Help and advice needed with bloods during NHS T4/T3 trial.

[Gilbo72]

Hi all, I posted a while back regarding my first blood tests after introducing T3. Unfortunately, I can't find my post.

Anyhow, I was finally started on an NHS trial of T4 and T3 therapy. Whoo!

PREVIOUS BLOOD TESTS ON T4 ONLY. (Dose of 142.8mcg of levo)

Jun 2020

(this was a few months after losing weight fast (16lbs) and my hair falling out, following the covid vaccination which caused my thyroid gland to swell)

TSH– 0.20 (0.30-3.94)

FT4– 35.10 (12.3-20.2)

FT3– 4.60 (3.70-6.70)

Aug 2020

(weight loss slowing)

TSH– 0.12 (0.30-3.94)

FT4– 28.10 (12.3-20.2)

FT3– 3.90 (3.70-6.70)

Jan 2021

(weight gain started)

TSH– 0.41 (0.30-3.94)

FT4– 28.10 (12.3-20.2)

FT3– 3.90 (3.70-6.70)

Jun 2021

TSH– 0.04 (0.30-3.94)

FT4– 29.20 (12.3-20.2)

FT3– 4.50 (3.70-6.70)

Sept 2022

(had put all weight back on)

TSH– 0.22 (0.30-3.94)

FT4– 28 (12.3-20.2)

FT3– 3.5 (3.70-6.70)

BLOOD TEST INTRODUCING T3.

May 2022 (Dose of 100mcg of levo and 10mcg of lio)

(Stupidly I took this test exactly as the others above to keep it consistant. ie 24 hours after levo, but also 24 hours after lio too. ( I didn't realise the 8-12 hour rule for lio). I felt a huge improvement in clarity, sleep, energy and mood. However, I also felt something was not 'enough'. Either T4 or T3. I also experienced some 'crashing' after eating. I tired varying doses with splitting, but it didn't really help. Some hair loss and soft nail splitting. Felt like weight was still increasing.

TSH– 0.34 (0.30-3.94)

FT4– 21.8 (12.3-20.2)

FT3– 3.8 (3.70-6.70)

Aug 2022 (Dose of 71mcg of levo and 20mcg of lio)

So on this dose still feel the above benefits but also still feeling the food crashing, and increased wanting to sleep. In between this dose and the previous dose I contracted Covid and was quite unwell for 3 weeks. Not sure if they are related. Again, I experimented with splitting the lio during the day, but it didn't make a difference. I am struggling with crashing after eating. Napping for several hours or just munged out. I think its an insulin resistance/sugar thing going on. I had a light bulb moment and remembered I was diagnosed with PCOS over 25 years ago which I hadn't thought about.

(This test below was taken as above. Again to keep it consistant. Ie, 24 hours after both levo and lio.)

TSH– 0.18 (0.30-3.94)

FT4– 18.8 (12.3-20.2)

FT3– 4.8 (3.70-6.70)

(This test below was taken the next day for comparision. This time 24 hours after levo and 11 hours after lio.) Note different ranges from different lab.

TSH– 0.4 (0.27-4.2)

FT4– 16.9 (12-22)

FT3– 6 (3.1-6.8)

I am seeing my endo on Wednesday. Does my dose need adjusting, or do I need to concentrate on looking at PCOS now? Any advice or comments appreciated. Many thanks

[Lalatoot]

Gilbo your last set of results would suit me nicely. I wouldn't change anything.Sometimes the body needs stable doses to heal and adapt longer term and for us to feel the full benefits of doses. I would stop as you are for the moment.

[Gilbo72 in reply to Lalatoot]

Hi Lalatoot do you think the crashing is a different issue that needs to be addressed separately? I am worried they will want to reduce one or the other due to the TSH being 0.18. Should I show the endo both test results to fight my case? (He will automatically see the one with the TSH of 0.18).

[Aurealis]

Think you can find your last post by clicking on your name above

[helvella in reply to Aurealis]

Which takes Gilbo72 to their profile:

healthunlocked.com/user/Gil...

Which lists previous posts and replies and profile information.

[Gilbo72 in reply to helvella]

For some reason I couldn’t find it, even now. Maybe it’s the browser I am using

[helvella in reply to Gilbo72]

Is this it?

healthunlocked.com/thyroidu...

From 24 days ago.

