Ft4 result

Ferritin was bad before and obviously even worse now

We need good vitamin levels on any thyroid hormones

Are you vegetarian or vegan.

Why no levothyroxine alongside T3?

Do you have any levothyroxine you can start taking

If not make an emergency appointment with any GP tomorrow

Or start back on just T3 .....5mcg twice day and increase back up in 5mcg steps as fast as tolerated

[Redlester in reply to SlowDragon]

I am not vegetarian or vegan and have never been either. I eat as much red meat as I can, fish, and chicken. Every other week I buy pate which I eat for a couple of days. I have chronically low stomach acid and have done so for the last decade, but for about the last 5 years or so I have been supplementing with betaine hcl with pepsin. I eat as varied a diet as possible, made from scratch, with minimal processed foods, no take away food and 8-10 servings of fruit and vegetable per day. So, I'm doing my best via diet and supps to ensure my vitamin levels are as good as they can be.

I was taking T3 by way of self- treatment for impaired sensitivity to thyroid hormone and was trying to follow Dr John Lowe's recommendation to treat with T3, as I met his paradigm having suffered for over 20 years with FMS and ME/CFS. Hence no Levo, so I don't have any levo I could start taking. I am allergic to pork so unless it is possible to get bovine NDT I don't think I could risk trying NDT.

I can start back on T3 tomorrow. You advise going up in 5mcg steps as fast as tolerated. If I start back with 5mcg twice per day tomorrow, when should I think about next adjusting upwards?

[SlowDragon Administrator in reply to Redlester]

Personally I would look at getting Levothyroxine prescribed if at all possible

Your high TSH shows you are clearly hypothyroid and need levothyroxine

Suggest you take copy of these results in to GP tomorrow are request prescription for 50mcg levothyroxine (or higher)

Bloods should be retested 6-8 weeks after each dose increase in levothyroxine

(You may need to add T3 later)

If you are going back on just T3

Trial and error how fast you can tolerate.

[glowing_cat]

You can try to get an emergency supply of the medication you need. Someone I know got an emergency supply of levothyroxine for one month and the GP told her that thyroid medication is considered an essential medicine because (as we know in this forum) going without it could be life-threatening. She had to come back with a prescription for T4 that she then arranged with a private GP to continue receiving the prescription on NHS.

The info on here could be of help

nhs.uk/common-health-questi...

Worst comes to worst, I would give a visit to A&E a try.

Maybe others have ideas on how to get hold of medication asap

Good luck!

[Redlester in reply to glowing_cat]

It's not really a case of needing emergency medication. It is more case of what to do going forward and I was really just hoping for advice about the results of my blood tests and for advice on things like iron and cortisol if they were part of the problem when I had to give up taking T3 in January. What medication is best for me - Levo? T3? other? I have a supply of T3 - but thanks for trying to help all the same glowing_cat.

[Mamapea1 in reply to Redlester]

Yes, I would say it's essential that iron and cortisol levels are improved before you will be able to increase any thyroid hormones to a level that improves your debilitating symptoms. I'm not sure which is better to raise the cortisol, nutriadrenal or Metavive or indeed if there's anything better...perhaps other members will know more? I know you are already using other methods for that. For the iron, I would try BetterYou iron spray to avoid the gut....I found raising iron difficult too. You could start another post re iron and cortisol [if you're up to it] to attract a more knowledgeable member...sorry I'm not much help. Hope you feel better soon💐

[Redlester in reply to Mamapea1]

You make good points Mamapea1 - you are very helpful - and I will come back to you on them later on but for now I thought I'd share this that I found last night about the best way to take T3. As you know there are several schools of thought on this - some argue for split dosing, which I was contemplating doing. Others advocate taking it all at once as a single dose. I saw these wise words from Grey Goose and, following her argument, I decided to go for half a tablet, 12.5mcg, all at once taken this morning:

"Remember that we have usually been surviving on the low doses of T3 made by our thyroids and conversion of not enough T4 - or even bad conversion of T4 - for a long time before we are finally diagnosed. Therefore, a lot of T3 receptors have been shut down - hence the symptoms. So, we are, so to speak, starting on empty - unlike euthyroid people whose cells have never been completely emptied, and therefor jog along nicely with small dose of T3 at regular intervals to top them up.

As I see it, with our empty cells, and switched off receptors, we need a lot of T3 in one go to flood all those receptors and turn them on again. And if the T3 comes in dribs and drabs, there will never be enough to flood all the receptors in one go. Whilst, on the other hand, there's always the possibility that some cells get too much - which is why people can have hyper and hypo symptoms at the same time.

The pro-split dose lobby says that T3 has a half life of - what? - 24 hours? And, therefore we should be constantly topping it up. But, that is the length of life in the blood. But, the T3 that has been taken up into the cells lasts a lot longer than that.

Could it not be that those that split their dose run out of steam after a short while because of these small doses they're taking? Because with a split dose there's not enough to go round all the receptors, and even those it does reach, don't all get enough, and therefore need topping up more often? Whereas if you give them all that they need in one single large dose, it would probably keep them going for longer - until the next day, in fact, when you take your next dose. "

Her argument made a lot of sense to me, and persuaded me to take my dose in one go as opposed to splitting it. I formerly tried splitting it and that didn't work well for me. Apologies for going off at tangent on a different issue but I just thought I'd run this past you to see what you thought.

