Reducing levothyroxine and taking HRT

[Pooky1]

I would appreciate some thoughts on whether I should reduce my Levothyroxine from 125 daily to 125 x Mon-Fri and 100 x Sat/Sun to bring TSH up a little bit. GP has agreed to this and started me on HRT patch (Evorel Conti 50) to see if that helps with the aches and pains as she thinks thyroid is treated well otherwise. Retest in September. Luckily, they tested FT3 this time as don't usually despite GP request.

I am not always given same make of Levo and sometimes two different packs (100 and 25mg).

I have low folate mostly - and D3 despite supplementing with Better You spray with K2. I managed to get B12 up from 300 to 900 last year with Better You spray. I am recently taking 1 Thorn Basic B complex each morning to see if that helps and stopped this a week before latest test. I take a cod liver oil capsule daily.

I am coeliac so gluten free and on 2 x 200 hyrdoxychloroquine for frontal fibrosing alopecia (which dermatologist recently said is “quiet” at present).

I was taking a daily (before bed) 210mg of Ferrous Fumarate but have dropped to every other day to give my stomach a rest and see if this absorbs just as well.

24 JUNE 2022- taking 125mg Levothyroxine daily

TSH: 0.22 mU/l (Range 0.35 - 4.78) -2.93% through range

FT4: 17.4 pmol/l (Range 10 - 20) 74.00%

FT3: 5.2 pmol/l (Range 3.5 - 6.5) 56.67%

29 MARCH (first test incomplete)

TSH: 0.33 mU/l (Range 0.35 - 4.78) -0.45%

FT4: 19.2 pmol/l (Range 10 - 20) 92.00%

Vit D: 68 (50-200)

15 MARCH

TSH: 0.41 mU/l (Range 0.35 - 4.78) 1.35%

Serum Ferritin: 103 (30-250)

B12: 777 (200 - 900 ng/L)

Folate 3.4 (2 - 17 ug/L)

3 NOVEMBER 2021 - 112.5mg Levothyroxine daily

TSH: 1.04 mU/l (Range 0.27 - 4.2) 19.59%

FT4: 20.6 pmol/l (Range 10.8 - 25.5) 66.67%

Ferritin: 159 (13 - 150) (Recovering from ear infection so possible inflammation?)

B12: 679 (180 - 999)

Folate: 2.9 (No range given - says “LLOW")

Vit D: 86 (50-174)

[SeasideSusie Remembering]

Pooky1

Why do you want to bring your TSH up? Your FT4 sits nicely at 74% and your FT3 isn't too bad at 56.67% (although you may need them better balanced), so if you reduce your Levo your FT4 will drop and most likely your FT3 will as well.

Your TSH isn't suppressed (suppressed is less than 0.1) so why upset the apple cart?

If I were you I'd concentrate on getting the same brand every time, and for the 25mcg I'd ask for 50mcg tablets of the brand of 100mcg that you get on with and cut in half to give 125mcg daily. Ask GP to put this on your prescription and stipulate brand you prefer in first line of script.

If your Vit D isn't responding to the BetterYou spray then change. I have always done well on Doctor's Best D3 softgels, a pure, clean supplement with just D3 and extra virgin olive oil. This brought my Vit D up from severe deficiency of 15nmol/L to 202nmol/L in 2.5 months and then I adjusted to a maintenance dose and keep it close to 150.

For Vit K2-MK7 I use Vitabay, Vegavero or Vitamaze (German brands available on Amazon but do go out of stock from time to time so I get what's available when I need it). It contains the better, converted "all trans" form of K2-MK7 rather than the unconverted "Cis" frm (a bit like taking methylfolate rather than folic acid).

Have you been taking magnesium as well, D3 needs magnesium for the body to convert it to it's usable form.

[Pooky1 in reply to SeasideSusie]

Thanks for your reply, Seaside Susie

I think it was because the GP mentioned twice that TSH was out of (their) range. I was not too fussed as I know from reading on here that it was not a problem. I suggested dropping a small amount - but I think I will stay on 125 daily as I had also heard about HRT affecting absorption. I will request same brand for both tablets at next prescription.

I take the D3 spray for ease of use (and easier to absorb being coeliac plus no waiting between taking other supplements) but I will try the gels and the Vit K2 you mention next and see how that goes.

I was taking liquid magnesium drops for many years (BodyBio brand) which is magnesium chloride then another brand but more recently Nu U Nutrition Magnesium Glycinate with Vitamin B6, Zinc and Pantothenic Acid - 250mg Elemental Magnesium from Chelated Magnesium. I can't remember why I stopped that - maybe it upset my stomach after a while.

Would the Iiquid ionic magnesium be sufficient?

I will keep taking the B complex for B12 and folate.

[SeasideSusie Remembering in reply to Pooky1]

Would the Iiquid ionic magnesium be sufficient?

I'm afraid I don't know anything about that type of supplement.

You don't have to wait to take other supplements with the D3 softgels or the Vit K2-MK7. The only thing is to keep D3 away from your thyroid meds by 4 hours, and the K2-MK7 away from your thyroid meds by 2 hours, same as all other supplements.

[Pooky1 in reply to SeasideSusie]

Thank you

[Buddy195 Administrator]

I’ve not needed to adjust my thyroid medication since starting HRT, but other members have needed an increase as it has affected the absorption.

It may be useful to have a look at Dr Louise Newson’s free Balance App, as I find it really useful for up to date research articles. There is also an ability to post questions.

healthunlocked.com/redirect...

[Pooky1 in reply to Buddy195]

Thanks, Buddy195

I think I will stay on 125 for now then until next test - as best to change only one thing at a time and I was aware that some members were affected by absorption.

Thanks for the link to the Balance App. It looks very good and will be handy to use as I am just starting HRT so can track how I am feeling on it to show GP next time - she specialises in women's health and menopause so she may be aware of it. She suggested HRT as the levo did not seem to be alleviating all my symptoms.

[Gingernut44]

Just a quick question- how many sprays of the Better You Vit D + K2 are you taking per day?

[Pooky1 in reply to Gingernut44]

3 to 4. There’s some Vitamin D in the cod liver oil as well.

[Gingernut44 in reply to Pooky1]

Just asked because some folk get confused and only take one spray. It obviously doesn’t suit you so perhaps trying Seasidesusie’s suggestions and see if they work. Good luck.