T3 Trial Test results Advice Please

[rick2525]

I'm a regular on here. But just to recap for you good people. Diagnosed hypo with Hasimoto 2 years ago. Gluten free for 1 year +. Blood tests always fasting before 9am and no meds from previous day prior to test. Currently on 100 mg Levo accord and 20 mg T3 daily. Commenced T3 trial on 30th August and titrated gradually. Placed on trial due to Dio2 positive gene test and symptoms of gut issues reynauds, lack of energy plus many more. My conversion of T4 to T3 was poor.Test results prior to T3 trial

Ferritin 122 range 30-400

Folate 7 range >3.89

Vit B12 active 105 range 37.5 -150

Vit D 63

TSH 1.19 range 0.27-4.2

Free T3 4.2 range 3.1 -6.8

Free T4 21.1 range 12-22

TGA 259 range <115

TPA 361 range <34

Blood test results T3 trial

Ferritin 180 range 30-650

Folate 15.1 range 8.83-60.8

Vit B12 92 range 25.1-165

Vit D 72 range 50-200

TSH 0.09 range 0.27-4.2

Free T3 5.4 range 3.1-6.8

Free T4 15.4 range 12- 22

TGA 241 range 0-115

TPA 292 range 0-34

My T3 has increased. My Energy levels improved plus my alertness (I dont suffer headlamp syndrome as much) Numbness gone from toes and Reynauds.

What has not improved is gut issues. Still bloating and cons. Any advice?

On T3 I have also lost weight approx 5 lbs. I also lost weight on Levo only.

TSH suppressed which is normal on T3. But Endo seen results I emailed to him. He just commented test results reasonable. As I took these bloods on 17th October he said I didn't need anymore before seeing him this weeks appointment. Unfortunately he had to cancel and reappointed for 6th Dec.

[SlowDragon Administrator]

What vitamin supplements are you currently taking

Folate quite low

Are you taking daily vitamin B complex?

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement (eg Jarrow methyl folate 400mcg)

How much vitamin D are you currently taking

And do you supplement magnesium (in afternoon or evening at least 4 hours away from levothyroxine)

Do you supplement zinc or selenium

Might want to test first….or just try a supplement once or twice a week

Have you had testosterone levels tested

[rick2525 in reply to SlowDragon]

Hi SDI arnt taking any Vit B supplement

I've started taking Better u Vit D plus K spray since darker nights. But only once daily. I dont supplement Zinc or selenium at moment. Would this help gut cons problem.

I know your a big believer in Vit B complex Igneous I think. What would this help with exactly.

With T3 I've experienced slight palpitations si just wondered if I'm over medicated with T3?

[SlowDragon Administrator in reply to rick2525]

On replacement thyroid hormones, Hashimoto’s and on gluten free diet we almost always need to supplement continuously to maintain OPTIMAL vitamin levels

Vitamin D at least over 80nmol and between 100-125nmol might be better

Likely to need 2000-3000iu daily, perhaps more in winter

Better You red bottle - one spray = 1000iu

How much are you currently taking

Vitamin D needs magnesium

Gluten free diet low in magnesium too

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance

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) 

currently cheapest on eBay

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 may want to consider taking a separate methyl folate supplement

[rick2525 in reply to SlowDragon]

Currently taking 2 x 1000 vit D but only recent because I was outdoors alot in summer. But need to up it it winter

[SlowDragon Administrator in reply to rick2525]

Zinc is essential for good gut health

healthline.com/health/diges...

theguthealingninja.com/blog...

Selenium too

Selenium also important for eyes….if your are dry/gritty/swollen

[SlowDragon Administrator]

Thyroid levels

Was test done early morning and last dose levothyroxine 24 hours before test

Day before test did you split T3 as 3 smaller doses spread through the day and last dose approx 8-12 hours before test

Free T4 (fT4) 15.4 pmol/L (12 - 22) 34.0%

Free T3 (fT3) 5.4 pmol/L (3.1 - 6.8) 62.2%

Many, many people find they need BOTH FT4 and Ft3 at least 60% through range

Would suspect, like many other members, your endocrinologist has reduced levothyroxine too much when adding T3

Suggest you increase levothyroxine to 112.5mcg and retest in 6-8 weeks

You might need to reduce T3 to 3 x 5mcg ……if Ft3 is too high after next test

Have you considered trialing dairy free diet?

Tougher than gluten, but worth considering……in the New Year

[rick2525 in reply to SlowDragon]

Yes test was done 8.55 am on a fasting test with last levo taken 24 hours previously.I was unable to split T3 into 3 doses because the Drs started me on tablets while I titrated on T3 and after 1st month they switched me to 2 x 10 mcg capsules daily to cost save which really annoyed me but I am going to see if Endo will ask them to put me back on tablet when i see him on 6th Dec so that i can split them .

I certainly need T3 the trial has proved that if nothing else.

Somehow I need to fine tune .

So Endo reduced my levo from 125 mcg to 100 mcg and gave me 2 x 10 mcg daily.

I went lactose free for a few months and it made no difference to gut issues.

[SlowDragon Administrator in reply to rick2525]

Lactose free is not the same as dairy free

Request change to 3 x 5mcg capsules?

My GP just agreed to trialing 3 x 5mcg capsules as cutting 20mcg tablet into reliable 1/4’s is tricky

[rick2525 in reply to SlowDragon]

If I request Endo to put me on 3 x 5 mcg capsules would I also need an increase in levo form 100 mcg daily or would you leave it ?

[SlowDragon Administrator in reply to rick2525]

ideally only change one thing at a time

How soon could you get 5mcg capsules prescription from endocrinologist

[rick2525 in reply to SlowDragon]

I was due to see my Endo this week but due to poor chap having an accident he has rearranged my appointment to 6th December

[rick2525 in reply to SlowDragon]

How long before and after T3 should I eat it drink other than water. I've been leaving it an hour either side. But is it different timings to taking Levo ?

[SlowDragon Administrator in reply to rick2525]

I think an hour is fine

It’s absorbed quicker than levothyroxine

[FancyPants54 in reply to rick2525]

I don't bother with that at all for my T3 doses. Only for my Levo dose in the morning. T3 is absorbed differently to T4.

[rick2525 in reply to FancyPants54]

I've been finding it difficult sometimes to juggle the different meds. So I take 1st dose of Levo and T3 together 1st thing in morning and 2nd dose T3 usually late afternoon. I also take Allupurinol in morning at least one hour after other meds. Then Vit D also So for the afternoon dose maybe I dont need to allow an hour either side of T3 med

[FancyPants54 in reply to rick2525]

I don’t. Only my Levo and first T3 of the day at 7:30 get the avoidance. I take a couple of regular meds at 11am just in case. Next T3 is 2pm and final at 8pm.

[SlowDragon Administrator]

are you normally splitting T3 as 3 doses per day?

Calm vitality magnesium powder is cheap and easy to use and helps improve constipation. Must be at least 4 hours away from levothyroxine and T3

Best start on low dose and increase until get desired effect. Too much can cause diarrhoea