Update - Thyroid Test Results Requesting Dosage Increase

[LeiL]

Update - After seeing my regular Endo last week and her refusal to add T3, I decided to use TeleDoc services of a Health Services that only treat the Thyroid. The doctor decided on his own without me requesting it that I have a conversion issue and prescribed 10 (mcg???) of Cytomel to my current dosage of Synthroid. He stated Armour would not be beneficial to me in that given my situation my T4 would increase.

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I’m currently on 100mcgs of Synthroid but would like the dosage to be raised to help with Lipids—LDL which is high. I had a total thyroidectomy.

Thyroid Results - 13 Sep

TSH 0.91 mIU/L ( 0.40 to 4.50 mIU/L)

T4, FREE 1.6 ng/dL ( 0.8 to 1.8 ng/dL)

T3, FREE 3.1 pg/mL (2.3 to 4.2 pg/mL)

T3 REVERSE, LC/MS/MS 21 ng/dL (8 to 25 ng/dL)

Vitamin D 50

VITAMIN B12 719 pg/mL (200 - 1,100 pg/mL)

FOLATE, SERUM13.9 ng/mL

Reference Range

Low: <3.4

Borderline: 3.4-5.4

Normal: >5.4

Ferritin 84 ng/mL (16 - 288 ng/mL)

[fuchsia-pink]

I'm assuming you'rein the US. I dont know how tricky it is there to get T3 meds, but on the basis of these results, I'd say that's what you nee more than an increase in T4 meds, as free T4 is already near the top of the lab range, but free T3 is only 42% through range.

You don't give a range or unit for vit D - but ferritin is clearly less than half-way through range - can you bear to eat liver?

[LeiL in reply to fuchsia-pink]

Yes, I’m in the US. Due to my age,62, my endo won’t prescribe Cytomel. I think my new cholesterol issue is probably due to the lack of T3. As for Vitamin D—anything over 30 is considered sufficient.

[penny in reply to LeiL]

I’m older than you, LeiL, and take T3 without issue. Why do you think that ‘high’ cholesterol is an issue? Have you read any of the books by Dr Malcolm Kendrick on cholesterol? IMHO vitamin D should be optimal not ‘sufficient’ particularly as low vitamin D is implicated in severity of coronavirus; low levels are also linked to certain cancers and autoimmune issues, from what I have read.

[LeiL in reply to penny]

I believe it is causing problems with my liver.

[penny in reply to LeiL]

It’s a while since I read it but Dr Kendrick’s ‘The Great Cholesterol Con’ is a great read.

[Staffsgirl in reply to penny]

I would also recommend one by Sinatra and Bowden, called The Great Cholesterol Myth. The authors are American…a cardiologist and a nutritionist.

[greygoose in reply to LeiL]

Do you mean you think high cholesterol is causing problems with your liver? Hardly likely, because cholesterol is made in the liver. But, you're right about it being connected to your low FT3.

The liver makes cholesterol because the body needs it - it's not the enemy, it's a necessary component of cell structure. The liver always tries to keep production steady, so that the more cholesterol you eat, the less it makes; and the less cholesterol you eat, the more the liver makes.

However, when T3 is low, the body cannot process cholesterol correctly and get it to the parts of the body that need it, so it tends to build up in the blood.

You need good levels of T3, the active thyroid hormone, at all ages. And, it's low T3 that causes symptoms. I'm 76 and take 50 mcg T3 at the moment (but that might be increased in the future) with no problems at all. What exactly does your endo think T3 is going to do to you? And, how would that be connected to your age? Does he even know what T3 is and what it does? So many questions you need to ask him, because he is keeping you sick.

[LeiL in reply to greygoose]

Yes, and my doctor is female Endocrinologist.

[greygoose in reply to LeiL]

My apologies to her for getting her sex wrong. But that doesn't excuse her ignorance.

My points were that a) high cholesterol is not causing liver problems, and b) there's no reason why you shouldn't take T3 because of your age. Perhaps those points didn't come across very well.

[LeiL in reply to greygoose]

No apology required. i only mentioned it because you would think a female endo would be more understanding. My nails have rigid vertical lines and have started lifting. Also being African American I read somewhere that our TSH should be lower.