[Gilbo72 in reply to helvella]

Yes, but I just wanted to copy! Doesn’t matter now as I have written this post!

[SilverAvocado in reply to Gilbo72]

For me, using a mobile phone, it is quite hard to get to your own profile.

Usually I do it by going into the top corner and clicking the option to edit my profile. Then on the edit screen there is the option to see my profile.

On your profile page you still have to click around quite a bit to find your old posts. You can also get to all your old replies.

[helvella in reply to SilverAvocado]

I do not understand why HU made Update profile the prime link. I suspect most people will wish to view their profiles far more often than update them!

Same issue on a computer.

[TaraJR]

What do you mean exactly by 'crashing' after eating? How long after?

I was diagnosed with reactive hypoglycaemia, as my blood glucose level goes very low about 2 hours after eating, It was diagnosed by a prolonged glucose tolerance test at the hospital. I'm pretty good now if I eat a small snack (mostly protein) every 2 hours in the day

[Gilbo72 in reply to TaraJR]

Hi TaraJR , I find after eating I cannot keep my eyes open. Can lose a few hours in the afternoons from either napping or being in a zombie state. So much so I bough a blood glucose monitor. I don’t seem to have low sugar, maybe the opposite. I will bring it up with the endo on Weds. my fasting level is just over range and hints at prediabetic. In the morning it can be anything from 5.6 to 6.7. During the day it has ranged from 5.2 to 7.4. It will even happen to some extent after eating a low carb meal (eg chicken salad) although defo worse after high carb.

[TaraJR in reply to Gilbo72]

Ah, it doesn't sound the same as me. But it does sound as if it could be endocrine related. Good luck when you see the endo.

My reactive hypoglycaemia got much much better when I started taking T3 and all my thyroid levels were then good. So pursue the thyroid line too. Have you got all your thyroid results with their reference ranges?

[SilverAvocado]

Gilbo72, not the answer to your main question, but as others have said reactive hypoglycemia and reactions to food are very common hypothyroid symptoms.

The first thing you could try quite easily is to experiment with your meals, both what you're eating and timings or how much you eat across the day.

Many forum users seem to eat a fairly low carbohydrate diet, reducing or cutting out altogether bread, rice, pasta, potatoes, and definitely sugary foods. Then to compensate add in more fats and proteins. Many Hashimotos sufferers benefit from being gluten free, and some benefit from being lactose (dairy sugar) free, too.

It's possible to buy a small finger prick, blood sugar machine that you can use to test yourself across the day and confirm what you're blood sugar is doing when you eat, and that is helpful for detecting which foods are better or worse for your particular blood sugar, too. Some people find quite benign foods disagree with them.

[SilverAvocado in reply to SilverAvocado]

PS, Another weird little thing your post made me think of. When I first had my thyroid removed and was very very hypo I found I didn't have many specific symptoms like you see on symptom lists, it just seemed like nothing in my body worked and I was in bed most of the time or just barely coping.

Then as I started to improve and my life became more normal, it seemed like in some ways my 'symptoms' increased and I got more specific things that you could actually describe and write down.

I've had a bit of improvement recently and a similar thing has happened. I feel more alert, my body feels more strong, and I can do more activity in the day. But more weird things are cropping up, like my feet are always cold and the rest of me is often too hot. Strangely, while being on a worse dose for the past few years my feet never seemed to be cold and I would go around the house bare foot with my slippers staying in the cupboard. Now I'm desperate for the slippers! This is more of a silly example, but there are many similar things.

I've always wondered if this happens to everyone. I think it might be part of the problem that different parts of our body need different doses. Or it might also be that when I am more well I will immediately do more chores or activities and rest less, so maybe it is the wear and tear on the body.

I should add: This kind of thing always makes it hard to tell each time whether I feel better on a given dose or worse. I think you've got to weigh up everything you've experienced on each dose and try to figure out whether this is worse or better than you were before. And also whether you've improved overall since you started taking T3, and if you are heading in the right direction. Symptoms are the most important thing, blood tests are just one tool.

[Gilbo72 in reply to SilverAvocado]

Hi SilverAvocado , yes! I know what you mean. I have just answered to the bit about blood glucose monitors above. I deffo think I have improved, but as you say more symptoms are apparent and more ‘definite’ rather than a general unwell feeling. And as you say, I am more active now. Good result is my BP which was always on the high side seems to have dropped back into normal levels.