I follow a lot of the questions on here. So I requested some tests that you all recommend, but my doc never mentions, (I’m in the US, so I’m not sure if it is common). The didn’t do the ferritin and folate or B vitamins, the wrong code was used. Anyway here are the results. I should say that I was taking 162.5mg NatureThroid, and am now on 180mg Armour. I still feel hypo, but my dr won’t increase the Armour, so I’m also taking 60mg of Thiroyd. Still feel slightly hypo(muscle pain, hand pain, tinnitus, constipation, tiredness). Thank you
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When did you take your last dose of NDT before the test? We suggest that the day before the test the dose is split into 2 or 3 with the last part of the dose taken 8-12 hours before the blood draw.
Your Free T4 and Free T3 are both over range so if you took your dose the day before as we suggest then your results suggest overmedication. However, your raised thyroid antibodies confirm autoimmune thyroid disease (Hashimoto's) so it's possible you're in or coming out of a "hyper swing" at the moment.
Vit D is recommended to be 40-60ng/ml so you're a bit over the recommended level. Are you supplementing with D3 and also taking D3's important cofactors - magnesium and Vit K2-MK7?
Why did you leave so long? Your results are showing a false low and if you'd taken your NDT at the times we advise then they would be quite a bit higher. So although it's possible that you may be having a Hashi's hyper swing it's also very possible that you are overmedicated.
Free T3 is always the most important test result as T3 is the active hormone that all our cells need. T3 and T4 taken exogenously peaks in the blood around 2-4 hours after ingestion. T3 has a half life of 24 hours so there is only half theamount of T3 that you've taken left after 24 hours, even less after 30 hours. So leaving 30 hours between last dose of NDT is giving you a false low. To get the most accurate measure of normal circulating hormone we advise testing as I said above - split dose and adjust time the day before the test, it's only for one day, take last part of dose 8-12 hours before the blood draw.
Possibly overmedicated but as both Greygoose and I have mentioned, it could be your Hashi's causing a hyper swing which would give higher than normal hormone levels. But with a time gap of 30 hours there is a possibility of overmedication. You would be better retesting with the correct timing of meds the day before to get a more accurate picture.
I am taking D and magnesium. There’s vit K in my multi, but I don’t think it’s much. I’ve never heard of MK7. I’m confused why this happened when I had to switch to Armour. I was really great on the same dose NatureThroid for years.
There’s vit K in my multi, but I don’t think it’s much. I’ve never heard of MK7
Its Vit K2-MK7 - one vitamin not two separate ones.
Is the Vit K in your multi Vit K1 or Vit K2? They do different things. Vit K1 aids blood clotting. Vit K2 directs calcium to bones and teeth where it's needed and away from arteries and soft tissues where, when deposited, can cause kidney stones, calcification of arteries, etc. As D3 aids the absorption of calcium from food, this is why we need Vit K2-MK7. 90-100mcg Vit K2-MK7 is enough for up to 10,000iu of D3.
How much Vit D do you take? As your level is over the recommended level you could drop dose to a maintenance dose.
A maintenance dose is an amount that keeps you at your optimal level without increasing it further.
Yo seem to be taking a total of 40mcg D3 which is 1,600iu. You could possibly reduce to 1,000iu. Most people make Vit D from the sun during the summer and only need to supplement during the winter months.
Is there a particular reason that you are taking calcium? Did you test and were found to be deficient and our doctor is monitoring your calcium level?
30-100ng/ml is the reference range, all ranges have an upper and lower limit. Below 30 would suggest deficiency, above 100 would be heading towards toxicity. The Vit D Society and Grassroots Health both recommend a level of 40-60ng/ml - it's a recommendation of a good level not a reference range.
Oh, and I forgot. I’ve had the most godawful heartburn for days. I know with hypo, your stomach acid is reduced, but I’m not sure why, all of a sudden. I eat pretty much the same thing.
