LowFt3 advice

[Sandytango]

I changed from 100mg eutirox to 40 then up to 80g Metavive III in May

My latest test results are Ft3 2.26, Ft4 0.98 and TSH 2,54

Trend over last few tests are that numbers are steadily dropping. Ferritin 46 stays low despite supplementation. I veer from being full of energy to zombie mode! I get to sleep but wake frequently.

What is advice for low Ft3 and Ft4 and mid TSH?

Many thanks

[greygoose]

Increase your dose! You're obviously under-medicated and the only way to raise your levels of thyroid hormone is to take more thyroid hormone.

[SeasideSusie Remembering]

Sandytango

What is advice for low Ft3 and Ft4 and mid TSH?

As Greygoose says, you are undermedicated.

Why did you change from Eutirox to Metavive?

What were your results on Eutirox - can you please add the reference ranges when giving results because they vary from lab to lab so we can't interpret your results without the ranges.

[Sandytango in reply to SeasideSusie]

Hi there, thanks the ref ranges are FT3: 2,3 - 4,2 FT4: 0,89 - 1,76

TSH: 0,55 - 4,78

I changed to a functional med doc here in Italy who prescribed the Metavive...I felt very tired and inflamed and had low FT3 which my conventional med endo refused to treat just kept increasing the eutirox. My doctor is away for a month, hence asking advice here. The metavive is difficult to judge as no measure of hormones so a bit hit and miss. I will increase!

[SeasideSusie Remembering in reply to Sandytango]

Sandytango

So your FT3 is below range and your FT4 is just scraping into range after 3 months on Metavive.

How does that compare with your results when on Eutirox?

There is a chance that Metavive doesn't work for you, it doesn't work for everyone. You might be better on a combination of Levo and T3.

But see how you go with an increase in your Metavive.

You really need optimal levels of Vit D, B12, folate and ferritin for any thyroid hormone to work properly. Does your FMD check these?

Recommended levels are:

Vit D: 40-60ng/L or nmol/L

B12 - top of range

Folate - at least half way through range

Ferritin -half way through range

What is your FMD doing about the fact that your ferritin stays low. This brings it's own symptoms:

drhedberg.com/ferritin-hypo...

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

Have you had an iron panel and full blood count to see if you have iron deficiency and/or anaemia?

[Sandytango in reply to SeasideSusie]

Thanks you are so helpful. My last levels on Eutirox were:TSH 3,06 (lab range >7 a different lab)

FT4 12,97 (10,6 - 9,4)

FT3 3,68 (4,0 - 8,3)

I did feel dreadful - really fatigued

My last full iron panel was 10 June:

Sidermeria 92 (60-180)

Ferritin 43 (10-291)

Transferrin 220 (250-380) LOW

Vitamin B12 513 (200-910)

Folic 12.3 (>2,5)

Vitamin D improved a lot now 97.1 (was 32 in Feb)

I have some of symptoms of low ferritin esp poor concentration, memory, brittle nails and fatigue (but my sleep quality also poor!). I take an iron supplement. Need to up dose.

I'm in menopause and had very low estrogen, testost and low progesterone when I did a DUTCH test in Feb. On DHEA for this. Was on pill for 37 years so gut messed up too - currently on a detox as stool analysis identified poor gut flora, yeast and Blastocystis - I'm probbly not absorbing nutrients. Have lost weight recently - so many issues complicating it!

Many thanks again

[SeasideSusie Remembering in reply to Sandytango]

Sandytango

TSH 3,06 (lab range >7 a different lab)

FT4 12,97 (10,6 - 9,4)

FT3 3,68 (4,0 - 8,3)

I think for TSH the top of range was 7 so results should be <7 (less than).

The aim of a treated Hypo patient on Levo only is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well.

With those results, the general suggestion you would have received here would be to raise your dose of Levo to get your TSH right down, to get the highest possible FT4 and then see where FT3 was. This would tell you whether you were converting well or not.

Your below range FT3 would have been causing your symptoms.

Changing you to Metavive was probably jumping the gun and you may have been better staying on the Eutirox to see how you fared with a higher dose and if necessary to put you on combination hormone replacement then adding some T3 to Levo would definitely be giving you the hormones, you don't know if Metavive contains any as they don't declare any.

Is it legal to have T3 in Italy?

Sidermeria 92 (60-180)

No idea what this is and Google isn't finding a translation for it.

Ferritin 43 (10-291)

As we know, this is far too low.

Transferrin 220 (250-380) LOW

Again, far too low.

I think this looks like iron deficiency but I may be wrong. Is your FMD looking after this, it desperately needs sorting.

When taking iron tablets these must be taken 4 hours away from your thyroid meds otherwise absorption will be affected. Also take iron 2 hurs away from any other medication or supplements.

Vitamin B12 513 (200-910)

Is this ng/L or pg/ml or pmol/L?

If ng/L or pg/ml (they are both the same) then according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

So you could supplement to raise this and a good quality, bioavailable B Complex will help. Take 2 hours away from thyroid meds.

When taking B Complex we need to stop this for 3-5 days before any blood test as it contains biotin which gives false results when biotin is also used in the testing procedure (which most labs do).

Folic 12.3 (>2,5)

This isn't too bad and the B Complex will help maintain this and may even improve it.

[Sandytango in reply to SeasideSusie]

So helpful thanks. Sidermeria is total serum iron.Yes the B12 is pg/ml so it sounds like I need to supplement that too..

Need to speak to FMD asap....too many different issues! Ive had iron deficiency for years thats how i ended up on thyroid meds in the first place. I supplemented for a long time and it did improve but ferritin levels always low range

I think you can get FT3 here but when I suggested I might need it to my x-endo he just gave me that look...you know the one! Thats why I changed as he didnt want to change anything.