How much T3?

[les121]

Hi currently on 150mcg levo and expecting my T3 tomorrow please can someone suggest a start dose I haven't a clue...previously on Thyroid s.

[SeasideSusie Remembering]

Les121

How long have you been off Thyroid-S and on Levo only?

What are your current test results on Levo only for TSH, FT4 and FT3?

Are your key nutrients - Vit D, B12, Folate and Ferritin - all at optimal levels - they need to be before starting T3.

[les121 in reply to SeasideSusie]

Hi..about a week or 2 now...not sure on vitamin levels but my ferritin is always low ..not had any bloods since taking levo

[SeasideSusie Remembering in reply to les121]

In that case it's impossible to say what you should be taking. You have changed from a combined thyroid med to T4 only, 3 days ago you said you were taking 100mcg and now you say you're taking 150mcg.

Your levels will not have stabilised, you need to wait 6 weeks after changing meds, test, post results with ranges on here and then we will be able to make a suggestion of whether or not you need to adjust your dose of Levo and guide you on how to introduce T3.

No thyroid hormone can work properly with low ferritin, it needs to be half way through range and some experts say the optimal ferritin level for thyroid function is 90-110ug/L.

You really should get all your key nutrients tested and address any insufficiencies/deficiencies before adding T3.

But, another way to go about it is you say you were fine on 3 grains Thyroid-S (what were your results on that dose?) then work out the equivalent in Levo and T3. Thyroid-S is said to contain 38mcg T4 and 9mcg T3 per one grain, so 3 grains would be 114mcg T4 and 27mcg T3. As you've been off Thyroid-S for a couple of weeks I would start a bit lower, say 100mcg Levo and 10mcg T3, maybe increasing the T3 by 5mcg after a couple of weeks when you know if your OK with that combination. I would then hold those levels for 8 weeks then test your levels.

Whichever way you decide to do this, you need to test your nutrients and work on optimising them.

[Evej13 in reply to SeasideSusie]

Hi Seaside Susie,

"No thyroid hormone can work properly with low ferritin, it needs to be half way through range and some experts say the optimal ferritin level for thyroid function is 90-110ug/L".

Do you happen to have any references for this statement? My ferritin has recently dropped to 56 (36% through range), and I can't get my doctor to agree that my ferritin is too low and that I need to supplement in order for my thyroid to work properly.

Thanks!

[SeasideSusie Remembering in reply to Evej13]

Evej13

Of course, your GP wont cosider that a low level because it's within range, that's all they care about, they have little to no knowledge of optimal levels or why we need them.

I don't have anything "official" such as NICE guidelines, that quote comes from an article about hair loss:

thyroidpharmacist.com/artic...

Scroll down quite a way to section 2 Consider Nutrient Depletions

....

Iron

.....

.....

Normal ferritin levels for women are between 20 and 200 ng/mL. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

......

SlowDragon might have something else.

I can't get my doctor to agree that my ferritin is too low and that I need to supplement in order for my thyroid to work properly.

What you need to do is an iron panel. Just because ferritin is low doesn't necessarily mean that you need to supplement iron. The iron panel will test serum iron, transferrin saturation percentage, total iron binding capacity plus ferritin. If your serum iron and saturation are good then you wouldn't take iron tablets because that would take those levels too high and lead to toxicity so in that case you'd have to try and raise ferritin through diet, eating iron rich foods has, for me, raised ferritin but not raised iron and saturation levels.

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...

[Evej13 in reply to SeasideSusie]

Thanks SeasideSusie.

She won't look at thyroidpharmacist as good enough - she'll suggest I'm simply going to 'Dr. Google'. All she'll accept is research papers. I did get a full iron panel, along with a thyroid panel (which has a bit of a weird result)

Ferritin 56.00 ug/L (20 120.00 36.00% of ref)

Iron 10.00 umol/L (10 29.00 0.00 % of ref)

Iron Binding Capacity 68.00 umol/L ( 5 72.00 94.03% of ref)

Iron Saturation 15.00 % (14 51.00 2.70 % of ref)

If I've interpreted correctly, according to rt3-adrenals.org/Iron_test_... it seems as if I should supplement.

[SeasideSusie Remembering in reply to Evej13]

Evej13

If I've interpreted correctly, according to rt3-adrenals.org/Iron_test_... it seems as if I should supplement.

Yes it looks like you should, your iron panel is dire! Serum iron is bottom of range, saturation is at the bottom of the range and TIBC is high - all points to iron deficiency. With a bottom of range serum iron I can't see why you couldn't have an iron infusion.

Your ferritin level at 56 could be falsely elevated if you have any inflammation or infection so it's not necessarily a true level, Hashi's can cause inflammation and it seems as though you have this.

Looking back at some of your previous posts it seems as though you've had this iron problem for a long time, at least two years, and you were going to supplement, have you not done so:

healthunlocked.com/thyroidu...

[Evej13 in reply to SeasideSusie]

Hi Seaside Susie,

Yikes! I didn't realize that's a 'dire' iron panel. I did supplement for awhile when it was a bit higher than this, but my GP wanted me to stop and so I did about 4 months ago. I insisted on adding irons to my latest blood tests.

I added a new post at healthunlocked.com/thyroidu... discussing the iron and my latest thyroid result.

[les121 in reply to SeasideSusie]

Sorry my mistake 150mcg