I’m always concerned at the assumed view that if you’re hypo, your stomach acid is reduced. Not necessarily. Conversely, low acidity in GI tract does not necessarily mean that you’re hypothyroid
Sorry, but why would that concern you? Have you made a study of stomach acid levels among hypos? Do you have a thyroid condition? There's no information on your profile.
And, I have never, ever seen it suggested that hyperacidity is a hypo symptom. So, where does that come from?
If the question you refer to relates to whether I have a thyroid condition - the answer is that I have surgically induced hypothyroidism. Have referred to this elsewhere in this thread
No, you haven't upset me. But, it would be nice if you could give us a bit more information about yourself before you start contradicting people.
And, you still haven't told us why you don't believe hypos have low stomach acid. How long have you been hypo - doesn't matter whether it's 'surgically induced' - I presume you mean thyroidectomy? - or otherwise.
Low T3 negatively affects stomach acid production. Which in turn affects absorption of nutrients from food. Including B12. And, low B12 also negatively affects production of stomach acid, so if you don't do something about it, you find yourself in a vicious circle. Also, stomach acid production reduces naturally with age, and as the majority of hypos are women of 'a certain age', you have a double whammy going on. So, I don't really understand why you question hypos having low stomach acid. Unless you have some information that we don't. In which case, please share. Perhaps your stomach acid isn't low? Yet. Give it time.
Not sure I contradicted anyone. Omitted a word which I quickly corrected. My point was, and will remain, that it cannot be assumed that all hypos have low stomach acid.Some do not and their digestive issues are caused by other issues.
When I was younger and had little experience of health forums I was told quite definitively that this was the case - not on this forum. I did the ‘baking soda’ test and either I did it wrongly (probably) or it’s not as good as is proclaimed.
I was persuaded that Betaine HLC would sort out all the ills of my GI tract. Only weeks after starting this I spent three weeks in hospital with perforated ulcers and massive blood loss.
The myth that stomach ulcers are always caused by H - pylori didn’t help. I was negative for HP.
No, I'm afraid it doesn't at all. I explained to you above why hypos are more than likely to have low stomach acid. How do you know that some do not? Were you hypo when you were younger and took Betain and HCl? If not, what does that prove?
I could analyse your last post, counter one or two points and have an interesting discussion. However, there’s little point in pursuing this. I respect your right to your opinion Greygoose and thank you for your responses.
Edit
I came into one of the categories described in this link. Hope the information therein will help those who aren’t certain about the reasons for their gastric problems.
Yes CarolinesCat, forums are a very dangerous thing if you don't do your own research. I had a similar problem with digestive aids, but not to the point of getting ulcers, just wide spread chronic gastritis. I research the death out of things now. And I don't believe that you need to take LOADS of thyroid meds either, you just need to take the appropriate amount to keep your TSH between 1 and 2 and your free T4 and Free within range. I feel great on 75mcg T4 and 5.5mcg T3.
Hello Greygoose,My free T4 was 2.8 in 2015, 1.8 in 2021, and 2.2 this year. My free T3 was never tested until this year. I’ve had Hashi’s for 20 years.
So, it was quite high last year. So, likely your FT3 was, too. So, it could be that your symptoms are not hypo symptoms, but symptoms of over-medication. Have you tried reducing it slightly to see if that helps? It's very difficult to tell the difference between symptoms of too much thyroid hormone, and too little.
I’ve found that 0.25 mcg decrease can make a world of difference
There seems to be an assumption that ‘optimal’ means as high as possible without going over range.
