I thought it was thyroid but seems to be calcium deficiency

[helen_m]

Hi,

I recently have been very tired, depressed, very forgetful and fatigued and recently waves of dizziness (yesterday and today - feels like an inner ear thing). I thought that perhaps my hashimoto's was playing up but no, I went to the doctor for blood tests and they did a full blood count as well as basic thyroid tests and my results show a calcium deficiency.

I'm 51 years old, on 112 mcg of levothyroxine, 20mcg of liothyronine and take HRT (in the form of Utrogestan which is progesterone capsules and Oestrogel). I'm still pretty active - still able to go hillwalking, indoor climbing, but the fatigue and depression is starting to get on top of me.

Blood tests, done 03 June 2021:

Bone profile

Calcium 2.14 nmol/L (2.20 - 2.60)

Calcium (adjusted) 2.18 nmol/L (2.20 - 2.60)

Thyroid function test

TSH 0.10 mU/L (0.35 - 5.00)

Free T4 11.4 pmol/L (9.0 - 21.00)

Total T3 1.4 nmol/L (0.9 - 2.5)

Liver tests are fine, urea is high but it is usually high (I get dehydrated quite easily). They followed up by testing my bone profile in more detail which turned out fine and my vitamin D which had dropped to half of what it was but because it's in their range, they don't care. My D had been at 145 but is now around 70 (that was a phone call to doctor's surgery). They haven't given me any action or supplements. I've heard you shouldn't take calcium supplements, but instead increase vitamin D and K. I take magnesium anyway which had kept my D level good, but due to HRT needing to be taken at night-time, I'd dropped off taking magnesium regularly, hence D levels falling.

I should probably increase my liothyronine too. Increasing levothyroxine doesn't work for me, I end up over replaced if I increase to 125mcg of levo. Is there any way I can tweak my dose further? I take lio twice a day X 10mcg.

I guess I'm trying to find out if there's anything else I can do as well as reintroducing vitamin D/K2 and possibly increasing T3.

Many thanks,

Helen

[greygoose]

I would not call that a 'calcium deficiency'. It's just a bit low. And, increasing your vit D would probably raise that nicely.

On the other hand, Total T3 is the wrong test. It doesn't give you much useful information. You need the Free T3, to see how much T3 you have available to your body.

Even so, your TT3 is only 31.25% through the ranges, so very likely that your FT3 is also low. Even though 20 mcg is a decent dose. Do you take your T3 the same way you take your levo: well away from food, other supplements and medication?

[helen_m in reply to greygoose]

Hi greygoose,

I'm good at taking the morning dose away from all food, as I take it with my levo but I am not so good about the afternoon dose. I try and take that one about 3pm

I've never managed to get my GP to test free T3. I bought a Medichecks free T3 fingerprick test but I'm really squeamish about my own blood and haven't been able to use it.

[helen_m in reply to helen_m]

I've just seen that you can go to a local clinic for the blood draw. This is awesome!

[greygoose in reply to helen_m]

Could you try taking the afternoone dose at a different time, when you are able to avoid food, etc.?

[helen_m in reply to greygoose]

3pm is a good time to avoid food, but I keep forgetting to take it. My memory is really absymal just now. Forgetting where I've put things etc, it's driving my husband mad!

[greygoose in reply to helen_m]

Oh, I see! lol Yes, that can be a problem. And, of course, the problem won't improve if you're not taking the T3. Can you not set an alarm on your phone or something? I don't know, I take all my T3 at the same time, in the morning.

Of course, if you forget to take half your T3, your FT3 will be low, and that is far more likely to be the cause of your symptoms than low calcium.

[helen_m in reply to greygoose]

Thanks greygoose! It always comes back to the thyroid, doesn't it. I'd forgotten that my afternoon dose was hit and miss, and my other supplements are a bit hit and miss too.

[greygoose in reply to helen_m]

Not easy to get into a smooth routine, I know.

[SeasideSusie Remembering in reply to helen_m]

helen_m

I bought a Medichecks free T3 fingerprick test

Just the free T3 test or the Thyroid Function test which does TSH, FT4 and FT3? FT3 needs to be tested with the others, not on it's own.

[helen_m in reply to SeasideSusie]

I'll do all three together - I had bought the single free T3 test but that's useless on its own

[nellie237]

Hi Helen,

Has your GP made any comment on the calcium?

[helen_m in reply to nellie237]

None whatsoever!

[nellie237 in reply to helen_m]

I think it would be reasonable to ask your GP to re-test in about 3 months.

[helen_m in reply to nellie237]

Thanks, I will do

[SlowDragon Administrator]

Suggest you consider adding 5mcg T3 at bedtime

Many, many people find T3 at bedtime improves sleep

Are you on strictly gluten free diet?

Can help with brain fog

Also if you can’t tolerate higher dose levothyroxine all in one go, you could split it

If wanting to try 125mcg daily…you could take 100mcg waking and 25mcg levothyroxine at bedtime

Only increase levothyroxine or T3 at any one time….never both

[helen_m in reply to SlowDragon]

Thanks SlowDragon

I was strictly gluten free but been caught out a few times - eat gluten or eat nothing. That could be why brain fog has increased.

I keep needing a nap after work - til about 8pm which then wrecks my night-time sleep. Now that greygoose has pointed it out, it's probably cos I keep missing my afternoon T3 dose or taking it too close to food.

I don't think I can add levo or T3 at bedtime - I take magnesium at 7/8pm then progesterone right before bed. It was much easier when I was on HRT patches, the progesterone has got me all mixed up but the type I was on are unavailable and the other types all make me bleed.

[thyr01d]

Hi Helen, nothing useful to say but I just felt a connection with you because I too struggle with remembering to take the T3 and then am more forgetful so forget even more! I also end up in that eat gluten or eat nothing situation sometimes and find the HRT difficult to time - when I even remember it! Lol

[helen_m in reply to thyr01d]

Thanks! It's so easy to get into a bit of a state due to forgetting stuff. I do have a medication app on my phone but even with that, still forget to take stuff. The HRT definitely threw me out so still trying to sort out my daily routine