Hi everyone - thanks to all the wonderful information on here and with a little push from Grey Goose (who assured me that introducing T3 myself was not as terrifying as I felt it was - thank you Grey Goose👍😀) I started sourcing my own T3 six months ago (the all too familiar reasons - doc - your T4 is in range you are fine - me - but I feel so ill I can't get out of bed and can't function). I had a partial thyroidectomy back in the mid 1990s (currently 59) for Graves disease and was absolutely fine on T4 only until about 5 years ago (suspect menopause) when everything went pear shaped. In 2019, a scan showed there was no thyroid tissue - presume the antibodies finished it off? No doctor has every explained that to me.
So the great news is within days of introducing T3 the results were so noticable. The muscle pain, headaches, brain fog, not sleeping well, skin problems, hair falling out, exhaustion, unable to walk without walking sticks - all began to improve. Over the couple of months everything just kept getting better. I had to play around a little with timings - but feel I have got there in the end. I am feeling so well - although I still think there is room for improvement. The most fabulous thing about reducing my T4 is the diarrhea I have suffered with for the last few years just disappeared (every morning when waking up for at least an hour).
I have just had my bloods done at medichecks and I think I have reduced my T4 too much. My test was taken as recommended on the site. Stopped all relevant supplements 2 weeks before test - did not take my usual T4 the night before the test or the T3 before I went to bed or in the morning when I woke up. Test at 9.30am
When i was on T4 only I was 200mcg and 150mcg alternative days.
I am now taking T4 100 mcg and T3 25ug (uni pharma) - the T3 is split over 3 doses 8 hours apart - see results below. I think I should try increasing my T4 by 25mcg per day and leave everything else alone for 8 weeks and retest?
Vitamins are still an issue? ferritin high - folate serum low (will start supplementing) B12 high - should I stop taking ny supplement - Fully Active B12 Doctor's Best brand. Vitamin D ongoing struggle 🙃
Sorry such a long post and thank you in advance for all the advice - why I didn't listen and start the T3 myself several years ago - makes me want to kick myself! But better late than never.
This was the doctor feedback from medichecks
A common cause of peculiar thyroid results is the vitamin Biotin. If you are taking this then we recommend omitting it for at least 24 hours before your thyroid blood test.I recommend repeating your test to confirm the findings. If you still have contradictory results then there are a couple of possibilities. These findings could arise when someone has antibodies to one of several common animal species (mice and livestock such as sheep and cattle) as these can confuse the laboratory equipment.
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Yes, indeed you have. You were on 175mcg daily (alternating 200/150mcg) and reduced to 100mcg daily. Why did you do that? I can't see any recent previous posts discussing the addition of T3 (last post 2 years ago) and if you'd posted you would have had guidance from patients experienced in adding T3 to Levo and would have been told that if your FT4 was high/over range then a reduction of 25mcg would likely be needed.
I am now taking T4 100 mcg and T3 25ug (uni pharma) - the T3 is split over 3 doses 8 hours apart - see results below. I think I should try increasing my T4 by 25mcg per day and leave everything else alone for 8 weeks and retest?
Yes.
Stopped all relevant supplements 2 weeks before test
No need. If you want to know what your supplements are achieving then you continue up to and including the day before the test with the following exceptions:
Iron - if testing iron and supplementing with iron then leave iron off for 7 days, test needs to be done after a 12 hour fast (water allowed).
B Complex or any supplement containing biotin - because biotin affects results then leave off for 3-7 days before test, with a B Complex containing a small amount of biotin, eg 500mcg, 3 days will be enough, it's the large amounts of around 5mg and more that need a 7 day gap.
Ferritin: 177 (13-150)
Do you supplement?
Was CRP tested?
CRP is an inflammation marker, ferritin rises with inflammation, so your ferritin could be high either because you supplement or there could be inflammation or infection.
ActiveB12: >150 (37.5-150)
Stop taking your B12 supplement. Your level is higher than their equipment can measure.
As you've been taking B12, have you also been taking a B Complex which is necessary when taking B12 to keep all B vitamins balanced?
Folate: 3.04 (3.89-19.45)
You may wish to discuss this with your GP, this could be folate deficiency - see
◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
Vit D: 58nmol/L
This is low. Do you supplement? If so what brand and dose and do you take D3's important cofactors?
You might want to check out a recent post that I wrote about Vit D and supplementing:
and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.
Your current level of 58nmol/L = 23.2ng/ml
On the Vit D Council's website you would scroll down to the 3rd table
My level is between 20-30 ng/ml
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 3,700iu per day. Nearest is 4,000iu.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-Trans form
Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.
This was the doctor feedback from medichecks
We suggest not bothering with doctor's comments, they are usually unhelpful and toe the same line as NHS GPs. Did you tell them that you take Levo plus T3, if not they they wont understand your results and probably wont even realise how to interpret results when on combination hormone replacement. You will get a more accurate interpretation of results here on the forum.
