Hello, I have my latest results and would really appreciate some advice about whether or not I should adjust my meds. At the time of testing I was taking 100mg of Levothyroxine, no meds within 24 hrs. I have a supply of Liothyronine if required. Thanks very much in advance.
TSH: 2.5 .35 ~ 9.4
T4: 12.1 9.01 ~ 19.05
T3: 3.7 2.63 ~ 5.7
Folate: 4.8 3.1 ~ 20.5
Ferritin: 51 22 ~ 275
Previous post a month ago on 75mcg plus T3
healthunlocked.com/thyroidu...
Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine or T3
So how long have you been on just 100mcg levothyroxine
Which brand of levothyroxine is this
Do you always get same brand levothyroxine at each prescription
Have you had B12 and vitamin D tested yet
Folate is low and likely to benefit from daily vitamin B complex - one with folate in not folic acid
Ferritin low, especially for a bloke
Are you vegetarian or vegan
Look at increasing iron rich foods in diet
Looking at previous posts
You have autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
Have you had coeliac blood test done
Are you on strictly gluten free diet or dairy free diet
Hello, thank you for your reply. I did test quite recently for gluten intolerance and I'm not. I've been on Accord Levothyroxine 100mg for 4 weeks. This was my dose for many years, none of which I would say I felt well in. I don't think I have ever had optimum blood test results because I wasn't sure what results I should aim for. I read somewhere TSH should be around 1 and T4/T3should be upper 1/3 so that helps. (I think?) I was hoping to get confirmation here.
B12: 444 187~883
Vit D my surgery no longer test for. When tested years ago I was low so I supplement 4000IU every day.
I'm quite desperate to stop nightly night sweats and interrupted sleep so I've increased Levo. to 150mg and will test again in 6 weeks.
Generally only ever increase levothyroxine by 25mcg
Do you always get same brand levothyroxine at each prescription
Assuming yes……Which brand
Many people find different brands are not interchangeable
B12 on low side
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...
Low B12 symptoms - includes night sweats
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...
Vitamin D
Important Test twice yearly via NHS private testing service when supplementing
p.s . . jumping to 150 from 100mg probably seems fast and loose to you . . . and ill-advised. I've been adjusting dosages and variety of meds, E.G. . . NDT and adding Liothyronine etc for years . . none of which seeming to be the answer. I've reached a level of frustration and untether now where I feel inclined to gamble on a different approach than previously tried and up the levothyroxine dosage. something I've been nervous of before. . . I don't know why!?
approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
As your coeliac result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
FT4: 12.1 pmol/l (Range 9.01 - 19.05)
Ft4 only 30.78%
FT3: 3.7 pmol/l (Range 2.63 - 5.7)
Ft3 only 34.85%
So definitely under medicated….but currently looks like good conversion
Hello, I thought I should heed your advice and raise Levo. by 25mg to 125mg to begin with. I've got some 25mg pills to help with accuracy.
Hi again,just got my results having taken 125mg for the last 6 weeks, up from 100mg previously as discussed with you at the time.
TSH: 0.05 NR; 0.35 ~ 4.94
T4: 17.00 NR. 9.01~ 19.05
T3: 4.2 NR. 2.63~ 5.7
So only about half way through T3 range but 3/4 through T4 range . . by my reckoning.
Satisfactory you think?
Thanks.
FT4: 17 pmol/l (Range 9.01 - 19.05) 79.58%
FT3: 4.2 pmol/l (Range 2.63 - 5.7) 51.14%
Helpful calculator for working out percentage through range
Suggest you retest again in another 6-10 weeks
Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test
Important to test vitamin D twice year when supplementing
And test B12, folate and ferritin once a year
Maintaining optimal vitamin levels helps improve Ft3 levels
Gluten free diet can reduce symptoms, and is always worth trying
After my blood test I tried upping to 150mg. I seem to feel better on this dose with less night sweats and better sleep (so far) Do you think that this dose might lead my TSH to become a problem ?
Hi, do you think that FT3: 51.14% through the range is a reasonable result? It seems to me that it could be higher but there's not much headroom to increase Thyroxine with FT4: at 79.58% through range?Thanks in advance
Personally I wouldn’t have increased after last test
Too high a Ft4 level can be counterproductive
Retest after 6-8 weeks on 150mcg
Test early Monday or Tuesday morning and last dose levothyroxine 24 hours before test
I did go up to 150 for a week or so but somewhat instinctively felt it to be too high. I’ve dropped back to 125
Thank you So much. Very interesting re. gluten and I look forward to reading up on that tomorrow. Undermedicated! That is obviously useful info. 'Good conversion' I take to mean that Levothyroxine (accord is what I take and always have btw) should do the job well for me without the need to resort to Liothyronine or NDT.
You can’t tell if you will remain a good converter of Ft4 to Ft3. Low TSH can reduce rate of conversion
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