Dosing T3

[chrysalis56]

(Apologies for the lengthy post)

Heartfelt thanks to all those who have been weighing in on dosing T3, on the link between Hashimoto's and depression (I can so relate), and on the importance of strong iron and ferritin levels in optimizing energy levels.

I've been self-dosing T3 liothyronine only for many years (12.5 mcg at 8 a.m., 12.5 mcg at 11:30 .m., 12.5 mcg at 3:30 p.m., and 6.25 mcg at 7:30 p.m.) Chronically low-energy, I tried adding another 6.25 mcg to my 11:30 a.m. and 3:30 p.m. doses, attempting to overcome a late-afternoon energy slump. Too much, too soon?

I've been feeling wobbly for awhile. The other day, I was walking outside and felt I needed to sit down and catch my breath for several minutes before continuing on. (This happens alot when walking even a couple of blocks. Why?) Suddenly, I fell, before I could reach a nearby bench. Kind passers-by stopped, picked me up off the sidewalk, and one of them even drove me home. Scary.

Latest blood labs:

Iron (chronically low): 49 UG/DL (Range 50-170) as of 7/4/2021

Transferrin: 260 MG/DL (Range 200-380) as of 7/4/2021

Transferrin saturation 13.00% (Range 15-50) as of 7/4/2021

Ferritin (chronically low):

14.24 NG/ML as of 7/4/2021; 22.53 NG/ML as of 6/7/2021; (Range 10-290)

I supplement with vitamins. Iron (13 mg /day) tends to cause constipation, so I load up on spinach and other "green leafys". RBC, HGB and Folic Acid always within range. Vitamin B12 (Solgar B Complex "50") off-the-charts high. Vitamin D 25-OH (4,000 IU/day) 71.70 NG/ML (Range: Sufficiency 30-50), as of 17/11/2020.

Any comments would be most welcome.

Warm regards and all best wishes,

Chrysalis56

[SeasideSusie Remembering]

chrysalis56

Vitamin B12 (Solgar B Complex "50") off-the-charts high

If your B12 is off the charts why are you continuing to supplement?

Your B Complex only contains 50mcg cyanocobalamin B12 so hardly a big dose anyway, what was your B12 like before supplementing?

Another thing with that supplement is that it contains 50mg B6 and the recommended amount for long term use is 10mg.

Your iron and ferritin levels are dire and this could be having a big impact. Taking just 13mg iron in tablet form a day wont do much. Here in the UK with prescription tablets the amount of elemental iron in one tablet is 65mg, and if someone has iron deficiency they would most likely be on 3 tablets a day.

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Signs and symptoms of iron deficiency:

healthline.com/nutrition/ir...

Your Vit D result is too old to comment on other than the recommended level is 40-60ng/ml according to The Vit D Society and Grassroots Health. We should test twice a year when supplementing and adjust dose if necessary as we may make more Vit D naturally during the summer months. There are also important cofactors needed when taking D3 - magnesium which helps the body convert D3 into it's active form and Vit K2-MK7 which directs the extra uptake of calcium to bones and teeth where it is needed and away from soft tissues and arteries where it can cause problems like kidney stones, calcification of arteries, etc.

We can't comment on the dose of T3 you are taking unless we see results and reference ranges for TSH, FT4 and FT3.

[chrysalis56 in reply to SeasideSusie]

Dear Seaside Susie,

I very much appreciate your detailed comments, and your prompt response.

TSH: 0.07 microIU/mL as of 6/7/2021;

TSH: 0.40 microIU/mL as of 7/4/2021 (Range in both instances 0.35-4.94)

Free T4: <5.15 PMOL/L (Range 9.00-19.10) as of 6/7/2021

Free T3: 4.08 PMOL/L (Range 2.60-5.70) as of 6/7/2021

Blood labs at 7:30 a.m.; fasting, apart from water, since 7 p.m. the night before.

Last T3 dose 12.5 mcg at 3:30 p.m. the day before.

I will speak to my GP about upping my supplemental iron, though constipation remains a concern.

Your comments on Vitamin D are well-taken. I cut back on my dosage in the summer on days when I'm outside more. I do take magnesium citrate (200 mg/day) and Vitamin K2-MK4 (15 mg/day).

