What's going on with my latest resume thyroid lab results?

[Peacefull]

Latest lab results, question.

Hello, I have a question, about my latest lab results.

My T4 Sept 2021 it was 11.6 (7.5 - 21.1) and today is 16.1

TSH in September was 1.11 (0.35 - 4.94) and today is 0.08

T3 September was 3.5 (3.8 -6.0) and today 3.3

Ferritin 72 (23-300) which is low but not low enough for the doctor to want to do anything.

I was on 150mcg Levothyroxine in sept which was increased to 175mcg.

My TSH has dropped and the GP now wants to decrease my Levothyroxine. But my T3 is still dropping.

I feel tired with hair falling out and very dry skin. Put on about 1.5 stones in 4 months which is definitely not down to bad diet. I've been doing more excercise and still gaining.

I am also 2 months into starting HRT. Could this be having an effect?

I have an appointment with my GP on Monday and need to know what to say to her so that they don't just send me away with less Levothyroxine, I definitely don't feel over medicated. Any suggestions as to what I can do?

Thank you in advance for your help.

Regards

Alli.

[greygoose]

Perhaps you could try telling them that it's wrong to dose by the TSH because the HPT axis is disrupted and therefore the TSH is a bad indicator of thyroid status? Or, that you are only over-medicated if your FT3 is well over-range and yours is under-range - I'll repeat that: YOUR FT3 IS UNDER-RANGE. A doctor that reduces the dose when the FT3 is under-range should not be treating hypos because he has no idea what he's doing. But, to be honest, I have no idea how to talk to doctors.

I've been doing more excercise and still gaining.

This could be part of your problem - i.e. poor conversion. Your FT3 is not high enough to sustain any sort of exercise except gentle walking. And, by increasing your exercise you are reducing your conversion, making yourself more hypo - i.e. low FT3 - and therefore putting on more weight.

You do need an increase in dose - and possibly the addition of T3 added to your levo - but you also need to reduce your level of exercise. Weight-gain when hypo is rarely due to lack of exercise, it's due to low metabolism and increased water retention.

[Peacefull in reply to greygoose]

Hi Greygoose,

Thank you for your prompt response. This is good to know. I was along the right lines with thinking high T3 should be the in indication of over medicated. I used to have quite good conversion, now suddenly it's tanked and I'm not sure why? I will lay off the exercise for now. Thanks for the clarification. It's much appreciated. 👍

Alli

[greygoose in reply to Peacefull]

Well, it could be that your conversion has tanked because of over-exercising, or because you're not ingesting enough calories, or your nutrient levels have reduced, or for many, many other reasons that we can only guess at. It happens.

[fuchsia-pink]

You are NOT over-medicated - and you feel bad because your actual thyroid hormones show really really bad conversion - free T4 is a vaguely respectable 63% through range but free T3 is UNDER-range. You need MORE levo not less to try and boost your free T3 level

But you are most likely to benefit from adding some lio to your levo - but this is endo-only, so you will need your GP to refer you to an endo - and not just an endo but one who is receptive to prescribing lio (not all are). You can ask to be referred to pretty well anyone - but they are not oblige to accept you and they should be reasonably easy to get to - so I'd suggest you contact Dionne at Thyroid UK for the list of T3-friendly endos - [e-mail] - and see if there is anyone there who is convenient. And it's worth a new post to see if anyone can PM you with recommendations near-ish to you

In my case, once I was on a suitable lio/levo combo, I lost all the pre-hypo weight and have all my pre-diagnosis energy back too, with good skin and glossy hair [please don't hate me]. I have found lio to be a total life-saver x

[HeartWoman]

I know in my case when I increased my HRT, specifically estrogen, hypothyroidism symptoms became very obvious. I don't have a uterus, so don't take progesterone, which I am glad because it makes me feel awful. I was having a lot of menopause symptoms so I asked to tested and my levels were very low. My GYN doubled my dose and those symptoms are much better.

I am positive I have been hypo for a long, long time, but could not get anyone to look beyond the TSH. I started seeing a Natropath right before Christmas. Based on TSH be higher in the range and FT4 was barely hanging on, and very symptomatic he started me on NP Thyroid. I slowly increased my dose and now on 1 grain (60mg) for a little over a week.

