Due to having an extremely low appetite I've been tracking my calories online at myfitnesspal and have increased from 800-1000 calories up to 1800+ calories and have successfully gained around 8 kg of weight which has increased my dose. At first I tried 100mcg 7 X week but soon developed sweating, body pain, fatigue, irritability with a heart rate of 101 and increased the systolic BP by 15 points so I reduced a few days to 88mcg.
Increasing my calories and eating a balanced diet of carbs, proteins, and fats has dramatically improved how I feel as well as thyroid hormone conversion. In the past my FT4 was always over range just to get my FT3 close to the top range. Now my FT4 is significantly lower and although I'm still having hypo symptoms I'm out on walks with my dog, running errands, and gardening. Two years ago when I made the decision to go on a medical leave from work due to debilitating symptoms my FT4 was at the top of the range and my FT4 was at the bottom. By increasing calories I've been able to bring my FT3 up by 0.6 points. I didn't see any improvement in my thyroid situation until I did this.
Due to the hypo my cycles were quite heavy and lengthy so my Ferritin dropped from 47 to 19. The iron serum levels were still normal but from what I've read online if your ferritin drops below 20 with normal iron serum levels it is called a 'stage 1.' I have Thorne brand easy on the stomach iron in 25mg. I emailed my Dr about the results but I'm thinking of taking one pill twice daily.
I plan to stay on this dose a little longer and take the iron pills then test again to see where my levels are. Not sure if my weight will shift again. I'd like to get my FT4 levels up a little more before attempting to add any liothyronine again.
For those still struggling, keep looking for the missing link. It took me several years to realize mine.
Written by
jrbarnes
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Great you are feeling better. The correct amount of carbs, fats & proteins are hugely important in getting thyroid meds to work best as apart from filling diet quotas, will stabilise blood sugars & insulin levels. Glucose is used by our mitochondria to produce cellular energy and ATP, and vital (along with many other cofactors such as B Vits) to enable good thyroid hormone uptake, T4 conversion and T3 to become biologically active in cells all over the body. It is T3’s influence on gene transcription inside the cell that enables the makings of proteins, the building block of bones, muscles, cartilage, skin that allows wellbeing.
Eating cleanly will also encourage improved liver function where our TBG is produced that carries thyroid hormones to the cells, and where a large amount of T4-T3 conversion takes place. A good diet also helps gut function where yet more T4-T3 conversion takes place.
TSH is still looking a bit high but I agree sometimes we can’t tolerate our optimal med dose until other issues have been addressed. You are sorting your iron but what about Vit B12, folate & Vit D? You may even find FT3 levels raise enough on the correct Levo dose when all nutrients are optimised meaning additional T3 meds may not even be necessary.
Thank you. It's my goal to maximize the most from the Levothyroxine. Only then will I consider adding T3 again and if so it will be a small amount. With the extra weight gain I've had difficulty getting the Levo right. It feels like my body is in conflict. It's possible when my body adjusts to the new caloric intake I could lose weight. I've always been lean and with a mostly fat and water weight gain it seems to need more thyroid hormone but at the same time it doesn't. When increasing Levo by an extra day per week I start to experience an increased heart rate and my BP goes up. The increased dose clears up my skin and gets rid of the foot pain yet it also makes my brain muddled, sweating, fatigued and worse sleep. I'm not sure if these symptoms are a combination of having low iron as well as low thyroid.
My T4 is only at 40% and T3 at 46% but I feel better when T4 is at least 60% as well as T3. Two years ago my T4 was at 100% and T3 was at 10%. It's an improvement. I've been taking B12 and Folate supplements for a few years so the levels are in an optimal range now. I get decent amounts of Vit D since I live in a sunny hot climate and spend a lot of time outside. My D in the summer is at least 80. I do supplement with D in the winter. Despite making things more complicated, increasing calories was absolutely necessary for the long run.
If T3 is running at 46% through range when T4 is only 40% this demonstrates conversion is very efficient and shouldn't have any need of T3 meds. However, these numbers are only indicative of the circulating amounts available to become biologically active and no guarantee this will happen. That's where the adequate iron, nutrients and healthy balanced diet comes in.
Thyroid hormones can take many months to work optimally but you definitely sound on the right path to recovery now and the good conversion demonstrates much better usage of meds which acting cumulatively will eventually allow T4 levels to be comfortably raised, ie without palps & increased BP but you may need to raise iron higher. When you are optimally medicated you should lose the weight 😊.
I feel hopeful now that I know the cause of my symptoms unlike two years ago when I was on the Dr. merry-go-round. It took years to get this low and I expect it will take awhile to get back to normal. It's one discovery after the next. Thanks again!
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