T3 and food query : Hi folks, me again. So still... - Thyroid UK

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T3 and food query

Tradoc profile image

Hi folks, me again. So still feeling crap on T3. Taking 5mcg at 7:30 with 75mcg of levo. Eating them at 8:30 although no interest in food and take the next 5mcg now at 4pm then eating at6. seeing my endo next sat so just holding out to then where he will take bloods and hopefully come up with a better plan.

My question is should I have some kind of eating routine on T3 to make it work better. I haven't had a good day in about 5 weeks

🥺

30 Replies

No special eating plan. Avoid soy wherever possible as it can affect the uptake of thyroid hormones by the cells. Avoid eating at dose times.Otherwise it is trial and error how much levo and lio you need and in however many doses. It has taken me 2 years to work out the dosing amounts and times of levo and lio. Now I am on steady doses it will take longer for my body to settle and to adapt and heal. This is not a quick process and benefits can almost come imperceptibly

Tradoc profile image
Tradoc in reply to Lalatoot

I hope it doesn't take that long. I've been sick since Feb. The worst thing is like I'm having brain tremors

Lalatoot profile image
Lalatoot in reply to Tradoc

My thyroid journey started in 2010!! I was wrongly medicated from day1. didn't know any better so just did what I was told to do. Survived on adrenalin plus citalopram as well as thyroid meds then from 2018 all but bed ridden for 2 years; found this site; learned a lot; end 2019 argued for levo + lio; slowly getting there.

jgelliss profile image
jgelliss in reply to Lalatoot

It's very telling how little Dr's and Endo's know about thyroids and thyroid dosing T4/T3.We are very Blessed to have this Great Forum.

SlowDragon profile image
SlowDragonAdministrator

Which brand of levothyroxine are you currently taking

Do you always get same brand

Are your vitamins optimal What vitamin supplements are you currently taking

What’s the cause of your hypothyroidism…..autoimmune?

Have you had coeliac blood test done

Have you tried strictly gluten free diet

Tradoc profile image
Tradoc in reply to SlowDragon

Yeah always get the same brand.Endo put me on vit d3 with the T3.

Was tested for coeliac last year but it was negative.

I'm not gluten free.

Not sure what the cause of my hypo is. I've had it for 25 years

SlowDragon profile image
SlowDragonAdministrator in reply to Tradoc

The fact they tested for coeliac suggests your hypothyroidism is autoimmune

About 90% of primary hypothyroidism is autoimmune

Have you ever had thyroid antibodies tested previously

How low was vitamin D

How much vitamin D are you currently taking

Needs retesting after 3-4 months and then twice a year

Is it tablet, gel or vitamin D mouth spray

Any vitamin D tablets/gels should be 4 hours away from levothyroxine

What were folate, ferritin and B12 results

Tradoc profile image
Tradoc in reply to SlowDragon

They tested me because I was having bowel issues that they couldn't get to the bottom of. See attached for last bloods I did with medichecks on march 9th before I started on t3.The endo has me on vit dgel caps 800 1 a day I have the medichecks well woman test that's covers lots of things including bits minerals and thyroid which I'm getting a blood draw for tomorrow morning

Tests
jade_s profile image
jade_s in reply to Tradoc

Ferritin looks very low, it can partially explain why you're feeling bad. You might consider getting an iron panel (iron, %saturation, tibc) and then supplementing iron if those are low as well.

Tradoc profile image
Tradoc in reply to jade_s

What should it be

jade_s profile image
jade_s in reply to Tradoc

Around 100 would probably be better. These explanation by SeasideSusie are better than I could explain. There are several replies by her so scroll down and read them all.

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Tradoc profile image
Tradoc in reply to jade_s

Oh that's really interesting. I've done a full well woman medichecks this morning and I think that has a full iron panel. Liver ... Yuk lol

jade_s profile image
jade_s in reply to Tradoc

Great! Low iron can really leave you feeling terrible. Ugh no liver for me either 😱😂

Tradoc profile image
Tradoc in reply to jade_s

Would certainly be the reason for some of my symptoms including appitite loss and weight dropping. Thank you

SeasideSusie And advice other than liver would be great 😁

SeasideSusie profile image
SeasideSusieAdministrator in reply to Tradoc

I often wonder whether those people who go "yuk" when liver is mentioned have ever tried it.

Liver is the best iron rich food. Chicken liver is said to contain a bit more that other livers.

Do you eat pate? If so then make your own, it's made from liver.

I personally do my liver meals more like a stir fry, cut it into thin finger-width strips, fry loads of onions and anything else you fancy - mushrooms, peppers, tomatoes, whatever - the liver takes about 5 minutes, needs to be tender not over cooked and tough.

Maximum 200g per week for liver due to it's high Vit A content, also liver pate, black pudding. Other iron rich foods but nowhere near as much as liver:

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

everydayhealth.com/pictures...

However, with your ferritin level of 28.1ug/L then according to NICE this is iron deficiency so your GP needs to do an iron panel:

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

The iron panel would show iron deficiency. You also need a full blood count to see if you have anaemia.

Depending on the results your GP may need to prescribe iron tablets.

Folate would be better in double figures.

Active B12 is too high to measure. Do you supplement?

Vit D is recommended to be 100-150nmol/L by the Vit D Society and Grassroots Health, with a recent blog post on Grassroots Health recommending a level of at least 125nmol/L.

