Please could you give me some advice on my latest test results?
Here is some background in case it helps: I'm currently on 100mcg of levo and 12.5mcg of T3 per day. I’m a bit better than when on levo only but still a long way from being well. Adding 25mcg of levo over the last 8 weeks hasn’t had any noticeable benefit.
My latest results are as follows:
TSH: 1.21 mIU/L (0.27 - 4.2 R)
Free T3: 4.52 pmol/L (3.1 - 6.8 R)
Free Thyroxine: 12.7 pmol/L 12 - 22 R
My previous test results were the following:
TSH: 3.01 mIU/L (0.27 - 4.2 R)
Free T3: 4.26 pmol/L (3.1 - 6.8 R)
Free thyroxine: 11.1 pmol/L (12 - 22 R)
Adding 25mcg of levo has made very little difference to my levels of T4 or T3. I would have thought it would at least have boosted my T4 a bit more than from 11.1 up to 12.7. My T3 levels have remained stubbornly at around 4.2-4.8 throughout the last year, whether I’ve been on 150mcg of levo, 175mcg of levo, 75mcg of levo +12.5mcg of T3, or 100mcg of levo +12.5mcg of T3. This makes me think I may have a problem with converting T4 into T3 and should try adding more T3 to see if I can get my levels a bit higher. I’m using a quarter of a 25mcg tablet of Tiromel at a time, so I would be going up from 12.5mcg to 18.75mcg of T3 per day. Does that seem sensible?
With supplementation, my vitamin levels are good. The only concern I have about them is that I take 5000mcg a day of Vitamin D and my levels have still gone down slightly over the last 8 weeks (from 91.4 nmol/L to 87.3 nmol/L ). I must have real problems absorbing it.
Any advice would be gratefully received.
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TiredDad
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Which brand of levothyroxine are you currently taking?
Personally I would increase levothyroxine up another 25mcg first
You probably never needed to reduce levothyroxine dose before adding T3
But you are likely to need 3 x 1/4 tablet T3 per day eventually so you might prefer to add 3rd dose T3 first. 3 doses at equal 8 hour intervals may suit you.
Just don’t increase both T3 and levothyroxine at same time
I’m on the Aristo brand of levothyroxine. I was on Teva until about a month ago but asked to go on another brand in case it could help with the bloating/indigestion I suffer from. It’s made no difference so far.
I agree it was a waste of time reducing my dose of levo by so much. I’m tempted to increase my T3 before my T4 because I’ve been ill for so long and my results show my T3 has never been above 4.8. As T3 is the more active hormone, it seems more likely to make me better sooner if I increase my levels directly and see if my symptoms improve? On the other hand, my T4 levels are still quite low so increasing that might help too. It’s just that little of the T4 ever seems to get converted into T3 for me so I don’t know how much better it will make me feel.
Thanks. I still need to talk to my endo about the results posted above so I’ll see what he says.
I think I’ll give the mouth spray a try, thanks for the recommendation.
In answer to your other questions: I have taken magnesium citrate but not as consistently as I should. I’ve been on a gluten free diet for about six months.
I seem to react badly to milk so I may be lactose intolerant. Why do you recommend Mercury Pharma and Accord levothyroxine?
The only concern I have about them is that I take 5000mcg a day of Vitamin D and my levels have still gone down slightly over the last 8 weeks (from 91.4 nmol/L to 87.3 nmol/L ). I must have real problems absorbing it.
What Vit D supplement are you taking - oral spray, tablet, capsule, oil based softgel?
Are you taking your D3 with the fattiest meal of the day or some dietary fat to aid absorption?
Are you also taking magnesium - this is needed for the body to convert D3 into it's usable form?
Are you taking your D3 4 hours away from your thyroid meds?
Thanks for the advice. I take tablets of vitamin D. What is the best method of taking it? Can you recommend something I could try?
I don’t tend to take my D3 with a meal because otherwise it would be hard to keep it apart from my afternoon dose of T3. My routine with thyroid meds and vitamins has been like this:
7am – levo and t3
11am – vitamin D, vitamin b12 (sometimes a b complex), folic acid.
3pm – 2nd dose of T3
7pm – Iron, vitamin c, magnesium
Does that seem okay? I may have to change it if I have another dose of T3 to take.
I’ve been taking magnesium citrate on and off but not consistently enough. I could only get large tablets which I struggle to swallow.
