Advice please

[loutomaio]

I History:

50 yr old female on 60 Armour for 2yrs, still feeling poorly with low t4, so DR bumped me up to 90 armour and 8 wks later I feel better, but still not great. these are my current lab results: Any thoughts would be appreciated!!!

Low WBC, low Neutrophils

TSH 1.500 uIU/mL 0.450-4.500

Thyroxine (T4) 3.6 Low ug/dL 4.5-12.0

Free Thyroxine Index 1.0 Low 1.2-4.9

T4,Free(Direct) 01 0.74 Low ng/dL 0.82-1.77

Reverse T3, Serum 7.3 Low ng/dL 9.2-24.1

Triiodothyronine (T3) 124 ng/dL 71-180

TPO <9 IU/mL 0-34

Thyroglobulin Antibody <1.0 IU/mL 0.0-0.9

Iron Bind.Cap.(TIBC) 214 Low ug/dL 250-450

UIBC 129 Low ug/dL 131-425

Iron 85 ug/dL 27-159

Iron Saturation 40 % 15-55

[radd]

loutomaio,

You are under medicated. The test result to monitor is 'FT3' and yours is still under-range. Also, TSH is usually well below 1.0 when medicating NDT because of the contained T3 within. Low FT4 is initally of little consequence until NDT dose is optimised, and only then if you are still symptomatic with iron & nutrients optimised, would you consider replacing low FT4 levels.

Seurm iron is 44% through range and yet your saturation rate is 40% which is higher end. This means your transferrin level (protein carriers) are low, which could be due to poor production of transferrin by the liver (where it's made, but which gets sluggish with inadeqaute thyroid hormone levels) or excessive loss of transferrin through the kidneys into urine (which also happens with inadequate thyroid hormone levels, much like TBG which are thyroid hormone protein carriers). Low transferrin levels impair haemoglobin production & so may lead to anemia (because to make haemoglobin you have to have iron which is transported by the transferrin).

WBC can eventually become low after years of Hashimotos, as can thyroid antibodies. Have you tested positive in the past?

[loutomaio in reply to radd]

Thank you Radd!

No, I've never seen anything with the antibodies off. I actually forgot to test the free T3 this last time, but in April it was (T3), Free 2.4 pg/mL 2.0-4.4, I am going to retest this week

[pennyannie]

Hello Loutomaio ;

When taking NDT - the aim is to track the free T3 and not the free T4 .

T4 is a storage hormone and needs to convert to T3 in the body :

Optimal conversion when on NDT will show as a higher T3 and likely a lower T4 than when on other forms of thyroid hormone replacement.

When on synthetic T4 - Levothyroxine my T3 was at 25% and my T4 at 110 % through the ranges :

When on NDT my first results on NDT showed a T3 at 110% and a T4 at 25% through the ranges.

With NDT you dose to the relief of symptoms and not a blood test - and you dose low and slow in 1/4 grain increments over a period of weeks until you sense you have taken a little too much and have become a bit anxious, and uncomfortable in yourself.

You then simply drop back to the previous weeks dose and take a blood test 6- 8weeks later letting that dose bed in :

If your T3 hasn't moved much from your original bench mark readings, and you are still with symptoms it's likely NDT is not the best option for you at that point in time.

I found my temperature rose from 35.4 to 36.6 : my blood pressure and pulse remained stable and the majority of my symptoms of hypothyroidism especially those of brain and cognitive functions were eradicated.

The blood test and ranges and guidelines were all introduced to be used with Big Pharma's synthetic thyroid hormone replacement medications and NDT was successfully used for over 100 years prior to the science of blood tests analysis and when doctors listened to their patients and medicated accordingly.

No thyroid hormone replacement works effectively until you ferritin, folate, B12 and vitamin D are maintained at optimal levels - is something that needs to be checked out ?

[loutomaio in reply to pennyannie]

Thank you thank you, that is all extremely clear now