Hello everyone, i’m new. Been reading most posts related to thyroidomectomy and hormone replacement therapy, now i need help with numbers. I had total thyrodectomy due to cancer in January and on Levothyroxine 125 since then.
Tsh 0.03 (0.27-4.2), t3 free 2.9 (2.0-4.4), t4free 1.80 (0.93-2.10), Tg less than 0.1, Anti TgAb 275.4 (less than 4)
My endo recently reduced Levothyroxine to 112. Is this a good decision?
No, it doesn’t seem to be. You were actually slightly undermedicated on 125mcg so if anything, an increase was warranted.
I think your endo (was it the endo or was it the more junior doctor working with the endo that day?) has fallen into the common trap of thinking the goal is to get TSH into range.
ferritin is 16.5 and vitD is ng/ml. I’m working on incresing both with 5000 UI daily D and iron supplement.
Your ferritin suggests iron deficiency. Has your GP done an iron panel to confirm this and is your iron supplement prescribed and your GP regularly monitoring your level?
Some experts say that the optimal ferritin level for thyroid function is 90-110ug/L.
When Vit D is measured in ng/ml the recommended level is 40-60ng/ml according to the Vit D Council, Vit D Society and Grassroots Health. You might want to check out a recent post that I wrote about Vit D and supplementing:
and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.
As you are taking 5,000iu D3 daily, you should retest in 3 months to check your level and adjust if necessary. Once you have reached the recommended level, when supplementing with a maintenance dose we should test twice a year to keep an eye on our level. Are you taking D3's important cofactors - magnesium and Vit K2-MK7?
Firstly, I'd say your endo is barking up the wrong tree...your levo does not need to be reduced from125mcg! Your low TSH was no doubt their reason, and a fear of overmedication....but possibly without considering your Frees and symptoms.
FT3 followed by FT4 are the most important labs
Science proves that TSH is not a reliable marker for dosing
T3 is the active thyroid hormone which, for good health, is essential to every cell in the body. It must be available in an adequate and constant supply.
Your FT3 is abysmally low it sits at 37.5% through the ref range
While FT4 is 74.36% through the range
This indicates poor T4 to T3 conversion ( high FT4 with low FT3)
Low cellular T3 = poor health.
Both Frees should be approaching 75% through their respective ranges
To support conversion the following must be optimal...
Vit D, vit B12, folate and ferritin
SeasideSusie had started to advise you, follow her advice, her knowledge on nutrients is much better than mine
vitamin D (25-80) 36 ng/mL.
B12 (232-1245) 567
folic acid (4.8-24.2) 19.3
ferritin (13-150) 16.5
Tg less than 0.1, Anti TgAb 275.4 (less than 4)
High thyroid antibodies indicate Hashimoto's disease/ autoimmune disease. This can cause fluctuation in thyroid levels. Many people find a gluten free diet helps
Initially it may help to increase levo to 150mcg along with optimised nutrients.....only increase after 6 weeks on a steady dose....125 mcg since Jan is OK!
Joint pain and hair loss are symptoms of undermedication
It is still early days in your recovery but you could start to improve your core strength vitamins and minerals as no thyroid hormone replacement works well until your ferritin, folate, B12 and vitamin D are up and maintained at optimal levels.
A fully functioning working thyroid would be supporting you on a daily basis with trce elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure o T4 at around 100 mcg.- with T3 said to be around 4 times more powerful than T4 .
The thyroid is a major gland and responsible for full body synchronisation which includes your physical, mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.
T4 is basically inert and a storage hormone which the body needs to be able to convert into T3 which is the active hormone that runs the body and it is too low a T3 for you that causes the symptoms of hypothyroidism.
Some people can get by on T4 - Levothyroxine monotherapy.
Some people find that the T4 doesn't seem as effective as it once was and by adding back in a little T3 - Liothyronine - probably to replace that little bit they lost when they lost their own natural production - their T3 and T4 hormonal balance is restored and they feel better :
Some people can't tolerate T4 at all and need to take T3 only :
Whilst others find their health and well being restored better by taking Natural Desiccated Thyroid which contains all the same known hormones as the thyroid gland and derived from pig thyroids, dried and ground down into tablets referred to as grains.
Hope that helps - but first off I'd suggest you get your ferritin levels investigated just to make sure nothing else is going on and then start supplementing with the vitamins and minerals where necessary as it does take a little time to build up your core strength but very worthwhile.
Your ferritin looks low as does your vitamin D Im sure someone who knows more about these items then me will come along…. I had thyroidectomy 7 years ago and have issues with low iron levels and low in range vitamin D too….. Your endo is dosing you based on TSH which he/she shouldn’t and your going to have to start saying no to reduction if your feeling fine.
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