I’d so appreciate your comments because I’ve been managing Hashimoto’s with glandulars only so I’m a bit nervous about taking levo
I’ve précised the post once as I thought perhaps it was ignored because it was rambling and unreadable. If this is the case with this third attempt please just say so
The numbers to the left of the brackets are current. Numbers to the right are April 21
TSH 0.03 (0.35 - 5.5) 0.82
FT4 12.8 (10.5 - 21) 9.9
FT3 5.5 (3.5 - 6.5) 4.7
Ferritin 73 (10 - 291) 76.9
B12 661 (211 - 911) 507
Folate 9.91 (>5.38) 13.42
D3 is lately extremely high so will be tested next time
C reactive <4 (0 - 6) <4
Ferritin 73 (10 - 21) 76.9
Iron 23.6 (10 - 34) 20.8
Transferrin 2.84 (2.5 - 3.8) 3.36
% iron saturation 37 (16 - 50) 27
Endo prescribed levo months ago but I never took it, preferring to increase glandular dosage and as you’ll see my current levels have improved but T4 is still low so because I prefer glandulars, gp was happy for me to continue with them suggested introducing levo gradually to raise T4. The objective being to address sleep and weight issues and other niggles
Week 1 Mon 50mcgs
Week 2 Mon 50mcgs Weds 50mcgs
Week 3 Mon 50mcgs Weds 50mcgs Fri 50mcgs
And if I feel well on this regime then to remain on week 3 until followup tests 6-8wks hence
I’m really grateful that she’s open to me remaining on glandulars and although she understands my concerns she says they’re unfounded for now and to wait and see. My concerns being: could taking levo potentially worsen my insomnia because assuming that my T4 conversion ability is reasonable, won’t my Ft3 (80% through range) also rise and isn’t it already high enough to be addressing weight problems? Should I go more slowly and maybe take a lower levo dose or possibly reduce glandular dosage? I’m so nervous because although I still have awful sleep problems the severity has recently improved and I’m starting to feel hopeful again. Yes the weight is a problem and I’m particularly worried about that because my entire paternal family has diabetes, many of whom have suffered leg amputations and although I desperately want to lose some weight I don’t want to go back to being a sleep-deprived wreck
I’m asking on here because although she’s reassured me, is she correct?
I’ve also included nutrient and iron overload studies for comment please but can put those in separate post if preferred
Thank you
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Noelnoel
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Noel You may not have had responses because most of us on here are on hormone replacement rather than a glandular (which is not hormone replacement as we understand it).We are not medically trained but offer our experiences and understanding.
Few on here will have had experience of glandular. What you are asking isn't about levo only - it is about adding levo to a glandular and the dosing of glandulars.
Glandulars have no declared hormone content so it would be very difficult to suggest a levo dose to go in tandem with a glandular dose.
All I’d really like to know is: bearing in mind those principles, potentially, could my Ft3 rise further because the extra T4 from the levo has been successfully comverted?
I of course understand that hopefully, my T4 will rise as a result of taking levo, that’s the objective but a “side-effect” if you will, could be a further raised Ft3, right?
If you don’t feel able to comment, I quite understand but whilst I’ve got you here, are you able to comment on nutrients and iron overload studies that I’ve included in the post?
Lol, I think I’ve actually answered my own question but any of your thoughts - and I absolutely appreciate they’re just your thoughts - would be welcome because it’s always really useful and helpful to hear other opinions and ideas
Metavive is something we understand on here as several use it. when you said glandular I thought you meant some thyroid support tablet which has no declared hormone content.I've nothing to add to what the others have said.
Im not by any means an expert but as no one else has replied.I dont understand why you want to raise T4 as its T3 which is the important hormone. I used to take levo and never felt really well on it, slept really badly for years, now I only take metavive, have low T4 and feel very well on it and sleep really well, though all of us are different. How do you feel? This is the important question as your thyroid numbers look ok to me. What was your last vit D result?
Have you tried magnesium which is good for sleep, either tablets or external cream or baths.