🌺

[Mamapea1 in reply to Redlester]

Sorry for delay in replying. Yes, I agree, it does make sense...I always take mine in one go, and it works well. Splitting didn't work for me either. I think the key is to go steady and try not to miss the sweet spot. I also think 12.5mcg is a good restarting point for you and you've definitely done the right thing👍🏼 I hope you're beginning to feel better now, although it may take a few days 💐

[Redlester in reply to Mamapea1]

Thank you Mamapea1.

And now I’m going to contradict myself.

I have been mulling over @tattybogle’s point above about the “pooling” theory (se per STTM site), which my experience did fit in the early part of January in terms of symptoms, but then I read this case study on Brimeyer’s site,

Thyroid Depletion | Case Study of the 17 Year Old Hypothyroid Grandma (forefronthealth.com)

And the lady he is describing sounds VERY like me. I’m not a Brimeyer fan – some of what he says doesn’t totally add up - however, that being said, he refers to people like her experiencing a sensitivity when taking thyroid hormone, causing elevated heart rate and increased feeling of stress. And says:

“In some cases this can be caused by a magnesium deficiency or other nutritional deficiencies. (I ramped up my magnesium intake after my experience). In other cases, this is caused by elevated adrenaline levels. As mentioned, hypothyroid sufferers compensate by over-producing stress hormones. T3 makes you more sensitive to adrenaline, thus amplifying its effects. This doesn’t mean that you don’t need thyroid hormone. It simply means that we need to lower the dosage and multi-dose it during the day to toleration and increase the dosage slowly to toleration as the stress response is lowered”

So perhaps what I experienced was, rather than pooling, a combination of sensitivity to thyroid hormone accompanied by magnesium deficiency and possibly amplified effects of arenaline, in which case I have learned something very useful, however, now I don’t know what to do re dosing – single dose or multi-dose.

Can you have some kind of “hybrid” do you think? As in, gradually build up a single dose [so that cells get flooded] to say perhaps 30-40ish mcg and then begin to add in quarter tabs later in the day and add any incremental increases to the later day dose so that you might end up with something like 40 (am) and 25 (pm)?

I am currently taking the 12.5mcg in the morning but this is running out quite early in the day and I am wondering about adding in 5mcg in the early evening - would be interested to know what you think?

[Mamapea1 in reply to Redlester]

Yes you could do it that way. There's no doubt you need more than the 12.5mcg, and maybe you could take 6.25 or 12.5mcg later on in the day. I wouldn't do too much too quickly though, as cortisol levels will still be low at present, as will the iron, and whatever else it may be that's making it difficult to increase. You may even find you need less than the dose you ended up on before the horrible adrenaline event when you get your nutrient levels optimal 👍🏼

[Redlester in reply to Mamapea1]

Thanks Mamapea1 - I would imagine that if I get my adrenals treated I would certainly get away with doing FAR better on lower dose of T3 than i was on before horrible adrenaline event!! Hope so! I added in another 5.25mcg last night at about 7pm and am going to do that again this evening - it seemed to help, a bit, but think it would need to be at 12.5mcg in that evening dose to get anything significant out of it, but will have to bide my time before getting to that level. Am trying to set up appointment with someone privately so don't want to be taking too much T3 while cortisol is still a problem and think I am going to have to start on Better you iron spray tonight. Oh joy!! Thanks for the advice.

[tattybogle]

TSH 9.05 mIU/L (Range: 0.27 - 4.2

)Free Thyroxine 11.3 pmol/L (Range: 12 - 22)

There should not be any need to see a particular GP to get some Levo prescribed with these results.

Because the TSH is over range , (and has been previously) AND the fT4 is below range , these results clearly put you in the overtly hypothyroid category, which requires treatment with Levo.

The difficulties about whether TSH is considered high enough for treatment only really apply when you are talking about 'subclinical hypothyroidism' (TSH over range but fT4 still within range)

I agree with the others , get the first appointment you can with any Gp , show them these results , obviously they will require to do their own test to confirm the private results, but the ball will be rolling much sooner than waiting for a particular Gp to see you

[Redlester in reply to tattybogle]

I will have to let GP know of my results - if nothing else to make sure they are on their system - it is high time they began to take responsibility in this area, but unfortunately, if you knew what I was dealing with, you would appreciate that I do not have high hopes of a successful outcome. There is huge family history of hypo on both sides of my family which GP has been made aware of and I have tried all of them in the past, one thought my symptoms were due to menopause, another dismissed them altogether and gave me a lecture about incorporating more tubers into my diet [???] and at the end of the appointment when I tried to raise hypothyroidism said to me "sure, what do I know about thyroids - try X (the female GP - she knows all about woman's hormones". I would imagine they will try to just refer me back to NHS endo who said he would keep me under review.

[SlowDragon Administrator]

Suggest you get started on levothyroxine prescribed via GP ASAP

Personally I wouldn’t take any supplements that mess with adrenals without getting cortisol and dhea tested via Regenerus

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

Cortisol is bound to be affected because you are hypothyroid. It should self correct on levothyroxine

[Redlester in reply to SlowDragon]

I have already had cortisol and DHEA tested via salivary testing and previously posted results the results for that on the forum. The doctor I consulted with reviewed those results alongside detailed patient history going back over 20 years and my recent thyroid and vitamin results and prescribed levo 50mg [Eltroxin] to be taken along with T3 and prescribed treatment for adrenals with ACE.