I specifically asked him about the estrogen and thyroid hormone connection and he said they definitely effect each other. When I started NP Thyroid, I got tender breast just like I did when I started estrogen. That has now gone away. What I thought was low estrogen is more than likely hypothyroidism.

I am on a hysterectomy forum as well. Women who take thyroid hormone often state they need to increase their thyroid hormone after starting or increasing their estrogen. Since you recently started HRT, I would not be surprised that it has effected your thyroid and now you need to increase it. Like fushia-pink said, maybe some t3 would help as well.

Hormones are a symphony that need to play well together. I hope you find the right combination soon.

[SlowDragon Ambassador]

Which brand of levothyroxine are you currently taking

Do you always get same brand

Have you had coeliac blood test

Are you on strictly gluten free diet or dairy free diet

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

[Peacefull in reply to SlowDragon]

Thank you Slowdragon, please see my responses below:Which brand of levothyroxine are you currently taking - Wockhardt

Do you always get same brand _ yes i insist on it

Have you had coeliac blood test -- I did some years ago and apparantly fine

Are you on strictly gluten free diet or dairy free diet - no i did try it for about 2 years and never really noticed a difference.

When were vitamin D, folate, ferritin and B12 last tested - Last tested in sept 21 Ferritin 53 (23-300)

Folate 6.2 (207-15.0) B12 - 236 (187-883)

What vitamin supplements are you currently taking - Vit D4000 per day.

[SlowDragon Ambassador in reply to Peacefull]

sept 21

Ferritin 53 (23-300)

Folate 6.2 (207-15.0)

B12 - 236 (187-883)

B12 is far far too low

Folate low

Ferritin could be better

Are you vegetarian or vegan?

B12 and folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Do you have Low B12 symptoms

b12deficiency.info/signs-an...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

ESSENTIAL to test vitamin D at least annually, ideally twice year

vitamindtest.org.uk

[Peacefull in reply to SlowDragon]

Thank you, will be straight online to get those vitamins sorted. thanks for the links.

I am not vegatarian or Vegan, i actually eat lots of meat. I do suffer several of the B12 deficiency symptoms including tinnitus, restless legs, balance issues to name just the main ones.

[SlowDragon Ambassador in reply to Peacefull]

Endocrinologist should have tested for Pernicious Anaemia …..have they

If not get endocrinologist/GP to run test for PA BEFORE starting B vitamins

[Peacefull]

Update- My Endo is happy for me to trial T3 and has suggested I drop Levothyroxine from 150mcg to 100mcg and add in 10mcg of T3. I have done this for the last 3 days but have not slept well for the last 2. I take T4 and T3 when i wake about 6am. I seem to slump a little early afternoon. Its only been 3 days so i'm not sure if there is a settling in period? Any advice would be greatly appreciated.

[SlowDragon Ambassador in reply to Peacefull]

Try splitting T3 into 5mcg twice a day

5mcg waking and 5mcg mid-late afternoon

Generally we recommend starting T3 very SLOWLY ….only adding 5mcg for first week or two

But if you’re already on 10mcg …..just stick with it

Bloods should be retested 6-8 weeks after each dose change

ALWAYS test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

On T3 the day before test split daily dose into 3 smaller doses, spread through the day at approx 8 hour intervals, taking last dose 8-12 hours before test

So take 5mcg waking, 2.5mcg 2pm and 2.5mcg at 9pm

[Peacefull in reply to SlowDragon]

Hi,I took your advice and have been splitting my dose. the first at 6am and the second at midday. I wake up and am ravenous, if i skip breakfast i get really jittery. Do you have any idea what may be causing this? Still tired and feel under medicated.

Many thanks.

[SlowDragon Ambassador in reply to Peacefull]

Better to split appox 10-12 hours after 1st dose

Otherwise too long between midday and 6am

Adrenals take a pounding if increasing dose too fast

Don’t skip breakfast

[Peacefull in reply to SlowDragon]

Thank you, for your advice. Helpfull as always. I dont know what we'd all do without you guys. Is there anything i can do to support my adrenals?