Morning. Quick question if I may?
Feeling good on levothyroxine 75mg, T3 5 mg and hrt.
My only issue is my thyroid/neck is really sore. I've had it scanned and no nodules just shows typical Hashimotos or Thyroiditis.
Endo wants to increase T3 to 10 mg but im not keen to have any more medication, im wondering if the T3 causing sore thyroid. Been on it for over a year.
Otherwise feeling pretty good, no symptoms
Anyone else have this issue?
Thank you
was test done early morning ideally around 9am and last dose levothyroxine 24 hours before test
Last 2.5mcg dose T3 approx 8-12 hours before test?
FT4: 18.1 pmol/l (Range 12 - 22)
Ft4 is 61.00% through range
FT3: 4.2 pmol/l (Range 3.1 - 6.8)
Ft3 is only 29.73% through range
When were vitamin D, folate, ferritin and B12 last tested
Hi yes to both
I would agree with endo, you need increase in T3
Perhaps try 5mcg waking, 2.5mcg mid afternoon and 2.5mcg at bedtime (assuming you get 5mcg tablets)
ferritin and B12 both too low….indicative of being under medicated too
What vitamin supplements are you currently taking
Are you vegetarian or vegan?
Low B12 symptoms
b12deficiency.info/signs-an...
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.
once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with vitamin B Complex.
B12 drops
healthunlocked.com/thyroidu...
B12 sublingual lozenges
amazon.co.uk/Jarrow-Methylc...
cytoplan.co.uk/shop-by-prod...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
2-3 weeks after starting B12 consider adding a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
chriskresser.com/folate-vs-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12
I am vegetarian but take B12
Then as vegetarian on replacement thyroid hormones it’s very difficult to maintain GOOD iron and ferritin on plant based diet
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Medichecks iron panel test
medichecks.com/products/iro...
Heme iron v non heme
hsph.harvard.edu/nutritions...
As vegetarian likely to need daily vitamin B complex plus continue separate B12 at least 2-3 times a week….possibly more frequently
aiming for ferritin at least half way through range
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Medichecks iron panel test
medichecks.com/products/iro...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Heme iron v non heme
hsph.harvard.edu/nutritions...
Here’s absolutely excellent reply by @humanbean
on iron and ferritin panel test results for another member
healthunlocked.com/thyroidu...
Good explanations of iron
Thank you
Sort of panic after blood-test >100 TSH
Thyroid swollen and sore 1 side only?
Thyroid not functioning well 
NP Thyroid, Latest labs
Incomplete thyroid test