Re your weight I think maybe there is a problem with your diet. Are you Gluten Free? This is strongly recommended for hypothyroid. I am completely GF, and also keep to a low carbohidrate diet,no sugar or much fruit as I have fructose intolerance. I eat almost no pre-prepared food, everything cooked from fresh or frozen whole foods, meat/fish, eggs,veg and good fats. I do intermittent fasting once or twice a week, (skip breakfast, just have coffee)and have very gradually lost 10k over the last couple of years. Probably could have lost more but its not a priority as happy with my weight now. Hope some of this helps, PM me if you want.
Hi E_lizab8 and thanks for taking the time to help
I dont understand why you want to raise T4 as its T3 which is the important hormone.
I’m guessing that she’s hoping the levo (T4) will successfully convert to T3. There are so many questions I could’ve asked her but she caught me on the back foot as I really wasn’t expecting her to suggest combing the two
I’m feeling slightly better since sleep improved but I still sleep abysmally but as greygoose just pointed out my calculation of Ft3 being 80% through the range is wrong. It’s 66.7% so it could do with being raised a little. On the while I actually feel well, amazingly but I’ve had insomnia for 22 years so perhaps my body has adapted. I do think though that in time my health will deteriorate if I don’t get it sorted soon and my thyroid hormones too
Yes, I take a broad-spectrum magnesium as well as re-mag chloride and I think this has helped. I also have recently started melatonin which seems to be helping me get a deeper sleep, as I feel slightly groggy on waking but in a good way and it soon lifts
I’m on and off the waggon with gluten-free but when I don’t eat it, after about two weeks I’m bloat-free, gas-free and seem to have less fluid retention so my weight decreases a little. I usually manage about six months of gf but I always relapse. I’m working on it. As for diet, it’s excellent. Only organic meat, fruit and veg and everything I eat is homemade. I don’t touch pasta and the only refined carbs I eat is bread from the local baker. And therin lies my weakness, he’s a master baker and his French bread is amazing
My last D3 was 150 something
You seem to be doing really well and I’m really grateful for your comments. I really like that you reminded me about intermittent fasting, I was doing that last year with great success but then I started reading on here about how bad it is for us hypos and I got scared. I think I might start again though
greygoose, you’re absolutely right. I must’ve either read or entered in the numbers incorrectly. This is something I often do with numbers
Ah, well then, that throws a completely different light on things! What are your thoughts on the way to go? Do you think her regime suggestion a good one?
Oh, I know what you mean about numbers! lol I have that problem, too.
As tattybogle says, her regime is a bit weird, and I don't think I'd want to start that low, but... It's you that has to decide. Personally, I'd just start on 50 a day and see how it goes.
greygoose, do you mean that “personally” you’d take 50 every day? If so, can I ask why? I’d like to try to understand some of the experiences some of you have had with varying doses. And yes, of course I appreciate that it’s different for every single individual
Yes, that's what I mean. Why? Because to begin with, we have no idea how much hormone you are getting from your glandular - if any - nor if your thyroid is still working and producing hormone.
The point of glandulars is not really to be used as a thyroid hormone replacement. They say that 'like helps like', so taking ground up thyroid - even without any hormone - can help the thyroid work better; ground up adrenals can make the adrenals work better; ground up pituitary... You get the picture. That's the theory, and it seems to help some people but not others.
So, imagine there is no hormone in your glandular, and it's just your thyroid working better and producing the hormone we see in your blood test results. If you start taking a very low dose of exogenous hormone, it could reduce your thyroid's out-put, or even stop it completely, but not be enough to compensate. 50 mcg T4 is probably enough not to cause that problem, and might actually increase your levels. That's my theory, anyway. What is your doctors theory for starting on such low doses?
Hi noelnoel . i don't use glandulars , so can only be of limited help .. but to give you some perspective .. the dose of levo suggested by GP is very very tiny , and it is being started off in an even tinier dribbble . 150mcg a week is only about 21mcg a day .
I'd be surprised if that dose would have much effect on your current T3 level.