Why did you do that? I can't see any recent previous posts discussing the addition of T3 (last post 2 years ago) and if you'd posted you would have had guidance from patients experienced in adding T3 to Levo and would have been told that if your FT4 was high/over range then a reduction of 25mcg would likely be needed.
I had a pm conversation with GreyGoose a year ago and then it took me time to find a reliable source and then as I had a bad reaction to my second Covid Jab I waited until that had settled down so as not to muddy the water introducing the T3. These were my results a year ago showing I was not converting well and feeling very poorly.
TSH 0.163 (0.27-4.2)
T3 5.84 (3.1-6.8)
Free thyroxine 24.5 (12-22)
No need. If you want to know what your supplements are achieving then you continue up to and including the day before the test with the following exceptions:
Iron - if testing iron and supplementing with iron then leave iron off for 7 days, test needs to be done after a 12 hour fast (water allowed).
B Complex or any supplement containing biotin - because biotin affects results then leave off for 3-7 days before test, with a B Complex containing a small amount of biotin, eg 500mcg, 3 days will be enough, it's the large amounts of around 5mg and more that need a 7 day gap.
Ferritin: 177 (13-150)
Do you supplement?
Was CRP tested?
CRP is an inflammation marker, ferritin rises with inflammation, so your ferritin could be high either because you supplement or there could be inflammation or infection.
ActiveB12: >150 (37.5-150)
Stop taking your B12 supplement. Your level is higher than their equipment can measure.
As you've been taking B12, have you also been taking a B Complex which is necessary when taking B12 to keep all B vitamins balanced?
Folate: 3.04 (3.89-19.45)
You may wish to discuss this with your GP, this could be folate deficiency
Sorry i thought you did have to stop taking B12 fully active before a test - I thought that had biotin
My supplements are
Doctor's Best B12 fully active
Doctor's best Vit D
Doctor's best Vit K
Magnesium - use a spray onto the skin.
CRP was 6.05 range 0-5 down from 7 in Jan 2020
I haven't been taking BComplex - so stop B12 and start BComplex?
Should I start a folate supplement - talking to my Doctor is a waste of time - he saw the results a year ago and said everything was fine - as did the endo I waited 2 years to see.
Ferritin has also come down from January 2020 from 219 to 177 now.
Yes I did say I was taking T3 and T4 to medichecks - and I am not worried what he said- just totally confused by the comment about animals and antibodies
😆Vitamin D is just an ongoing issue - but its up from 22 a year ago.
Sorry i thought you did have to stop taking B12 fully active before a test - I thought that had biotin
No, ingredients would say biotin or B7 if it was included, but a B12 supplement is usually just that unless it says otherwise. Most B Complex supplements contain all the B vitamins including biotin.
I haven't been taking BComplex - so stop B12 and start BComplex?
Should I start a folate supplement - talking to my Doctor is a waste of time - he saw the results a year ago and said everything was fine - as did the endo I waited 2 years to see.
Speak to GP first about your low folate level, referring to the NICE guideline above, emphasising that you are just 0.4 above official deficiency and that your result comes within the indeterminate zone which is suggestive of deficiency. You may be prescribed folic acid. If so finish the course then repeat the test.
CRP was 6.05 range 0-5 down from 7 in Jan 2020
This could be why ferritin is high - your CRP shows inflammation.
Vitamin D is just an ongoing issue - but its up from 22 a year ago.
Hi Seaside Suzie - thank you25mcg reduction would have been enough.
So shall I increase by 25mcg and retest in 8 weeks or increase more?
How much D3 are you taking?
Softgels or veggie caps?
I take 1000iu Vit D a day - soft gels
Speak to GP first about your low folate level, referring to the NICE guideline above, emphasising that you are just 0.4 above official deficiency and that your result comes within the indeterminate zone which is suggestive of deficiency. You may be prescribed folic acid. If so finish the course then repeat the test.
Yes will speak to the doctor - I don't want to tell him I am taking T3 - our last conversation just over a year ago was a complete full on melt down, with me trying to explain how ill I felt and that I felt I was being forced to find a way to self medicate for T3 and he lost it with me - saying I was totally irresponsible and he would not support that in any way. After that I was told I would be supervised by the prescribing nurse for this condition - not my doctor. When my NHS blood test came through she had no idea what was what - said there was no T3 result on there and when I pointed out it was - she replied oh yes that's what that is!!!
This was the point I decided I had to introduce T3 myself. I shall just tell him I have had a vitamin test to check on my supplements.
Thanks SeasideSuzie your advice is greatly appreciated
So shall I increase by 25mcg and retest in 8 weeks or increase more?
We should change Levo by 25mcg at a time, so I would add 25mcg now and retest in 8 weeks to see how things change.
I take 1000iu Vit D a day - soft gels
So that needs increasing and if you check out the link I mentioned before you will see what the Vit D Council recommends so I would increase your D3 to 4,000iu daily and retest in 3 months. 1,000iu is just about a maintenance dose for someone with a good level already, it's unlikely to raise a low level.
Yes will speak to the doctor - I don't want to tell him I am taking T3
No need to discuss your thyroid results, you just want to discuss folate.
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