Truly, I don't remember what my B12 levels were before I began to supplement. It's been high for a number of years.

Latest reading: >2,000 PG/ML (Range 187.00-1060.00) (as of 4/2/2021)

Many thanks,

Chrysalis56

[SeasideSusie Remembering in reply to chrysalis56]

chrysalis56

Blood labs at 7:30 a.m.; fasting, apart from water, since 7 p.m. the night before.

Last T3 dose 12.5 mcg at 3:30 p.m. the day before.

Last dose of T3 should be 8-12 hours before test. You should have adjusted timing the day before so last dose was between 7.30pm and 11.30pm. You have a false low FT3, your normal circulating amount of hormone would be a bit higher than the result you have for your June test:

TSH: 0.07 microIU/mL as of 6/7/2021;

Free T4: <5.15 PMOL/L (Range 9.00-19.10) as of 6/7/2021

Free T3: 4.08 PMOL/L (Range 2.60-5.70) as of 6/7/2021

and this test in July:

TSH: 0.40 microIU/mL as of 7/4/2021 (Range in both instances 0.35-4.94)

is of no use because just testing TSH alone is inadequate, as you're on T3 only you absolutely must test FT3.

I will speak to my GP about upping my supplemental iron, though constipation remains a concern.

Do yu take your iron tablet with Vit C? This aids absorption and may help prevent constipation.

I do take magnesium citrate (200 mg/day)

Try increasing this dose. Normal dose of magnesium is around 350-450mg per day. I take mag citrate as I suffer from constipation and I use the powder form. I weigh mine out as the pack says 4g = 350mg magnesium, I use a bit more.

Truly, I don't remember what my B12 levels were before I began to supplement. It's been high for a number of years.

Latest reading: >2,000 PG/ML (Range 187.00-1060.00) (as of 4/2/2021)

What is your folate level? The recommended level is at least half way through range. If your Folate level is also over range I'd say you don't currently need to take a B Complex.

[chrysalis56 in reply to SeasideSusie]

(Dates are day/month/year, European style)

My last T3 dose at 3:30 p.m. the day before my blood labs was on the advice of my physician. Will discuss your suggestion with him before I retest.

Yes, I take my 13 mg iron with 500 mg Vit C (Ascorbyl Palmitate) in the a.m., far from dairy.

Magnesium citrate dosage: I can try upping the 200 mg dose by at least 100 mg.

Folic acid (tested in our lab, rather than folate): 14.10 NG/ML (Range 3.1-20.5) (as of 7/4/2021)

Warm thanks to all of you for your thoughtful responses. So wishing you well.

My best,

Chrysalis56

[greygoose]

Increases in T3 should be only 6.25 mcg every two weeks. So, yes, possibly you did increase by too much.

I supplement with vitamins. Iron (13 mg /day) tends to cause constipation, so I load up on spinach and other "green leafys".

You won't get much iron from spinach, the oxalic acid stops you absorbing it. Are you vegetarian?

[chrysalis56 in reply to greygoose]

Thank you, greygoose. I'm not vegetarian, though I do eat alot of vegetables. I don't eat meat, but do eat fish, eggs and (goat) dairy. Gluten-free.

My best,

Chrysalis56

[greygoose in reply to chrysalis56]

So, I suppose you're not open to eating liver, or liver paté, which is the best way to raise iron levels? It's really difficult to get enough iron from vegetables.

[chrysalis56 in reply to greygoose]

You are quite correct, greygoose, about raising iron levels most effectively by eating liver or liver pate. Will have to think hard about this. I haven't eaten meat for many years and, truth to tell, really don't miss it.

My best,

Chrysalis56

[greygoose in reply to chrysalis56]

Yes, I can understand that. But, there is a theory that going of meat is another hypo symptom. Hypos have low stomach acid, usually, so that makes meat hard to digest. Hypos look for food that gives them more readily available energy.

[chrysalis56 in reply to greygoose]

Thank you, greygoose. I hadn’t been aware of that theory.

Hoping you are well and thriving,

Chrysalis56

[greygoose in reply to chrysalis56]

I'm well, but not sure about thriving! lol But maybe that's a bit much to hope for at my age.

[helvella]

(Apologies for the lengthy post)

Far better to put everything people need to understand your question in one post than to leave lots of information out.