Blood test results and bloating

[Alex_p]

For the past few weeks I've been feeling tired and super bloated - with a bloating that doesn't pass, so I thought I'd check my thyroid levels with MonitorMyHealth. Here are the results:

FT3 4.6 (3.1-6.8 pmol/L)

FT4 14.2 (12-22 pmol/L)

TSH <0.01 (0.27-4.2 mU/L)

An endocrinologist in Romania has recommended in September I take Novothyral, which has 100 T4 and 20 T3 and I've been taking it during weekdays and 125 Euthyrox during the weekend. When I first started to take these I was feeling fine but not so well for the past few weeks, and it feels like it's getting worse. I've put on weight, especially on my belly (I look like I'm 5 months pregnant and I'm not!) and I'm tired.

The test results are kind of baffling, can anyone explain what's going on and if I should return to taking 125mcg Euthyrox?

[SeasideSusie Remembering]

Alex_p

My understanding is that Euthyrox is Levothyroxine and, of course, Novothyral is combined T4 and T3.

You can't take T3 just 5 days out of 7, when taking T3 it has to be a steady daily dose, not missing a couple of days every so often. This is because T3 has a short half life of 24 hours, so the dose must be constant.

Your TSH is suppressed because you are taking some T3, this is just what it does.

When you posted in May these were your results on 125mcg Levo only:

Serum free T3 level 3.9 pmol/L 3.1 - 6.8

Serum free T4 level 17.8 pmol/L 12.0 - 22.0

Serum TSH level 0.01 miu/L 0.27 - 4.2

This showed poor conversion but your Ferritin level was dire at 16ug/L. As you said that you didn't tolerate iron supplements well, did you discuss alternatives with your doctor? That level of ferritin will make you very unwell and thyroid hormone wont be able to work properly and conversion will be poor. What is your current ferritin level?

Rather than taking your current thyroid meds with a fixed rate of T4 to T3, it may be better to take separate Levo and T3 and work on tweaking the doses which gives you optimal levels of both FT4 and FT3. I am on Levo plus T3 and I would be very unwell with such a low FT4, although some people are fine with a low FT4 as long as FT3 is in the upper part of it's range. It's a case of gradually tweaking doses over time to find what is right for us as an individual. It's taken me a few years to get there.

[Alex_p in reply to SeasideSusie]

Thank you for the reply. I did take iron for 3 months, after my previous test results. I did find a type that didn’t make me constipated :)I don’t currently have any vitamin results but I did get blood drawn this morning and they are testing iron, d3 and calcium levels. I will post the results when they arrive (that might take a while since they need to go through NHS and my endo from St Thomas’ Hospital).

I’ll try going back to just Euthyrox and re-check bloods…and obviously take vitamins if needed, I’m currently taking only vitamin D (started 5 days ago) and calcium.

Do you think that the weight gain could be related to low vitamin D or is it just because of low T3 and T4?

[SlowDragon Administrator]

As SeasideSusie says….you can NOT take T3 on some days and not others

When taking T3 it must be exactly same dose every day…..many people also need to split T3 into smaller doses spread through the day

Until you have GOOD vitamin D, B12 folate and ferritin levels you may not be able to tolerate taking high enough T3

Suggest you consider going back to just levothyroxine (euthyrox) and work to get vitamin levels optimal

Retest after 6-8 weeks minimum….If Ft3 remains low in comparison to Ft4 ….Then look at adding just 5mcg T3 everyday

[Alex_p in reply to SlowDragon]

Thank you for the reply and help as usual. I’ll switch back to just levothyroxine and will re-check levels. I’m currently waiting to see the results for vitamin D and iron and take it from there. Is there something else I could do to stop the weight gain or will that get fixed by getting my vitamins to a good place?

[pennyannie]

Hey there again Alex :

Well, your T3 looks a lot better than last time we spoke :

You will need to keep your ferritin, folate, B12 and vitamin D maintained at optimal levels which may mean supplementing yourself as just being somewhere in a range isn't good enough when you haven't a thyroid.

You need to take the same medication every day if it contains any form of T3 as this is an active hormone and yo can't stop, go, stop this powerful vital hormone.

It could just be that the ratio of 1/5 T3/T4 in Novothyral doesn't suit you :

I take Natural Desiccated Thyroid which has a 1/4 ratio T3/T4 and has been used successfully for treating hypothyroidism for over 100 years. It is actually pig thyroid dried and ground down into tablets referred to as grains and contains all the same know hormones as that of the human gland that you now lost.

Another option would be to try taking T3 and T4 - Liothyronine and Levothyroxine seperately to find what mix of T3 and T4 suits you best.

[Alex_p in reply to pennyannie]

Hi and thank you for the help (again). I think I'll go back to just levo for some time, while I work on getting ferritin, folate, B12 and vitamin D at optimal levels. Out of curiosity, was Natural Desiccated Thyroid prescribed by your endo?

[pennyannie in reply to Alex_p]

No, I was refused anything other than T4 - I've had to buy both T3 and NDT experiment myself and I've settled on NDT - now 4 years in, on the same dose for all this time.

I think you'll struggle going back on just T4 especially if you are being dosed and monitored on a TSH as that lowers with T3 and may not bounce back and you may face being told you need less rather than more T4 :

Doesn't Novothyral produce another option with a 1/4 ratio ?

My ferritin took over 6 months to double from 22 to around 44 and a further six months + to tip over 100 where I seem to feel at my best :

Building vitamins and minerals is a slow old business and you need T3 to help your digestion and support you during this period and I think a step backwards should you choose to go back on T4 monotherapy.

[Skylane2]

Dear Alex. Have you seen a doctor for possible GERD ? My daughter in law has a terrible time with this recently. She works for an airline and has always maintained her weight. But a few months ago she started to get this “ bulging tummy” and looks like she could be pregnant ( but she isn’t) her stomach bothers her a lot so she saw a gastroenterologist, and had an endoscopy. (Where they look into your esophagus to see if the valve to your stomach isn’t closing the way it should.) Do you get heartburn and gas a lot? You could have GERD or Barrett’s syndrome. It’s pretty common and there is medicine for it.

[Alex_p in reply to Skylane2]

That’s exactly how I feel too! And I look like I’m pregnant, the weight is all on my tummy. I have a GP appointment in a couple of weeks and I’ll mention GERD, see if I can get an appointment with a gastroenterologist. Thank you for the suggestion.