To be honest .. i'd be surprised if it had much affect on anything. But the only way to find out is try it for at least 6/8 weeks and then see what it feels like for you. No one can really predict what will happen to bloods/symptoms on a changed dose. Everyone is different.
As for going more slowly .. i'm not sure you could go much slower than she's suggested....
but having said that ...i do think it's slightly odd to have you doing it using 50mcg tablets... she could for example have prescribed 25mcg tablets and got you to take half each day ie 12.5mcg everyday.. which rules out any chance of you feeling different on the days when you get 50 to the days when you get none ... a lot of people wouldn't feel the difference due to Levo's long half life in the blood .. but given that you seem to want to do this extremely cautiously .. it seems a bit odd to be doing 50 one day then nothing for the weekend.
tattybogle, now that you’ve put it like that it does seem odd. Perhaps it was because she knew I already had the 50mcgs that the endo prescribed and I never took. It’s a shame I was so unprepared, I didn’t expect her to make any such suggestion so I had no questions at the ready and because my brain is so slow at the moment it was only afterwards that I started to wonder about other options
I’m undecided about what to do because I’ve had so much good advice today on this forum some of it conflicting but all of it good. I think I like your idea of taking a smaller dose every day. Proceeding cautiously appeals because I seem to be so sensitive to changes and I always miss my “sweet spot” and feel over-medicated quite quickly, which is strange because I still don’t lose any weight!
Greygoose and tattibogle have a point and they're so much more experienced than me, it all depends on whether you convert well or not, I obviously dont as my T3 was never very good on levo. As yourT3 not so high as you thought if it was me I would just add in an extra metavive once or twice a week depending on how you feel, but then Im biased as levo didnt agree with me.
As I understand it, all supplements (available without a prescription) are considered glandulars, including Metavive. That simply means they contain gland extracts but have no declared hormone content as that would make it impossible to sell them OTC.
As glandulars do not contain declared amounts of T3 and T4, the only way to know if you are getting enough would be to go by symptom-relief. That is how doctors used to treat patients back when they were on NDT, before the TSH test was invented and levothyroxine became the standard treatment. You will likely find that where you feel best correlates with FT4 levels at least 50% through range and FT3 levels in the top third of range. Some like both their free Ts in the upper third of range range, but sometimes taking T3 will lower FT4 levels and that is not a problem if you don´t feel undermedicated. The TSH is likely to be very low or suppressed when taking T3. So, lower FT4 happens on both glandulars, synthetic T3+T4 treatment and prescription NDT and is caused by the direct T3 you are getting.
Some people combine levo with T3 and NDT, and there is no reason you cannot combine levo with glandulars if you feel you need your FT4 levels higher. The problem with NDT and glandulars is that you will be getting more T3 and T4 every time you increase the dosage. So, if you need more T4 but not more T3, you would need to add levo to your glandular. But, low FT4 levels in themselves do not automatically mean you are hypothyroid if your FT3 levels are optimal, as T3 is more active than T4 .
Also, when taking anything containing T3, less T4 will be needed for conversion, which is why low FT4 levels are not automatically problematic on combination treatment.
First, that so many companies claim their products to be "hormone free", "thyroxine free" (or whatever precise form of words they use). Yet, at the same time, claim nothing has been removed and they have done everything they can to preserve the original constituents of the glands.
Second, some companies claim (implicitly or explicitly) that their products are not assayed for hormone content. Thus they could vary wildly. On the other hand, steps such as blending could mean they are quite stable across batches.
Third, they appear to make some questionable choices about excipients.
Basically, we do not know enough and marketing language seems to dominate most of the companies involved.
I guess that stating that the products are "hormone-free" or "thyroxine-free" is a way of being able to sell them as supplements. But I have not found any way to remove hormones from thyroid (or any other) tissue, leaving only enzymes. The same applies to adrenal glandulars sold as "cortisone-free" and ovarian glandulars marketed as "estrogen-free". As you say, the hormone content is now known and most likely not standardised. But how would you remove just the hormones, leaving everything else intact???
Might well be possible to dump them in strong acid or alkali (or some such indiscriminate and potent approach) and achieve that but it would likely affect everything.
