Thyroid Results

[Experiment1982739903]

Vitamin D is optimal last check, B12 is around 500 but Im taking a methyl b12 and folate that is helping a lot. Ferritin is high. Starting phlebotomy soon. Protein is 9.8 and the range is 6-8.5. ALT and AST also went up above range. Not sure what that is about...So anyway my doctor agreed to add T3 and reduce T4 to see if it helps my dry mouth. Hope it helps...Dont know what else to do. Maybe try armour if t3/t4 combo or t3 alone doesnt work. Im happy my doctor agreed to trialing T3...What do you guys think about the results? This was on 188 mcg. Now we are trying 150 T4 and 10T3. Thanks for reading

[SlowDragon Administrator]

Will flag iron results for radd to perhaps comment on

There’s nothing on your profile

Please add to profile wether male or female, approx age and current levothyroxine dose

[Experiment1982739903 in reply to SlowDragon]

Thank you

[Experiment1982739903 in reply to SlowDragon]

Do you think my FT3 would fall below the range if my FT4 decreased to the mid range based on these results? If my tsh is low in this circumstance, would that be considered central hypothyroidism?

[radd in reply to Experiment1982739903]

Experiment626,

‘Do you think my FT3 would fall below the range if my FT4 decreased to the mid range based on these results? If my tsh is low in this circumstance, would that be considered central hypothyroidism?’

No, not now you are medicating T3 but FT4 might fall as T3 meds can interfere with signalling, and this is normal. It isn’t a good idea to take FT4 over-range as the body can only convert what it is capable of at that time and excess either gets excreted straight out in urine but a proportion will be turned into inactive metabolites that not only can start working against us but impair future meds from working. 

You have reduced Levo but am not sure if these TFT results were before or after introducing T3 meds, as results stand at FT3 66% through range which is a good level. If before you most likely do not need T3 meds as very few need to take FT3 to top of range, and which again if in excess can start working negatively against us. It can also encourage high SHBG & low levels of free testosterone.

Your utilisation of thyroid hormone meds are influenced by variable factors including lifestyle, other health conditions, diet and nutritional status. Therefore, it is imperative to optimise all nutrients/micro-nutrients and may be supplement additional selenium known to improve conversion. Some of us have common genetic mutations and T3 meds must be taken to replace the shortfall. If your TFT's were taken before starting T3 meds, the results do not indicate any genetic impairment.

Often only a small increase in FT3 levels is required to achieve well being because the amount of FT3 circulating in the blood influences how the deidinases work (thyroid enzymes that dicate activation/deactivation). Therefore, a little bit extra T3 might achieve much higher levels than the amount you have added, and why we introduce T3 low and slow. 

Your results do not indicate central hypothyroidism because your TSH is responding appropriately, ie reducing in response to elevated FT4 levels and adequate FT3 levels. 

Liver enzymes are commonly raised when thyroid hormones aren’t working effectively, and peeing out elevated proteins when kidneys aren’t working as they should. Optimising thyroid hormones reversed both of those conditions for myself. Optimising does not mean taking thyroid hormone levels as high as you can but finding your sweetspot where hormone can work most effectively, and then allowing them to do so by making appropriate lifestyle/dietary change if necessary.

Heriditary hemachromatosis doesn’t always warrant venesection in every case. There are many reasons for elevated ferritin levels (ie have you had COVID or other infection, it doesn’t have to be recent? Do you have autoimmune conditions?). 

TIBC - high

UIBC - high

Serum Iron 67 (38-169) at 22% through range

T/S 16%.

Also your serum iron levels are only 22% through range with high TIBC and UIBC indicating iron deficiency. Iron saturation further evidences iron deficiency with a result of just 16% (this is a calculation of the other results to give indication of how much iron is bound and ready to be transported around the body.)  Iron is complex as implicated and influenced by many other systems, and can be both a cause and result of hypothyroidism.