Hormones are powerful. Sometimes less is more. Same goes for vitamins and supplements. You can feel very unwell if you take high doses or even water soluble vitamins
We rightly accuse doctors of being obsessed with numbers. I believe that many thyroid folks are falling into the same trap. Listen to your body. The late Dr Lowe understood that this was the only way forward.
i agree that sometimes 'less is more'. When in doubt about my symptoms my first response (now) is always 'try going down a tiny bit' rather than 'i need more'
Subtle dose changes of just 12.5mcg (half a 25mcg daily) are definitely enough to have an impact on changing symptoms (and on my blood results)
To be honest i think the lack of sympathy /understanding which GP's give to the severity of living with thyroid symptoms is part of the problem of "everybody tending to think more is better" ... you feel so fobbed of and ignored for years, that somehow a GP suggesting you need a slightly lower dose feels like they are saying "you're not as ill any more" .. so our natural tendency is to resist this suggestion because they don't seem to appreciate how dreadfully ill we are feeling.
I know that is how i felt the first time a dose reduction was suggested ... but i really had become overmedicated and the reduction led to a gradual improvement in symptoms.
I reckon it's going to be rather dependent on 'where you were when you were healthy'
I think someone who's 'healthy previous' was towards the lower quarter of T4 /T3 ranges may well feel overmedicated with T4/3 at eg. 80/95% range.
I don't mean that they would still feel alright if T4 /3 was in that lower quarter once on Levo , because it does seem that relatively higher T4 is somewhat inevitable on Levo ...... but i do believe some people can have symptoms of overmedication while their Ft4 /3 is still 'in range'.
It stands to reason , everyone is so very different in where their T4/3 sits before they go on thyroid hormone replacement so why would they all suddenly be 'the same' once they do .
But having said that ....the 'numbers' (especially fT4 ) don't always make sense .. when i was clearly overmedicated (fine tremor, over fast reflexes, over frequent bowel movements ,too hot ,the lot) my fT4 was about 120% .. but at another time i've had 200% even 240% fT4 and have felt perfectly fine and a reduction caused all the usual hypo symptoms .. chronic constipation. brain dead, freezing cold etc.
Personally my TSH has (so far) been a fairly reliable guide on the 'overmedication' front.. my usual on Levo was always 0.04/5 ish despite my FT4 occasionally going 'off piste'..... but the times i was definitely overmedicated my TSH had fallen to 0.01
I have no thyroid - thyroid cancer. No thyroid function irregularities. Before they removed it they did TFTs. Oddly, my ‘comfortable levels’ now are same FT4 and FT3 as then. Different TSH obviously.
The Full Blood Count (Complete Blood Count) is an example. The cost is incredibly low because so many are done, and the automation is phenomenal. Even now, though, the tests that are included vary across laboratories.
Maybe we will find changes, other than to TSH & thyroid hormones, which are common to thyroid disorders? Preferably, simple, physical or chemical things which can be measured by a machine easily and quickly - and cheaply.
I think it’s very important that there should be more testing. The CBC you mention is one of the most helpful diagnostically.
However, trends in results are important too. The graphs provided by GP software should make that very easy but I doubt that most of them are ever looked at. The icon/asterisk which indicates whether you’re ‘out of range’ or not means that blood tests are never interpreted within the context of symptoms. Lazy doctoring.
It’s concerning that blood tests obtained during hospital admissions or outpatient visits are seldom communicated to GPs. This makes any attempts to identify ‘trends’ almost impossible.
The CBC you mention is one of the most helpful diagnostically. Yes , i suppose they are , for a lot of things, but they don't seem to be much use for detecting any 'thyroid' issues. They were giving me CBC's like smarties for 4 yrs when i was going autoimmune hypo, all those CBC's were fine , 'nothing to see here' (apart from slightly below range lymphocytes for several yrs. which wasn't ever mentioned )
And testing of many other factors. Temperature. Muscle strength/relaxation.
We can already see some possibilities such as are used for oxygen saturation on some watch-like devices (Apple Watch being an obvious one) as well as fairly inexpensive finger tip devices.
Some GP surgeries have a device to measure weight, height, blood pressure, etc. as you enter the building. Just go further, deeper, and with enhanced interpretation.