I chose Metavive precisely because the only excipient/additive (don’t know the difference) is rice bran and the fact it’s the “whole” gland and not just an extract. I know that it raises my thyroid hormone levels because my endo tested it by looking at my levels whilst on it and then stopping for a month and testing again. I didn’t need to see test levels to know that it works because my weight gain during the month without it attested to that
I do agree in general though with all of what you say, except I always understood “hormone free” to mean without the use of growth promoting hormones
Is it you hellvella who understands iron, ferritin, etc? If so, would you mind taking a look at my latest results and letting me know what you think. The range for ferritin should read 10 - 291. I’ll try to edit it
I do agree in general though with all of what you say, except I always understood “hormone free” to mean without the use of growth promoting hormones
I agree that the wording can be interpreted that way. But without clear wording, either interpretation is possible - and more likely to suggest the thyroid hormones if you see it alongside products that say "thyroxine-free".
On the basis that growth-promoting hormones are illegal in the EU (and still the UK, I think), any product that contains them would automatically be disallowed. Might not stop them being sold, but...
I’ve checked the wording and it does actually say “without growth-promoting hormones” which given that it’s illegal here I suppose it’s a bit like saying gluten-free when we’re talking about a product such as porridge. As you say, it’s all about marketing but by stating it’s free from growth hormones you could argue that they’re underlining this fact in order to emphasise that it’s not free from all hormones without explicitly stating that it still does contain T4 and T3. Maybe …
The rules here seem to have moved in the direction of not allowing "obvious" free-from claims. E.g. bottled water that is fat-free, gluten-free, dairy-free, etc.
No, "hormone-free" means without thyroid hormone when we are talking about thyroid glandulars. That makes it easier to sell the product as a supplement. If the manfacturer is referring to growth hormone, it usually says "from cows raised without growth hormones" or something like that. That, along with the risk of BSE, is the reason most if not all manufacturers of bovine glandulars use raw material from BSE-free countries (New Zealand and Argentina). Those countries also ban the use of antibiotics and growth hormone, so the manufacturers can claim their products are "purer".
I’ve looked at the manufacturers details and as far as I can see it doesn’t claim to be entirely hormone free, only “without the use of growth-promoting hormones” but I’m a bit slow and could be missing something here
No, you´re right. I get the impression they are stressing that the animals are raised in a natural environment, so that consumers taking their products know that the animals have not been fed growth hormone or antibiotics.
Plus, Metavive and Adrenavive only contain glands from animals raised in the UK, so that automatically makes them growth hormone-free as GH is still banned in the UK (as pointed out by helvella ). That is one of the problems with the trade agreement with the US where growth hormone is used (along with antibiotics).
Some people combine levo with T3 and NDT, and there is no reason you cannot combine levo with glandulars if you feel you need your FT4 levels higher. The problem with NDT and glandulars is that you will be getting more T3 and T4 every time you increase the dosage. So, if you need more T4 but not more T3, you would need to add levo to your glandular. But, low FT4 levels in themselves do not automatically mean you are hypothyroid if your FT3 levels are optimal, as T3 is more active than T4
Thank you for that information, that’s given something to think about
As greygoose rightly corrected, my Ft3 is 66.7% through the range and not 80% as I stated. This may be perfectly adequate for many but it seems not for me, so if these were your numbers (Ft4 is I think 29%) and you were taking metavive and you have stubborn weight gain and insomnia, which scenario would you choose out of the two I’m going to present:
Would you gradually raise your porcine met (more T3), given that your Ft3 is only at 66.7%, in the hope that it would raise both Ft3 and Ft4
Would you gradually raise your bovine met (more T4), given that your Ft4 is only 29%, in the hope that not only would your Ft4 rise but so would your Ft3 if we can assume you’re converting T4 reasonably well
And on a separate note (though not entirely)
Also, when taking anything containing T3, less T4 will be needed for conversion, which is why low FT4 levels are not automatically problematic on combination treatment.
