Thoughts on these please.

[les121]

Been taking 125 levo and 25 tiromel.

[les121]

Morning before

[les121]

To be honest I was nervous taking T3 didn't know what to expect but I don't feel anything really to say ahh that's the T3 working

[les121]

I don't feel any different to taking levo alone at the minute..I was taking Thyroid s for the last few years but got fed up of the high cost so thought I'd try a combo..it's only my 2nd week though does it take time to build up

[SlowDragon Administrator in reply to les121]

No point testing thyroid levels until been on unchanging dose and brand levothyroxine/T3 for minimum 6-8 weeks

[SlowDragon Administrator]

Which brand of levothyroxine are you currently taking

Do you always get same brand

Did you reduce levothyroxine when T3 was added

If yes, by how much

What was Ft4 result on previous test, before you started on T3

How are you taking your T3

As single dose or 2 or 3 smaller doses spread through the day

How long have you been on current dose before testing

Day before test, even if you don’t normally split T3, you should split into 2 or 3 doses taking last dose approx 8-12 hours before test

So as you left 24 hours between last dose T3 and test, Ft3 is falsely low. Perhaps nearer 5 might be realistic result

Are all four vitamins at GOOD Levels

[les121 in reply to SlowDragon]

Only started back on levo about a month and it's eltroxin brand and tiromel T3...I know take 125 levo and 25 T3 in a single dose.

[SlowDragon Administrator in reply to les121]

Suggest you experiment with splitting your T3 as 2 or 3 smaller doses spread through the day

Ft4 is now too low suggest increasing levothyroxine to 137mcg daily

Retest again after 6-8 week ……with correct time gaps for last dose levothyroxine 24 hours before test and last 1/4 tablet T3 approx 8-12 hours before test

Meanwhile working on improving low vitamin levels essential

Getting coeliac blood test done

Ultrasound scan of thyroid if not had one

Trialing strictly gluten free diet

[SlowDragon Administrator]

Looking at previous posts

You have Hashimoto’s

Ferritin level was dire 9 months ago

When was ferritin last tested

What are most recent results for

Vitamin D, folate, B12 and ferritin

Have you had coeliac blood test done

Are you on strictly gluten free or dairy free diet

[les121 in reply to SlowDragon]

Was tested years ago but negative and no special diet.

Results

[SlowDragon Administrator in reply to les121]

Were BOTH TPO and TG antibodies tested

Significant minority of Hashimoto’s patients only have high TG antibodies and won’t get TG antibodies test on NHS as NHS only tests TG antibodies if TPO are positive

If not had both test, test via Medichecks or Blue horizon

If both antibodies are negative

20% of Hashimoto’s patients never have high thyroid antibodies

Have you had thyroid ultrasound scan?

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

[SlowDragon Administrator in reply to les121]

No vitamin D test?

Nether levothyroxine or T3 will work if vitamins are not optimal

Optimal vitamin levels are

Vitamin D at least around 80nmol and around 100nmol maybe better

Folate and ferritin at least half way through range

B12 at least over 500

What vitamin supplements are you currently taking

You need coeliac blood test done while still eating gluten before considering cutting gluten out as 3-6 months trial

[SlowDragon Administrator in reply to les121]

When were these vitamin test results from?

Ferritin is deficient

Do you eat red meat most days and liver once week

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

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked

preventmiscarriage.com/iron...

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

GP should do full iron panel test for anaemia

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron

Medichecks iron panel test

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

Low B12 and folate

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...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12

Low B12 symptoms

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.

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...

How other member saw how effective improving low B vitamins has been

healthunlocked.com/thyroidu...

[les121 in reply to SlowDragon]

Wow lots of good advice there thankyou...erm..tested years ago TPO and that's all coeliac test was negative...always had low iron really..not taking any supplements but I do have a B12 spray I use occasionally..I'm so rubbish at taking tablets..the blood tests were this week and I started HRT patches this week also..have really bad arthritis in my knee which now is affecting my other knee and feet..so that's sort of taking over at the min...joined a new doctor who actually said the word Hashimoto's!!!...so hopefully a good start there...so in short what supplements do you recommend so I can order now...I already have ferritin from my gp.

[SlowDragon Administrator in reply to les121]

Post full iron panel test results when you get them

From GP or test privately

Never supplement iron without testing full iron panel

When doing an iron panel test …stop any iron supplements a week before test. Don’t eat steak night before test (or any iron rich food) and test early morning fasting

Meanwhile increasing iron rich foods in diet

B12 and folate…..please reread reply

Supplements details all in there

Come back with new post once you get vitamin D tested

No thyroid hormones work if vitamins are poor

Get GP to do coeliac blood test BEFORE trialing strictly gluten free diet

[SlowDragon Administrator]

these results from 7 months ago show you need to work continuously to maintain optimal vitamin levels

Nether levothyroxine or T3 will work if all four vitamins are not optimal