You may find once thyroid hormones are working effectively then your iron mechanisms improve. You want the body to use the serum iron effectively for euthyreosis, and so more is drawn out of storage and ferritin levels reduce. The increase in metabolism initiated by good thyroid hormone function often increases the whole euthyreosis process from gut absorption to the bone marrow's formation of RBC's, and iron levels end up dropping. 

Have you had an FBC, ie haemoglobin and RBC health measured? 

Have you had thyroid antibodies tested?

[Experiment1982739903 in reply to radd]

Thanks a lot, this gives me much to think about...This lab result was before taking any T3. We started T3 not because of conversion issues but because of the dry mouth I have on levo. Like a trial to see if it improves as Ive heard some anecdotal evidence that that can solve this issue...I had a previous result a while ago that had my T4 at .99 and my TSH was still low at .270. There was no T3 result but I feel it probably wouldve fell well below range if it was measured. So maybe a conversion issue like you said. I will try Selenium to see if it helps. Maybe I can go back to T4 only if it helps conversion. Maybe selenium could resolve dry mouth...idk. The dry mouth is really bad. Very dry in the morning and always thirsty since starting levo.

[Experiment1982739903 in reply to radd]

So I have iron defeciency and iron overload at the same time?

[radd in reply to Experiment1982739903]

Experiment626

Mouth issues are immensely common on this forum. I too was convinced it related to Levo excipients and the reason I switched to NDT. Residual symptoms improved and I am now luxuriously warm with fair amounts of energy (although no stamina) but mouth issues have never improved.

You will need to test six weeks after initiating T3 meds and possible before if you start feeling hyper because FT3 at 66% is a pretty good level and you don't want it going too high.

regarding iron, yes, it’s really tricky. Low transferrin saturation (T\S) indicates likely iron deficiency regardless of ferritin levels. Remember ferritin is only a protein that stores iron and not iron itself. It can be a good indicator of iron stores but not of how iron is being utilised. 

After absorption iron attaches to ferro portin that transfers it to transferrin for transporting around the body. But ferro portin is vulnerable to other health conditions/inflammation, and  any form of immune inflammatory response will cause the liver to start releasing chemicals called cytokines such as hepsiden that inhibits ferro protein function further. Without this initial good utilisation of iron the whole rest of its journey can not proceed, and the transferrin proteins become high and left unbound. 

I too have heamochromatosis and my ferritin levels generally follow a rising T/S which has reached levels of 99% before. It may be that yours will eventually increase over the next few months/years dependant upon how quick an accumulator you are or you may never need venesection. Not every haemochromatosis sufferer does.

You didn’t answer as to whether you have Hashi or not as this often makes a big difference.  Or if you have had FBC? As ferritin is so elevated have you had other inflammation markers tested such as CRP & HDL? It would be foolhardy to have venesection with lowish iron levels and low T/S without checking haemoglobin levels.

[Experiment1982739903 in reply to radd]

I was never diagnosed with Hashimoto's. Hemoglobin levels were good at last check. Not sure about FBC, CRP and HDL. I'll look through my old labs and get back to you.Sorry if I'm slow at answering. Still not feeling 100% and have brain fog. Grateful for your replies.

[Experiment1982739903 in reply to radd]

I think I will hold off on the phlebotomy based on what you have said. Need to learn more about

[radd in reply to Experiment1982739903]

Experiment626,

Who said you should have phlebotomy based on these results? Are you under a hemo?

[Experiment1982739903 in reply to radd]

No my GP did after looking over my results for a few minutes

[radd in reply to Experiment1982739903]

Experiment626,

GP's often aren't good with the intricacies of iron, reading results at face value. If you are worried about elevated ferritin you could ask to be referred to a hemo, or if you are already under one, send him these results.

If it was me I would place more effort into thyroid hormones first because the rest could right itself anyway, and ask for iron to be reassessed in 3 months.

[Experiment1982739903 in reply to radd]

Sounds like the right idea

[Experiment1982739903 in reply to radd]

CBC

Dont know if this helps. From about 5 months ago