Tablets are the least absorbable form of D3. Best absorbed are oil based softgels and some people find the oral spray is good as it is absorbed through the mucous membranes in the oral cavity.
A good D3 softgel is Doctor's Best and some members use BetterYou oral spray. If you use the oral spray there is no need to have the 4 hour gap from thyroid meds as they are absorbed differently.
When taking D3 we need magnesium and we also need Vit K2-MK7. D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as calcification of arteries and kidney stones.
Is there a reason you are taking folic acid? Is it prescribed for folate deficiency?
When taking B12 we need a B Complex to balance all the B vitamins, a B Complex will contain folic acid or methylfolate. Methylfolate is the better form and a good B Complex will contain this.
If you need magnesium citrate then you could use the powder form which is what I use - Natural Calm Original - start with a small amount and gradually increase until you find the dose to ease your constipation.
Thanks for the tip about not having to take the spray 4 hours from thyroid meds. It could make things a lot easier.
I’ve been taking folic acid to increase my folate levels but I don’t know if I need to boost it as much as some people. My levels are currently 16.72 ug/L so I may not need to worry about it. I still think I'll try taking a good B complex for the reason you state.
I don’t need to have magnesium citrate for constipation anymore. I needed to when I started taking iron but thankfully not anymore. I think I’ll try the triple magnesium as suggested by SlowDragon
Thanks very much for this – really helpful. I’ll have a go at doing it this way.
Over the course of a year it’s going to cost quite a bit to have the Igennus triple magnesium and B complex capsules. If it helps me to get better I suppose it will be well worth it.
Is it okay to take extra B12 tablets with the B12 complex? I’ve needed to take 2000mcg per day to get my levels up and the amount in a B complex is usually less.
Yes you can take separate B12 as well as Vitamin B complex if serum B12 is under 500 (or Active B12 under 70)
Once B12 is over these levels, you can reduce/stop separate B12 and just carry on with vitamin B complex
If folate isn’t high enough, you might next extra methyl folate (Jarrow is good brand) once a week
In week before ALL blood tests it’s important to stop vitamin B complex as it contains biotin. During that week might want to be taking just separate folate and separate B12 to maintain good folate and B12 levels
Thanks again for the proposed schedule. I was intending to go ahead with it but remembered that I take gaviscon during most evenings to help with bloating/reflux so I can't take my levo in the evening. Can you think of another way of making it work? I could keep levo first thing in the morning but then I might need to move vitamin D, B complex and selenium back to later in the morning. Does the magnesium need to be separate from vitamin D or B complex?
Planning when to take the T3 is a bit tricky because I’m not sure how much difference food or supplements can make to it.
I would say you need to focus on your T4 before your T3 as your T4 is right at the bottom of range whilst your T3 is mid range. Like someone already pointed out your T3 probably will rise a bit on higher T4.
As for Vit D: if you’re going to take capsules don’t bother with the NHS Hux brand as it’s not as potent and hence cheap. My levels rise way more on the same dosage of Pro D3. It’s 4 times the price but so worth it as Hux is very poor value for money.
meraki-nutrition.co.uk/indi...Taking over the counter antacid medications and PPI’s such as Omeprazole, Gaviscon, Tums and Rennie’s provide immediate relief, but they also block the stomach from producing more stomach acid worsening the problem in the long term.
These medications are designed to mask the symptoms short term, and don’t address the underlying cause. They also come with many unwanted side effects such as diarrhea, constipation, upset stomach, headaches, iron deficiency and palpitations to name a few.
When we carefully test people over age forty who're having heartburn, indigestion and gas, over 90 percent of the time we find inadequate acid production by the stomach.
Our own clinical experience supports this. So far every client we see with heartburn or acid indigestion has responded well to enzyme or hydrochloric acid supplementation.
Thanks. The difficult thing for me is that I get reflux overnight (acid coming back up the oesophagus) and take the gaviscon to reduce the damage done by the acid. Sadly, I don't think I can stop taking it until my reflux goes away. Hopefully, increasing my thyroid medication will help to reduce my symptoms. In the meantime, I'll have to work out a way of making my routine work while allowing for the gaviscon in the evening.
I'm not totally sure whether to believe the theory about low stomach acid in hypothyroidism because I haven't read any science-based, peer-reviewed academic articles supporting the idea.
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