Based on this, does that mean the T4 in any product would automically just rise then if less of it converts and so would it be more prudent to take the product with less T4 and by product I mean bovine metavive, which has a lower ratio of T4
I ask this because if I understand what you’re saying, if I want to raise both Ft4 and 3 but I want to raise Ft4 more than 3, then I should bear in mind that taking a product with higher T4 will raise both my Ft4 and 3 but my Ft4 will be raised by more because much of it will be redundant because of the T3 content in the product
I’ve got a couple of questions about introducing the levo but will wait to digest what you say about the above. That’s if you’ve time. I’m assuming rather a lot, sorry
Using T4 or syntetic T3 along with NDT allows you to independently fine tune the ratio of both hormones, compared to the static ratio in NDT (which does not suit everyone).
The more I read about combination treatment (with either NDT or synthetic drugs) the more I get the impression that the more T3 you are getting from the meds, the less T4 is needed for conversion (logical as you are no longer totally depending on conversion but are getting some direct T3). So, the body increases rT3 conversion to get rid of the T4 no longer needed.
Logically, if you take more T4 than you need, the body will increase rT3 conversion. That was once considered a problem as it was thought that caused rT3 dominance, but newer research shows that rT3 is inactive and does not block the action of FT3. rT3 conversion is just the body´s way of disposing of unwanted T4.
So am I to understand that should I overdo T4 - not that I plan to but this is uncharted territory for me and could happen - that my body will convert the excess T4 to rT3 which has no use other than to be safely disposed of? Have I got that right and if so, rT3 doesn’t just sit there in body accumulating and causing harm?
Apologies if it seems a silly question but I’m learning so much today
Thank PurpleCat71, that’s a must-read. Most of it is impossible for me to understand/unravel at the moment but I can see that there’s a lot of information in there that will help me if I keep going back to it and reading tiny excepts at a time
It’s worrying how so many of us are ignorant about our condition and how it allows the “experts” to meddle and muddle their way through
This section of the article is especially interesting:
As a person’s T3 intake and T3:T4 ratio intake increases, one must permit their FT4 to drop to accommodate the T3, or you will overload them with “net T3 supply” in tissues.
On the other hand, if you lower T3 dosing, you will need more T4 in blood to deliver more T3 to cells within T4 “delivery packages” that provide slow-release tissue T3.
In combination therapy, T3 sufficiency is only obtained by flexibly adapting ratios and not fearing statistically-predetermined boundaries. The current paradigm fears and prohibits the crossing of reference range boundaries that often need to be the most flexible in T3-T4 combination therapy:
Unnecessary Fear #1) The upper boundary of the Free T3 reference range (which is not hyperthyroid if FT4 is considerably lower),
Unnecessary Fear #2) The lower boundary of the Free T4 reference range (which is not necessarily hypothyroid if Free T3 is considerably higher), and
Unnecessary Fear #3) The lower boundary of the TSH range (which is not necessarily hyperthyroid if T3 dominates over T4 in a high T3:T4 ratio and both are within reason)
Some people do need t4 higher in range when on Metavive or t3 and add levo.( Not me I'm afraid, can't tolerate t3 or t4.)SeasideSusie is I believe on t3 And t4 as she needs t4 higher. My memory is shot but I am pretty sure that is true😊
humanbean is very knowledgeable on iron levels so best place to advise on those. X
Both, I started on the reformulated version at a particularly hectic time and didn't realise for a few weeks! Luckily no difference for me at all thank goodness.
Can you describe how you think Metavive is "smoother" than Thyroid-S? Many seem happy on TS but it does contain a lot of fillers...I have been wondering if that affects its absorption in some people.
Not sure how to describe... Thyroid s changed my life in a good way. No cure for fibro, no difference to pain or fatigue but stopped getting worse which to be honest is all I hoped for. Okay, always felt a slight...tightness... in my chest, a slight edginess? Didn't really register it until it went. Metavive, after finally finding the right dose for me, gives me similar numbers to TS but no 'tightness'. Hmm, clear as mud
Some people have reported side effects such as the one you mention, leading to speculation about a possible reformulation...but I don´t think that has been confirmed by the manufacturer. But I have seen statements such as "it no longer seems to work the same", which is exactly what happened after Armour and other brands were reformulated.
