Was given t3 by nhs six weeks ago 5mcg x2 daily plus 75evothyroxine .previously 75mcg mon to Thursday 100 Friday to Sunday
TSH 0.56 (0.27-4.20) tsh has never been under 3.8
Free T4 15.7 (12.2-22.0) highest previous highest 16
FreeT3 not tested this time but previously 3.2 (4.0-6.8)
For years have been feeling rubbish gp said you are in range
What do you think of my new results and will I feel better soon
Drs refused to test b12 etc at al
TSH 0.56 (0.27-4.20) tsh has never been under 3.8
Free T4 15.7 (12.2-22.0) highest previous highest 16
FreeT3 not tested this time but previously 3.2 (4.0-6.8)
Well your GP/endo could/should have increased levothyroxine dose first
If TSH was 3.8 and Ft4 16 you were under medicated
FT4: 16 pmol/l (Range 12 - 22)
Ft4 was only 40.00% Through range
Approx how much do you weigh in kilo
75mcg was only one step up from starter dose levothyroxine
When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you currently taking
Weigh nearly 11 stoneI kept asking gp for increase to no avail even though she agreed with me when I said tsh should be around 1
Not taking any supplements
Vit b12 563 (197-771)
Ferritin 68 (13-150)
Serum folate 14.9 (2.9-26.8)
These were June 2021
Vit d never been tested
Thank you for replying
So results are now out of date
They are/were reasonable
Weigh nearly 11 stoneI kept asking gp for increase to no avail even though she agreed with me when I said tsh should be around 1
Change GP….this one clueless
Guidelines on dose levothyroxine by weight is 1.6mcg levothyroxine per kilo per day
11stone = 70kg
70kg x 1.6mcg = 112.mcg per day as approx guidelines
Some people need more….some less
Endocrinologist should have increased levothyroxine to 100mcg initially ……retested after 2-3 months…..then increased to 112.5mcg (cutting 25mcg tablet in half)
Getting all four vitamins tested and optimal essential
If, once all vitamins optimal and levothyroxine dose is fine tuned …..if after this Ft3 remains low ……that’s when to consider adding T3
Have you had thyroid antibodies tested at any point in past or recently?
Yes thyroid peroxidase abs (tpo) 98(0-34) july 2021
High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
Likely to have low vitamin levels
Have you had coeliac blood test done yet
If not get tested BEFORE Considering trialing strictly gluten free diet
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
pubmed.ncbi.nlm.nih.gov/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
As per your post a year ago
You need FULL thyroid including thyroid antibodies and vitamin testing
gponline.com/endocrinology-...
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
Also to test vitamin D, folate, B12 and ferritin
sps.nhs.uk/wp-content/uploa...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Aim is to bring a TSH under 2.5
UK guidance suggests aiming for a TSH of 0.5–2.5
gp-update.co.uk/SM4/Mutable...
Persevere - have all guidelines printed and be ready to quote them
Nat987pal123
I agree with SlowDragon in that Levo should have been increased before considering adding T3.
What do you think of my new results and will I feel better soon
Whoever has prescribed the T3 should know that when taking T3 it is essential to test FT3, otherwise how on earth do they know what it is achieving?
Unfortunately we can't tell you if you'll feel better soon, it all depends on what dose of thyroid meds you need to achieve optimal thyroid hormone levels and how long it will take yu to get there plus achieving optimal key nutrient levels too.
Essential to test vitamin levels at least once year
Nether levothyroxine or T3 will work unless vitamin levels are OPTIMAL
Suggest you test yourself privately
Splitting T3 day before test, with last 5mcg dose approx 8-12 hours before test
Last dose levothyroxine 24 hours before test
Always test early Monday or Tuesday morning, before 9am
List of private testing options and money off codes
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
If taking any supplements that contain biotin stop these a week before test as biotin can falsely affect test results
T3
t3
T3
T3
