Advice welcome on t3 dose: n CRP HS 0.57 mg/L... - Thyroid UK

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Advice welcome on t3 dose

BiscuitBaby profile image
12 Replies

n

CRP HS 0.57 mg/L (Range: 0 - 5)

Iron Status

Ferritin 52.7 ug/L (Range: 13 - 150)

Vitamins

Folate - Serum 5.98 ug/L (Range: > 3.89)

Vitamin B12 - Active 95.4 pmol/L (Range: 37.5 - 150)

Vitamin D X 47 nmol/L

<25 Deficient

25 - <50 Insufficient

50 - 75 Adequate

>75 - 200 Optimal

(Range: 50 - 200)

Thyroid Hormones

TSH X 0.01 mU/L (Range: 0.27 - 4.2)

Free T3 6.22 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 20.5 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies X >4000 IU/mL (Range: < 115)

Thyroid Peroxidase Antibodies X >600 IU/mL (Range: < 34)

Hi folks

I'd welcome advice/opinion on above results. I currently take 125mcg levothyroxine and 10mcg Liothyronine. I started this at the end of January following the advice on here to take it slowly. I feel a heap better. Feet are improved, palpitations almost non existent, fatigue better toilet better, headaches better. My problem is I feel I still have symptoms of being undermedicated. I am still cold when others aren't. My sleep is still bad. I take 5mcg at bedtime. I sleep better the first half of the night but the rest is awful. I have increased my activity a bit to improve fitness but I feel horrible after. I know my vit d is low. I am doubling it to 4000 for a while to raise it. My last vit d test was done at the end of September and it was fine so I wonder if winter is part of the problem?

My question is is there wiggle room for a wee increase in t3? I don't feel I need much more?

Thank you all in advance for your help.

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SeasideSusie profile image
SeasideSusieRemembering

BiscuitBaby

CRP HS 0.57 mg/L (Range: 0 - 5)

The lower the better with CRP so this is a good result.

Ferritin 52.7 ug/L (Range: 13 - 150)

This is on the low side but doesn't necessarily suggest iron deficiency, you'd need ani ron panel to show that.

Always advised here is for ferritin to be half way through range although some experts say that the optimal ferritin level for thyroid function is 90-110ug/L.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

Folate - Serum 5.98 ug/L (Range: > 3.89)

This is low. Medichecks folate range is 3.89-19.45 and always suggested here is that folate should be at least half wayt hrough it's range so that would be around 12 plus.

Vitamin B12 - Active 95.4 pmol/L (Range: 37.5 - 150)

This is OK, we always suggest 100 plus for Active B12 so you're not far off/

If I had your Folate and B12 results I'd be supplementing with a good quality, bioavailable B Complex which should improve your folate level and also help raise your B12.

I have used Thorne Basic B for a long time and always been happy.

If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.

When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).

Vitamin D X 47 nmol/L

My last vit d test was done at the end of September and it was fine so I wonder if winter is part of the problem?

This is far too low and the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.

As we can't make Vit D naturally during the winter then our stored Vit D gets used so this will account for the drop in your level.

Increasing your dose to 4,000iu should be helpful. Retest in 3 months to check your level.

Do you take D3's important cofactors - magnesium and Vit K2-MK7?

TSH X 0.01 mU/L (Range: 0.27 - 4.2)

Free T3 6.22 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 20.5 pmol/L (Range: 12 - 22)

My question is is there wiggle room for a wee increase in t3? I don't feel I need much more?

In my opinion no, no room to increase either Levo or T3, they are both top of the range. I think what is needed here is to optimise your nutrient levels, optimal levels are needed for thyroid hormone to work properly.

Thyroglobulin Antibodies X >4000 IU/mL (Range: < 115)

Thyroid Peroxidase Antibodies X >600 IU/mL (Range: < 34)

These confirm autoimmune thyroid disease (Hashimoto's) which possibly you may already know. Are you gluten free? Some Hashi's patients find that helps. Also supplementing with selenium can help but make sure it's either selenium l-selenomethionine or a yeast bound selenium and avoid selenite or selenate forms, also 100-200mcg maximum without testing for selenium deficiency.

BiscuitBaby profile image
BiscuitBaby in reply to SeasideSusie

Hi SeasideSusieThanks for your reply. I do take Thorne basic b but stopped it as last time I was way over for b12. I was prescribed folate last year for a month but gp never retested it. It was about that time that a gp took over after noticing my tsh was suppressed and tried to lower my dose. When I refused due to loads of symptoms she referred me to neurology for functional neurological disorder! That was when I went private.

