Once you find your optimal level, does it remain the same?

[Xheila]

I am taking NDT and I was feeling optimal when my FT3 was 4.4 (2.3-4.2 pg/mL). Will my 'optimal' always be right around this level or will it fluctuate over the years?

[humanbean]

I am taking NDT and I was feeling optimal when my FT3 was 4.4 (2.3-4.2 pg/mL). Will my 'optimal' always be right around this level or will it fluctuate over the years?

I don't believe it will stay the same, but I have no proof other than my own experience.

I spent several years unable to tolerate Levo so I ended up on T3 only. Eventually the T3 only wasn't working for me so I experimented with Levo again (for about the tenth time!), and finally I managed to tolerate it quite well.

I am now on a combo of Levo and a small dose of T3.

I think the differences in tolerance levels were caused by my nutrient levels - I've optimised them as well as I can, and as many as I can. I've also found a supplement that helps my high cortisol problems.

[Hidden in reply to humanbean]

HB,Can I ask what that supplement is for high cortisol?

[humanbean in reply to Hidden]

Holy Basil. I use this one :

dolphinfitness.co.uk/en/swa...

[Hidden in reply to humanbean]

Thanks!

[Xheila in reply to humanbean]

Thanks. I am trying to optimize all my nutrients, but something is still off because I'm experiencing leaky gut once again. When my nutrients are all optimal, I can tolerate supplements and foods much better as well.

[humanbean in reply to Xheila]

Do some research into L-Glutamine. It helps some people with leaky gut. It comes in powder form or in capsules. The powder form is much better value than capsules and means you can tailor your dose.

It must be taken away from anything hot, such as hot drinks or hot food because heat destroys it.

It has no flavour so can be put into water and drunk.

[PixieElv in reply to humanbean]

Hi humanbeanDo you have consistently high levels of cortisol or does it fluctuate over the day/night? And I assume Holy basil doesn’t interfere with Levo?

Thank you

[humanbean in reply to PixieElv]

Do you have consistently high levels of cortisol or does it fluctuate over the day/night?

In healthy people cortisol should have a circadian rhythm. In people with Cushing's Disease/Syndrome the body loses that rhythm in cases of Cushing's, and cortisol output will end up as a flat(ish) line at a high level.

I have done saliva cortisol testing in the past. When I did it my results had a circadian rhythm but all results were well above the reference range in 3 out of 4 of my saliva samples. In the remaining sample my result was about 90% of the way through the range.

I've copied a rather cartoonish graph of cortisol output into this post.

And I assume Holy basil doesn’t interfere with Levo?

I take Levo in the morning and Holy Basil in the evening, so I've had no issue with interference. When I first started taking Holy Basil I was taking a large dose but over the years I have gradually been able to take less and less and now I only take 1 capsule a day most of the time, and just occasionally take 2.

Cortisol circadian rhythm and what to expect in Cushings

[PixieElv in reply to humanbean]

thank you. That’s really useful

[jgelliss in reply to humanbean]

That's so interesting humanbean. After doing so well on T3 sole and now T4 and T3 combo is working for you now. May I ask you what dose of T4 and T3 work well for you now? What do you attribute this change to?

[humanbean in reply to jgelliss]

I don't take the same dose of Levo every day, but on average I take 89mcg of Levo per day. I also take 12.5mcg T3, but my TSH is too high and I'm rather lethargic and apathetic so I'll be raising one of them (haven't decided which yet, and I want to test more first).

I mostly attribute this change to better nutrient levels.

[jgelliss in reply to humanbean]

Thank you so much . I had a hunch that more optimal nutrients help with tolerating thyroid hormones better. I can now tolerate more T3 because of my supplementing Iron. Yet no Dr ever suggested supplementing Iron knowingly that my Iron levels where so low. Thank you for sharing. It's so very helpful.

[humanbean in reply to jgelliss]

I wrote this thread that you might find of interest :

healthunlocked.com/thyroidu...

[jgelliss in reply to humanbean]

Thank you for this great reminder of a great and very valuable post. It's very sound advice if possible to prior to dosing with thyroid meds to have the nutrients up to par. But it's not always possible. Even after my TT no suggestions nor advice was given for nutrients. Thinking back now I don't think that any labs where done back then on vitamin D ,Iron/ferretin,B-12/folate etc. Only after joining this great forum I learned how important nutrients are to make our thyroid meds work better for us. As well as going gluten dairy free for Hashimoto.

Thank you humanbean for all your valuable posts and all the wonderful members ❤ on this forum that contribute to our well-being. We are so much better for it.

[Imaaan in reply to jgelliss]

Beautiful sentiment

[Imaaan in reply to humanbean]

Such a gem of a post, thank you for the valuable reminder

[Hidden]

No, not in my experience (and the same goes for levo as well). Many women find that they need a little less after menopause as it´s common to be estrogen dominant in pre-menopause (and estrogen can increase the need for thyroid hormone). My own experience is that physical activity also plays a role, as do optimal vitamin and mineral levels. So, many factors will affect how much you need. I find it harder to fine-tune NDT compared to levo, probably due to the fast-acting T3.

[Xheila in reply to Hidden]

Thanks, I guess nothing with our thyroid issues is ever quite so straightforward as we might wish. It makes sense that everything works together.

[Alejandrita17 in reply to Xheila]

How much thyroid hormones you need will depend on your energy demands. It's not the same in winter as in summer, and it varies according to your physical activity, diet, nutrient levels, estrogens, and so on. Our bodies don't always need the same amount. That's why TSH also fluctuates.

[tattybogle in reply to Alejandrita17]

I totally agree , if we could get by with a 'standard/stable' level of thyroid hormones for life i doubt the HPT axis would have evolved to be so fiendishly complex. we'd just have a gland that chucked out a regular amount of T4 and that would be that.

Like you say , it has to be able to compensate effectively for winter /summer/ arctic / sahara/ pregnant / non pregnant/ menstrual hormone cycles/menopause/ training for a decathalon while running around after 4 kids under 10 /or sitting on your ass for 6 months .. not to mention figuring out what to do with your fT3 level when you become acutely sick/ or are trying to survive a famine.... etc etc etc.

I definitely needed /used less since i went through the menopuase.. even though my activity levels was the same.

Nowadays a need slightly less again, because my physical activity demands are a lot less than when i was working a very physical job.

I expect if i moved to Murmansk, i would need more again.

[Alejandrita17 in reply to tattybogle]

Exactly!

[pennyannie]

Hello Xheila :

Conversion of T4 into T3 can be compromised by low levels of ferritin, folate, B12 and vitamin D , inflammation, any physiological stress ( emotional or physical ) , dieting, depression and ageing - so yes, the goal posts will more a little as life dictates your requirements.

Just remember that this range you are referring to was introduced to be used alongside Big Pharmas T3 and T4 and not NDT - as with NDT you dose to the relief of symptoms as it was successfully used for over 100 years to treat hypothyroidism and long before the ' science ' of blood tests and ranges.