The endo has me on vit dgel caps 800 1 a day

That wont cut it, that's barely a maintenance dose for someone with an optimal level already. You'd be better off buying your own D3 along with it's important cofactors - magnesium and Vit K2-MK7. You need more like 2,000-3,000iu daily until it reaches 100-150nmol/L then adjust to a maintenance dose.

Edited to add a bit more Tradoc

Tradoc profile image
Tradoc in reply to SeasideSusie

Getting my doctor to anything is a chore. I've done the medichecks one this morning that has the attached

Iron
SeasideSusie profile image
SeasideSusieAdministrator in reply to Tradoc

OK, that's the iron panel. Post results when you have them.

Tradoc profile image
Tradoc in reply to SeasideSusie

SeasideSusie Oh I'm just seeing what you said about the other vits now.

Those results are from march. I have stopped my b complex with folate in the last few weeks. I was taking vit d and K2 last year but stopped that and I'm taking 200 mgs of magnesium citrate now. Finding it hard to swallow tabs at the moment

I'll post all my new results when I get them . Thanks for all the advice everyone

SeasideSusie profile image
SeasideSusieAdministrator in reply to Tradoc

Tradoc

I'm taking 200 mgs of magnesium citrate now. Finding it hard to swallow tabs at the moment

I use a brilliant magnesium citrate in powder form, often works out cheaper than tablets and so easy to take, also no added ingredients:

Natural Vitality Calm magnesium citrate powder, available from various sellers, I just choose the cheapest:

dolphinfitness.co.uk/en/nat...

ebay.co.uk/p/2297559003?iid...

amazon.co.uk/Natural-Anti-S...

You just use however much powder you need, add a little warm water and let it fizz, I then add a little orange juice which gives a nice flavour. Measure using a kitchen scale, start low and build up, if you get diarrhoea drop back a bit.

Doctors Best D3 softgels are very small and easy to take, no nasties.

Vegavero do K2-MK7 in a very small capsule, no nasties.

Tradoc profile image
Tradoc in reply to SeasideSusie

Brilliant. I'll have a look for these now. Thanks 👍

Tradoc profile image
Tradoc in reply to SeasideSusie

iron 23.0 (5.8-34.5)tibc 52.7 (45-81)

uibc 29.7 (24.2 - 70.1)

transfererrin saturation 43.6% (20-50)

ferritin 50.4 (13-150)

SeasideSusie profile image
SeasideSusieAdministrator in reply to Tradoc

Tradoc

iron 23.0 (5.8-34.5)

tibc 52.7 (45-81)

uibc 29.7 (24.2 - 70.1)

transfererrin saturation 43.6% (20-50)

ferritin 50.4 (13-150)

Optimal iron panel levels according to rt3-adrenals.org/Iron_test_... are:

Serum iron: 55 to 70% of the range, higher end for men - yours is 59.93% so very good if you're female.

Saturation: optimal is 35 to 45%, higher end for men - yours is 43.6% so towards the higher end of the range

Total Iron Binding Capacity (TIBC) or Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is at the lower end of the range

Ferritin: Always recommended here is that ferritin is half way through range and some experts say that the optimal level for thyroid function is 90-110ug/L.

Well you certainly don't have iron deficiency, just lowish ferritin so you don't need to supplement with iron tablets (they will take your serum iron and ferritin too high and too much iron is as bad as too little) so try raising ferritin through diet 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...

SlowDragon profile image
SlowDragonAdministrator in reply to Tradoc

Looking at previous posts you say your on 75mcg tablet

So this is Teva brand?

Are you lactose intolerant that you are on Teva brand?

Teva upsets many people

Tradoc profile image
Tradoc in reply to SlowDragon

I'm not

SlowDragon profile image
SlowDragonAdministrator in reply to Tradoc

You mean your not on Teva levothyroxine?

20% of autoimmune thyroid patients never have high thyroid antibodies

Ever had ultrasound scan of thyroid

healthunlocked.com/thyroidu...

Tradoc profile image
Tradoc in reply to SlowDragon

Sorry I meant I'm not lactose intolerant.I've never had my thyroid scanned. My endo actually asked me that in my appointment . The funny things is my energy levels are fine I just feel like there's an imbalance in my body and my brain

SlowDragon profile image
SlowDragonAdministrator in reply to Tradoc

Suggest you request endocrinologist organise ultrasound

As you had very high TSH on 75mcg levothyroxine before T3 was added, you may still be not on high enough dose of levothyroxine

But have you considered that Teva brand levothyroxine might be causing issues

Teva contains mannitol as a filler, which seems upset many patients. Mannitol apparently changes the gut biome

As Teva is the only brand that makes 75mcg tablet.

If avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Teva, or Aristo (100mcg only) are the only lactose free tablets

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets

Accord only make 50mcg and 100mcg tablets

Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets

beware 25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

New guidelines for GP if you find it difficult/impossible to change brands

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Tradoc profile image
Tradoc in reply to SlowDragon

I have found a box of 25mcg mercury pharma and a box of 100mcg almus at home. Could I take 3x 25mcg at a time

Lalatoot profile image
Lalatoot in reply to Tradoc

You could half 100mcg to make 50 and add a 25mcg to that too.

SlowDragon profile image
SlowDragonAdministrator in reply to Tradoc

Yes or Lalatoot suggestion of cutting 100mcg to make 50mcg

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