I wonder if I could ask you a question about my current predicament - you are all so knowledgeable!
I've had hashimotos for at last 11 years and am 10 months into a trial of T3 and T4 combined. I have felt well at times on this combination but often tip into over-medicated territory based on feeling wired and resting heart race increasing significantly - at no point has my TSH got into normal range with bothers both my GP and my endo. I am currently on a reduced dose of just one x 5 µg T3 and 125 of thyroxine each day.
I am ten weeks post Covid - it was a mild infection but took a while to get a clear test result and the linger fatigue was crippling and has only just lifted. I was fully vaxxed.
Over the last 2-3 weeks I have noticed increasing problems with the circulation in my lower legs and feet. this has coincided with me gradually walking longer distances (i used to do 20k steps daily before i got covid). If i sit even for short periods of time my legs go red to purple to blue-ish and feel prickly and uncomfortable. I saw the doctor yesterday who has referred me for leg scans to check arteries. He was pretty unconcerned tho and said there is nothing obviously or urgently wrong. I am waiting for the scan appt but told it could be months off. Am worried!
I wonder if this is a thyroid thing, or a post covid thing or something else. Here are my latest blood test results does anything stand out? I thought iron looked low but GP dismissed this and said it doesn't need treatment. He did of course latch onto the supressed TSH and try and reduce my thyroxine to 100mg a day sigh.
Plasma iron level (XaIRe) 10.3 umol/L [10.7 - 32.2]
Also weirdly for the first time ever my thyroid peroxidase anti bodies are 32 iu/ml so just within normal range (<34). They are normally through the roof.
I'm really sorry for such a long post but hope someone might have time to advise me!
Thank you
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but often tip into over-medicated territory based on feeling wired and resting heart race increasing significantly
You have Hashi's, this will happen, it's typicall Hashi's activity for fluctuations between hypo and "false hyper".
Also weirdly for the first time ever my thyroid peroxidase anti bodies are 32 iu/ml so just within normal range (<34). They are normally through the roof.
Just confirms that antibodies go up and down, it doesn't matter, you still have Hashi's.
at no point has my TSH got into normal range with bothers both my GP and my endo.
Your TSH will be low, even suppressed, because you take T3, it's just what it does. How on earth can a doctor who prescribes T3 not know this? Just goes to show their ignorance when it comes to treating hypothyroidism.
I am currently on a reduced dose of just one x 5 µg T3 and 125 of thyroxine each day.
How much has your T3 been reduced? What dose did you feel best on?
Plasma iron level (XaIRe) 10.3 umol/L [10.7 - 32.2]
Serum ferritin level (XE24r) 26 ng/ml [11 - 307]
Ouch! What has been said about these levels. Below range plasma iron and ferritin less than 30ug/L confirm iron deficiency.
Have you had a full blood count to see if you have anaemia? You can have iron deficiency with or without anaemia.
Doctor needs to address this.
Serum vitamin B12 level (XE2pf) 486 ng/L [145 - 914] - ng/L is the same as pg/ml
This is on the low side but not low enough for doctor to do anything about it.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
It would be advisable to supplement with some B12 sublingual plus a B Complex to keep all B vitamins balanced. One bottle of B12 should be enough to raise your level to over 550ng/L and then just continue with the B Complex.
If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this can stop the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
If these are the results on 125mcg Levo plus 5mcg T3 then it's very obvious that your FT3 is far too low. You need your T3 raised to get your FT3 higher up the range. When on combination thyroid hormone replacement it's usual to see a higher FT3 than FT4. Some of us are fine with a low FT4 as long as FT3 is in the upper part of the range, some of us need the FT3 and FT4 more in balance over half way through range, but to have FT4 high and FT3 low shows the need for more FT3.
Hi SeasideSusie and thanks so much for the detailed response - it's much appreciated and I am reading and digesting what you said.
Regarding Anaemia the doc said my levels aren't low enough to be considered anaemic - I didn't realise the FBC was the main test - I saw low iron levels at 10.3 and though that equated to anaemia. My FBC result look ok I think? Pls see below - hope you dont mind this level of detail. Thanks so much in advance x
Haemoglobin and haematocrit are the main tests which would suggest anaemia if they are below range.
Your iron results confirm iron deficiency and your haemoglobin and haematocrit being within range show you don't have anaemia, so you have iron deficiency without anaemia.
This could be a long shot but thought it was worth mentioning in case you get no luck with the above suggestions!
Have you noticed any difference with blood pressure/heart rate, particularly when standing up?
I have Postural Orthostatic Tachycardia Syndrome (POTS) and it can sometimes come on after an illness (my case glandular fever at 21). Some of my symptoms include pins and needles sitting down and loss of circulation. It’s not dangerous just uncomfortable and is a bastard to work out what’s wrong! I had mine diagnosed by a cardiologist but I think lots of people look for answers for years as it’s not very commonly talked about. My symptoms were worse before I treated my thyroid or not on the correct dose but even then it never fully went away but I stopped noticing it as much.
Again I don’t know if this is useful but thought it’s worth bringing up ☺️
Thanks so much for your message. I have heard of POTS and did wonder if that might be what’s happening. It’s still as bad as ever with my lower legs and feet red/purple and prickling whenever I sit down without elevating my legs. My HR and BP have both been higher than normal but I thought this might be thyroid meds related. I’m having a Doppler scan on my legs to check the arteries at some point and I guess if that shows all looks ok then perhaps it is POTS and sounds like a cardiologist is the way to go. I really appreciate your reply - I hate not knowing why my body is doing weird stuff!! The after affects of Covid are a nightmare. X
Yes definitely look into it you get no joy from the Doppler scan! There are different types of POTS and although I don’t have it myself, there are quite a number of sufferers who have pooling in their legs which can be painful.
There are a few checks you can do it at home to back up your theory before suggesting it to your doctor. I’m sure there is more info on the official website but I believe you can take your blood pressure after sitting down for a while and then stand up and measure whether your heart increase by a certain amount and if your blood pressure drops. Again, I stupidly can’t remember the exact figures but I’m sure a quick Google could fix it 😁
I hope you get some answers and let us know how you get on!
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