Complex Newbie - T4 Query

[Lib_Scot]

Hi Folks

I'm new to the forum and I have been avidly reading the posts and learning a ton about Hypothyroidism.

I have had Hashimoto's for 20 years and I am embarrassed to say that I know very little about it. Although, through this forum, I am catching up fast.

To give you a bit of background I have Polyglandular Syndrome Type II. I have Addisons Disease, Hyprothyroidism, Pernicious Anaemia and Type 1 Diabetes, premature menopause since I was 30 (I'm now past my half century)

Since January I have felt pretty rough, the usual stuff - weight gain, sluggishness, cold, dry skin, constipation, poor memory to top it off. I have managed to get hold of my last blood results (I don't go through the GP, it's always the hospital) so it's taken a while to get them as I have to apply to see them.

In all honesty I have not felt great in the last couple of years and I am trying to pin point what it is.

I appreciate that I don't have my folates, ferritin, b12, selenium and I could do with more up to date results which I will getting shortly. This is what I do have, these were done in Oct 2022:

TSH 1.37 mIU/L (0.4 - 4.0) 26.9%

Free T4 (fT4) 13.1 pmol/L (11.5 - 22.7) 14.3%

Free T3 (fT3) 5.0 pmol/L (3.3 - 6.1) 60.7%

T4:T3 Ratio 2.620 

Do these results look ok? Is my FT4 a too low?

With much thanks

[PurpleNails Administrator]

Welcome to forum

Do you have Hashimoto’s (positive TPO or TG antibodies) or is your hypothyroidism part of you syndrome?

 Either way hypo is treated the same.  

What is your current dose? & do you always have same brand? 

Your FT4 is low in range but your FT3 is better as in top half of range. Some would feel ok but many would need FT4 in top third of range as well as FT3 in top half.

Would your doctor agree to increase as FT4 low in range? As you sound like you have some hypothyroid symptoms sound like you might need an increase.

 Do you test as recommended? Fast overnight, (drink lots of water) delay dose until after draw.  Cease any supplements containing biotin 3 days before test,  biotin can interfere with test. 

[Lib_Scot in reply to PurpleNails]

Hi PurpleNails

Thank you for responding

My syndrome is all autoimmune based and I am going to guess that I did have positive TPO or TG antibodies

My current does has been upped from 75mcg to 125mcg, the increase was based on the symptoms I am experiencing rather than on bloods. I started on the new does 2 1/2 weeks ago and I am thinking that this should be supported with bloods to see where my levels are at. This increase was not through my endo but through the neurologist that I am seeing for chronic migraines.

Yes, my doc would be ok with Ft4 being in the higher part of the range

I didn't know about testing as recommended until I very recently joined the forum and will be doing this for my next test, which I will be organising this week.

Supplement wise I take, Eve Primrose oil, Vit D, Magnesium - these are bog standard Tesco Vitamins. I have no idea if they contain Biotin but I can stay off these for the 3 days prior to testing just to make sure.

[PurpleNails Administrator in reply to Lib_Scot]

was the 75 - 125 mcg in 1 go as many would have difficulty.

Dose adjustment should be by 25mcg and testing after 6weeks.

Those supplements should not affect test.

might be good idea to test vitamin D levels see if supplement is sufficient.

Monitor my health offer vitamin D test as private option,

See link for companies and discounts of range of private tests

thyroiduk.org/help-and-supp...

[Lib_Scot in reply to PurpleNails]

It’s in one go but I have been thinking that it would be better doing this incrementally .

Thanks for the link, I’ll ask my endo if he would consider Vit D testing before going for the private option. Can I ask why vit d for testing?

😊

[PurpleNails Administrator in reply to Lib_Scot]

Some can tolerate larger / faster increases - other are sensitive to adjustments & need it to be gradual,  go by how you feel.

Vitamin D & other key nutrients,( folate, ferritin, & B12) are often low when hypothyroid.

Having low nutrients can mimic hypo symptoms and can lower conversion of FT4 to FT3.  Levo to works best if nutrients optimal.  Optimal not same as with range, what doctors are satisfied with.  

Low nutrients can also make TSH lower & not reflect low FT4 & FT3 levels & doctors tend to focus on TSH.  Many are deficient in vitamin D, a healthy adult is recommended to supplement in winter months but standard doses from stores may not be high enough level.

[Lib_Scot in reply to PurpleNails]

Merci Buttercups PurpleNails

Lots of good info for me to get a good start with the vits ect, thank you for your time responding 😊

[Marz in reply to Lib_Scot]

VitD is more than a vitamin - it is a steroidal anti-inflammatory pro-hormone. You need a test result so you can calculate an approximate dose.

grassrootshealth.net

VitD is fat soluble so should be taken with a meal containing good fats. Or a gel capsule containing olive oil by Drs Best - on-line.

I would test at the end of winter. Large dose VitD requires co-factors magnesium and VitK2-MK7.

[Lib_Scot in reply to Marz]

That’s good to know, I was’nt aware that vit d is a steroidal anti-flammatory pro hormone. I see what you mean about needing a test result 👍

[Marz in reply to Lib_Scot]

Maybe read up on VitD on the link I posted above. It is American but has lots of research backed info ....

[Lib_Scot]

Great and will do. Some research I thinks 👍