Don’t you find that you have to do it for them sometimes? It’s appalling. Visits to the surgery seem to require a thorough investigation of differential diagnoses before I go. Then I may gently and tactfully refer to one of them - and the doctor’s face lights up with interest
The other week, it was me who suggested capsaicin cream for postherpetic neuralgia. GP was fine about prescribing it - but didn't come up with it herself.
(And then found out it was unobtainable - supplier issue. And there is only one in the UK.)
It’s a wonder she didn’t prescribe Gabapentin for PHN. First line medication.
I used to think that those words ‘First line’ meant that they were likely to be the most effective. Then I discovered that they’re the cheapest - and if they don’t work or you have side effects, they’ll try something else a little more efficacious and expensive
Even just doing the old skool stuff they used to have time to do would be a start .. for the first 10 yrs on Levo i was always weighed and blood pressure done by phlebotomist at each annual thyroid blood test... not any more .
Sorry to be slightly cynical but I think that about 10 years ago, GP targets included obesity. They were literally paid for identifying each patient whose BMI exceeded ‘normal’ range.
That's OK . 'becoming cynical' is a well known symptom on here. They won't have got paid for me then, cos i never really put much weight on , i'm usually at the lower end of what they think i 'should' be .
I think they used to get paid something for keeping a list of hypothyroid patients too but i think that's gone now .
The first subtle clue is realising i've been going for 12 wee's before lunchtime for a week , but i haven't got cystitis.
Then i realise my calf muscles feel much tighter and stiffer than usual in the mornings and i'm hobbling down stairs in the morning like a 92 yr old
. I usually notice that when i'm making a cup of tea i keep missing the cup with the spoon and bashing it on the side instead.. (but this happens when i'm undermedicated too) .
My legs will start playing up and being weirdly painful it the early evenings but then feel comfortable later, a bit like restless leg syndrome , but not.
I feel a bit agitated/impulsive not so calm and tolerent... i start thinking "i'm going over there right now to have a word with that bloke leaving rubbish in our alleyway" .. whereas i would normally spend a day or so finding out if he was an arsonist first, before picking an argument and inadvertantly letting him know where i live ...
Then eventually, i will start needing 3 poo's every the morning and i'll get a fine tremor in my fingers.
If i lower the dose very slightly, these things all go away.
However i'm currently finding there is a VERY fine line between lowering it enough that these things improve and not lowering it so much that i feel fine but start getting a spare tyre and podgy thighs...
Gosh it's all so confusing. And such a fine line between the over and under.
I can't work out what's going on with me. My legs and feet hurt all the time and walking is now very difficult. When I stand up from sitting I can't stand up straight. I have to wait and internally tighten those leg muscles and then try to relax them to move or stand up straight. It hurts. I have bathroom urgency (but sadly not for wee as I retain fluid like crazy). I feel hot and sweaty easily but my temp is low. I am feeling very tired and very miserable.
I've reduced my Levo dose right down to 50mcg now as it looks like I have a problem with my body converting T4 into rT3 and even perhaps converting T3 into T2. But as I've reduced I have felt more and more exhausted. This could be because I need more T3 (on 50mcg) but it could be that more T3 is becoming available due to the changes and therefore I'm over-dosed on it!
That is difficult to figure out .. i wish i had a useful answer , Sometimes i think i was daft for not just getting on with it and trying T3 a couple of years ago, but i could already see how tricky things can get for some folk, it seems really easy to get lost..... so on balance i'm glad i decided to spend year or so properly figuring out my own bodies responses to very fine tuning of Levo while staying on a consistent brand... but that's easier for me to do cos i'm not still trying to run a business .
i guess you have to keep on keeping on , be consistent and logical in your plans ,and be observant . Sending you some perseverance as thats the best i can suggest. xx
Oh I have spent a long, long time trying to make Levo work and recording every little anomaly and issue. I have truly exhausted that avenue. And now I know I have the Dio2 genetic problem from one parent that just adds to the issue of conversion.
I decided to try dosing in 3 doses today instead of 4. Thinking the higher morning dose might get me going. Total opposite so far! More exhausted than ever and barely keeping my eyes open. Temp dropped really low and yet I feel hot. My legs hurt worse than ever. It's ridiculous.
