My mother's recent test results and some historical ones for reference.
She has not been feeling great and her Jan bloods show why. Increasing to 100mcg has dropped her TSH but not increased her T4 by as much as I would have liked.
She's still not feeling great so I am considering asking GP to up her thyroxine, but am also conscious that her TSH is already below 1 and any further thyroxine will drop her TSH too low. Any thoughts? Should she be trying to get her T4 levels into the upper quarter?
I note she had a trial of T3 many year ago, although had to stop due to side effects because the idiot Endo started her on 20mcg which is too high a dose! My own Endo started me on 5mcg - I'm taller and much heavier than my mother. Her recent results don't show any conversion issue but would there be grounds for a second trial starting at 5mcg and working up slowly given her age now of 65.
She has been referred to NHS Endo (from the Thyroid UK list) who may prescribe T3 - still waiting for a date for this appointment.
Her symptoms include fatigue and lethargy, struggles to wake up, needs a lot of sleep and has no motivation or energy to do anything. She doesn't work but can barely so basics like showering, cleaning and cooking. Really do need to get to the bottom of her issues.
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Wired123
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Personally I would space it out. But in theory it shouldn’t matter
How much vitamin D is she taking
Vitamin D should be tested twice year when supplementing
Is she also taking vitamin K2 and magnesium
As she has B12 injections it’s recommended also to supplement 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
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
IMPORTANT.....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
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
Thanks, let’s try the increase in T4 then we can see Re conversion.
T3 has changed my life so I’m assuming, given genetics and hypothyroidism running throughout my mums family, it’s likely T3 will also help her... and perhaps her siblings who also are hypo.
Yep but my doctor still felt I should try T3 regardless and it’s been fantastic.
I figure the fact that we don’t have a thyroid gland anymore due to Hashimoto’s means the body is limited to how much T4 it can convert. After all most of the conversion is done in the thyroid gland itself and if you don’t have one I can’t see how the body can keep up on the conversion.
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