[greygoose in reply to LeiL]

No, I wouldn't think that. Not in my experience. My first endo was female - and a professor of endocrinology in a teaching hospital in Paris - and she was utterly useless! No idea how to treat me.

I'm not sure that starting lifting at this point is a good idea, while your FT3 is so low. Maybe wait a while and try and raise it? It won't do you any good anyway, right now, but will put you at risk of torn muscles.

There's no 'should' about TSH for anybody. Once you are on thyroid hormone replacement, the TSH is a bad indicator of thyroid status, the FT3 level is far more important. But, with all levels, you need them to be where you feel well, not where any doctor thinks they should be. And, most hypos need thier TSH pretty low - suppressed even - whatever their ethnicity.

[LeiL in reply to greygoose]

Totally agree about the TSH and like others I get tired of hearing “you’re in range.” The “lifting” I was referring to is fingernails detaching from the nail bed like in Terry Nails. Just wondering if anyone else has this problem. It’s very painful especially at night.

[greygoose in reply to LeiL]

Oh, sorry! lol I thought you meant you'd started lifting weights! lol

Yes, I think lots of people get that with their nails. I know I do. But, I find a nightly massage with hemp balm works wonders on them. Not a permenant solution, I know, but it does help.

[LeiL in reply to greygoose]

I really hope that it is due to the my thyroid issues and not something else.

[greygoose in reply to LeiL]

I don't know of anything else that causes it - do you? Hypothyroidism can be the cause of just about anything that goes wrong with a body, because thyroid hormone is needed by every single cell in your body to be able to function correctly.

However, low thyroid function usually leads to nutritional deficiencies, no matter how good your diet, due to low stomach acid. So, have you had your vit D, vit B12, folate and ferritin tested? Low nutrients can cause their own bunch of unpleasant symptoms!

[LeiL in reply to greygoose]

Yes, included results in original post.

[greygoose in reply to LeiL]

Your B12 and folate look fine, but there's no ferritin result, and no range for the vit D. Are you taking any supplements at the moment?

I would suggest also that you get zinc and copper tested, if you can. Zinc and copper need to be kept balanced, but hypos are often high in one and low in the other - usually it's the zinc that is low. Zinc is also needed for conversion, so really worth getting those tested.

[LeiL in reply to greygoose]

Ferritin 84 ng/mL (16 - 288 ng/mL). For Vitamin D—anything over 30 is considered sufficient.

[greygoose in reply to LeiL]

Well, the ferritin could be higher. Do you eat things like liver or liver paté?

It may be considered sufficint for vit D, but very much doubt if it is.

Do you take magnesium? Most people are deficient in magnesium but not point testing because the tests aren't reliable due to the way the body handles magnesium. It might be an idea to try taking some, see if it helps.

[magsyh]

Have you tried selenium for T3 conversion? Your Rt3 is high so I wouldn't add anymore T4. I found if I kept T4 a bit lower with the use of selenite I got a far better T3 conversion rate. If it doesn't work theñ you need T3 regardless of age. I'm 63 and would use it if I needed it.

[LeiL in reply to magsyh]

Thank you. I just read that selenium and zinc may help increase my T3.

[Stourie in reply to LeiL]

Dr Peatfield told me that selenium helped the t4 to convert into t3. It might be worth giving it a try. Jo xx

[Batty1]

Why did you have you thyroid removed? I had my thyroid removed for cancer 5 years ago and have always been on a combo of T3/T4 and it has done absolutely nothing to my cholesterol levels in fact my cholesterol levels over the past couple of years have gone through the roof but I also have a lot of other health issues that I developed since losing my thyroid and take medication for those issues. Anyway if you don’t have a heart issue then a small dose of T3 is not going to harm you if anything it will improve emotional health (at least it has for me). Maybe you need to see another Endo I had to fired 7 in past 5 years because they just would refuse to do anything to see if it improves my issues.

[LeiL in reply to Batty1]

Stupidly had thyroid removed due to goiter and suspicious nodule in 2008. I hoping that when I see her tomorrow she will be willing to prescribe at least 5 mcg of Cytomel. I’m having bouts of moderate depression.