The muscle problems might be caused by something non-thyroid. I find that sometimes I can't relax my muscles very well, and have to tighten them further and then relax them in order to make them work properly - but they start tightening up again immediately. The condition might be called tetany but I've never been diagnosed and I'm on extremely shaky ground with this :
I have found after lots of experimentation on myself that the answer for me lies in my electrolytes. I make myself a version of an adrenal cocktail with magnesium added to it, but I only take it when I think it is necessary. It actually gives me four of the electrolytes the body needs. (There are seven in total given in many lists of electrolytes but I think there might actually be a lot more.)
Some other things you could look up to see if the symptoms are relevant to you are the conditions which result from low or high levels of the individual electrolytes i.e. low/high sodium, low/high chloride, low/high potassium, low/high magnesium etc...
Feel free to ignore this. I'm not a doctor, and what applies to my symptoms may have nothing to do with your symptoms.
Edit : I should point out that my problem with muscles is never a shortage of calcium. I always have levels which are high in range (which in itself is quite worrying, to be honest). But calcium being low in range seem to be quite common on the forum.
That's good information and I can look into that. But I tend to think it's thyroid related because if I trick my body (which gets around the enzyme over production problem for a few hours) by taking a slightly higher dose of T3 I will suddenly have free leg movement and be able to walk properly and at normal speed with confidence. By the time I've been to bed and got up again that effect has gone (which might mean that the over production of D2 and D3 enzymes has caught up with itself). This effect can also occur when I reduce a dose of something. I feel initially better for a day and then back to normal.
A very accurate picture of how slight overmedication can affect me too.
Edit tattybogle
I have to say that my muffin top remains with me whichever side of the line I’m on. This is quite new to me. A bit off topic, but I have all the symptoms of progesterone deficiency and ‘muffin tops is one of them 🙄.
My multi has 25 mcg, and my calcium supplement has 15 mcg D, 400 mg magnesium, 1000 mg calcium, and 15 mg zinc.
Does your multi also have iron? If so, you won't absorb any of the above. Iron should be taken two hours away from everything else, so multi-vits are a total waste of money for that reason - and for many other reasons, too. We never recommend multis on here.
Ironically, most adrenal support formulas contain vits B12 and C…and more clued-up doctors treating adrenal fatigue tell us to take both and not necessarily separately…
• in reply to
I know. It’s a minefield. Still trying to work out why some quite reputable companies mix magnesium and calcium in one product
I've even seen one supplement that contained iron and calcium - nothing else, not even a multi, just iron and calcium. Talk about throwing your money down the drain! 🤣🤣🤣
You are quite simply overmedicated. Heartburn is just one of the pleasures. Muscle pain, fatigue, tinnitus, all part of hyper. Lower your dose and you will feel better. If you overdose, your body turns down deiodination in some parts, so you might even get symptoms of hypo.
TSH is too low. Not that TSH is all that important, but when mine was low like that, I did not feel well. I feel you are just pushing too much T3 into your system, and probably T4 too, as shown by your frees. My TSH hovers around 0.6. Functional medicine types like to see it in the range 1.0-2.0 because that is what is seen in healthy people who don't have thyroid problems.
I would suggest you look at what thyroid experts are saying about Hashimoto's; how it makes people feel, and how to get rid of it. You could start with thyroidpharmacist.com. Hashimoto's is often correlated with poor digestive function. In my case, I had gluten enteropathy. You really need to find out if you have high levels of toxins like heavy metals, or if you are regularly consuming substances (e.g. gluten, dairy) that trigger autoimmunity. TPOAb at 255 is higher than I ever had, yet I was sick as a dog, and even after I got my TPOAb close to zero, it still took years for my digestive system to recover sufficiently, to feel well.
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Test results, any advice?
Adaptogens lab results
help to interpret lab results, please