PurpleCat71, thank you. It would be amazing if the manufacturers had a re-think and subsequent reverting to the previous formula. I wonder why manufacturers try to fix things that ain’t broke. Maybe they thought it would have wider appeal with nucleotides or perhaps it’s a cheaper option, which, if the case, it certainly isn’t reflected in the retail price!
Did you see my question at the end of the last message I sent you about an hour ago?
I’ve sent the entire post again but underlined the question part
So then PurpleCat71, going back to:
Some people combine levo with T3 and NDT, and there is no reason you cannot combine levo with glandulars if you feel you need your FT4 levels higher. The problem with NDT and glandulars is that you will be getting more T3 and T4 every time you increase the dosage. So, if you need more T4 but not more T3, you would need to add levo to your glandular. But, low FT4 levels in themselves do not automatically mean you are hypothyroid if your FT3 levels are optimal, as T3 is more active than T4
Thank you for that information, that’s given me something to think about
As greygoose rightly corrected, my Ft3 is 66.7% through the range and not 80% as I stated. This may be perfectly adequate for many but it seems not for me, so if these were your numbers (Ft4 is I think 22%) and you were taking metavive and you have stubborn weight gain and insomnia, which scenario would you choose out of the two I’m going to present:
Would you gradually raise your porcine met (more T3), given that your Ft3 is only at 66.7%, in the hope that it would raise both Ft3 and Ft4
Would you gradually raise your bovine met (more T4), given that your Ft4 is only 29%, in the hope that not only would your Ft4 rise but so would your Ft3 if we can assume you’re converting T4 reasonably well
And on a separate note (though not entirely)
Also, when taking anything containing T3, less T4 will be needed for conversion, which is why low FT4 levels are not automatically problematic on combination treatment.
Based on this, does that mean the T4 in any product would automically just rise then if less of it converts and so would it be more prudent to take the product with less T4 and by product I mean bovine metavive, which has a lower ratio of T4
I ask this because if I understand what you’re saying, if I want to raise both Ft4 and 3 but I want to raise Ft4 more than 3, then I should bear in mind that taking a product with higher T4 will raise both my Ft4 and 3 but my Ft4 will be raised by more because much of it will be redundant because of the T3 content in the product
I’ve got a couple of questions about introducing the levo but will wait to digest what you say about the above. That’s if you’ve time. I’m assuming rather a lot, sorry
You are correct fibrolinda . I take Levo plus T3 and if my T4 is low in range I am quite unwell. My last two tests have shown FT4 at 18.5 (12-22) and FT3 at 6.0 and 6.3 (3.1-6.8) and this seems to be where I feel optimally medicated thyroid-wise.
I couldn't function properly when my FT4 was 9.2 (7.0-17.0) with a GP test (and this lowered my FT3 as well). Long story but I lowered my dose to prove a point and have it recorded on my records at the surgery (hopefully that has been done). It took me about 7 months to raise my levels again and feel properly well - I wont be repeating that experiment!
Do you also feel unwell when your Ft3 is reasonable but Ft4 low
It has taken years, when feeling unwell, of tweaking doses to realise that both need to be fairly well balanced in the upper part of ranges.
Even 18 months into my Levo/T3 journey my result was FT4 at 47.00% and FT3 at 73% and it's now 4 years later and I think I've now found my optimal doses, lots of very fine tuning in the meantime to find this.
Ah, got you. Yes, that’s exactly what happened to me when nucleotides were added, in addition to sweating profusely, headaches and heart irregularities and exacerbating my sleep issues. How lucky you are that you’re not affected by this. For me, it was a wonderful product before that
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Just thought I’d do a new post for understand I managed to get a copy of my results
Why is my body reacting like this? Levo & NDT. Please help
I Would Like Some Advice Please? Re: Blood Test After Levo Reduction.
Can someone help me read my thyroid results please?