I have restarted the Thorne and was thinking about the full dose for while? I normally only take 1 a day. I find the regime exhausting in itself. I work full time and I can't just schedule time to take stuff.

Thank you for your advice. It confirmed what I was thinking. Interestingly I haven't had a t4 at that level before. It's always been lower. I thought it would go down!!!

SeasideSusie profile image
SeasideSusieRemembering in reply to BiscuitBaby

BiscuitBaby

I do take Thorne basic b but stopped it as last time I was way over for b12.

When I first tested my nutrient levels a few years ago, I had good B12 levels but bottom of range folate - not folate deficiency (which is <3ug/L) but low in range. I took Thorne Basic B at 1 capsule per day and within 2.5 months my folate was top of range. I've never taken more than 1 daily. Yes, it did increase my B12 level but excess B12 should be excreted, high B12 is a problem if it's naturally high without supplements but if it's the supplements that make it high then there's no "medical reason" for it so personally I continue with the 1 capsule Thorne Basic B to maintain my folate level and don't worry about my B12. Last time my Active B12 was tested 3 years ago it was 162pmol/L (37.5-188), I've only tested Total B12 since and it is over range but not a worry for me.

Taking a stand alone folate supplement isn't necessarily the best idea, we need to keep all the B vitamins balanced so a B Complex is suggested unless you need prescribed folic acid for folate deficiency.

BiscuitBaby profile image
BiscuitBaby in reply to SeasideSusie

Thank you for that. That's interesting about your b12. I didnt know that! I have gotten more useful information on this forum than I have ever had from doctors! In answer to your earlier question about gluten free. I tried for a while but it didn't make a difference. TBH I think I just felt so crap it was too hard to do it.

Lalatoot profile image
Lalatoot

Agree with SeasideSusie regarding the need to get its optimal first.After that if your thyroid results are similar I would look to lower levo dose by 12.5 or 25mcg so that you could up lio dose by 5mcg. This is a very personal thing and it is about finding where your body likes ft4 and where it likes ft3 and to do this you need to slowly tweak the doses 1 thing at a time over a long period.

BiscuitBaby profile image
BiscuitBaby in reply to Lalatoot

Thank you LalatootI was reading earlier about the antibodies attacking the thyroid. I wonder if that is what has just happened? I have regular episodes where I have more pain than normal u thyroid and throat with flu like symptoms. It lasts a few days to a week then goes away. Is it ever possible to be symptom free?

Lalatoot profile image
Lalatoot in reply to BiscuitBaby

Antibodies don't attack the thyroid. Your immune system attacks the thyroid - it is an autoimmune disease. the antibodies appear to clean up the mess left by an attack.Have hope - there are those on here who lead a normal life.

BiscuitBaby profile image
BiscuitBaby in reply to Lalatoot

Hi LalatootThat's reassuring. I certainly feel so much better than I did 6 months ago. Its just a long, confusing journey to get there!

SlowDragon profile image
SlowDragonAdministrator

First step is to improve low vitamin levels

Then you may be able to increase T3 in 2-3 months time

Increasing vitamin D supplement

Daily vitamin B complex

In week before blood test, when you stop vitamin B complex, replace with daily B12 and daily folate (not folic acid)

I would agree with suggestion to slightly lower levothyroxine…..perhaps to 112.5mcg initially

Your antibodies remain extremely high

Suggest you consider retrying gluten free diet

Gluten free diet often results in antibodies reducing slowly over many months

BiscuitBaby profile image
BiscuitBaby in reply to SlowDragon

Hi SlowDragonThank you. I might have to try again then. I certainky feel a bit more like my old self now so it might be easier. This might sound like a stupid question but if the antibodies don't cause a problem why would reducing them help? Also why are they so high? My antibodies have always come back off the scale. I know they show autoimmune condition but do have any other relevance?

SlowDragon profile image
SlowDragonAdministrator in reply to BiscuitBaby

Antibodies are the hoovers cleaning up after an attack

The antibodies in themselves don’t cause symptoms…..but they indicate there’s still lot of cleaning up to do

Brain fog often improves after 9-12 months……gluten crosses blood brain barrier

BiscuitBaby profile image
BiscuitBaby in reply to SlowDragon

Housework was never strong point!!! 😄. Thanks for replying. Your advice is much appreciated!

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