Going round in circles - Your input please

[Mikico]

Hi - to cut a long story short.

Do you think I need NDT? Am really keen to try the natural option as my T3 seems borderline but Naturopath didn't think it was necessary? I haven't felt 100% - am currently on 100mcg/daily Levo.

Blood test - 17.02.23

T4 7.0 ug/dL (5.5-11)

FT4 1.10 ng/dL (0.7 - 1.48) - 51% range

T3 0.8ug/L (0.7 - 2)

FT3 2.70 pg/mL (1.58 - 3.91) - 48% range

TSH 0.0083 mU/L (0.3 - 4.2)

All other vitamin levels are within range apart from Ferritin which is dire but am taking supplements to correct it (3 month course then reassessment).

Ferritin 8 ng/mL (11 - 307)

Seems to me that you guys are the only ones that really understand whats going on.

Thanks!!

[Lalatoot]

Mikico your ft3 is not as borderline as you think. Ft3 tends to lag slightly behind ft4 and that is what your results show with ft4 at 51% and ft3 at 48%.

I would try an increase in levo.

[Mikico in reply to Lalatoot]

Thanks - will look into increasing Levo 👍

[SlowDragon Administrator]

Your results suggest you need dose increase in Levothyroxine

Approx how much do you weigh in kilo

Ferritin - aiming for at least half way through range (usually at least over 70)

Likely to take at least 4-6 months to improve ferritin levels and retest at least annually ongoing

Any iron supplements at least 4 hours away from Levothyroxine

What are actual vitamin D, folate and B12 levels

What supplements are you taking

[Mikico in reply to SlowDragon]

ok - thanks 👍

Am about 58kg.

Vit D: 50.9 ng/ml (30-100)

B12: 321 pg/ml (187 - 883)

Actually, not sure about Folate - didn’t test it this time.

[SlowDragon Administrator in reply to Mikico]

B12 too low

What vitamin supplements are you currently taking

Daily B12 initially, plus adding a daily vitamin B complex a week or so after starting B12

[SlowDragon Administrator in reply to Mikico]

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and add a separate vitamin B Complex after a week 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week 

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...

supplementing 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 

healthline.com/nutrition/fo...

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) 

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

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

[Mikico in reply to SlowDragon]

Brilliant - thanks! I didn’t realise my B12 was considered low.

[DippyDame]

Suggest first step is to increase Levo to 125mcg, if after 6 /8weeks on 125mcg this hasn't helped then increase to 150mcg and again wait and test again....you have plenty room to make these levo increases.

I wouldn't be changing to NDT .....your T4 to T3 conversion looks ok so the added T3 in NDT may upset the T4/T3 hormone balance

You are undermedicated so little wonder you feel under par.....more Levo which should provide more T3.

For good health every cell in the body needs to flooded with T3....it needs to be available in a constant and adequate supply.

Listen to your body it will tell you when you reach your therapeutic dose....no symptoms!

Are vits D and B12 optimal?

Good luck with ferritin increase

You're right medics are not generally well clued up about thyroid disease.....grrrrrr!!

There is no quick fix so patience is essential ( not my strong point so I know how hard waiting can be!)

[Mikico]

Thank you - will look into increasing Levo.

Vit D and B12 are good?

What do you think of just adding a little ‘synthetic’ T3?

[Hidden in reply to Mikico]

Your conversion is excellent. I would try the levo increases first and see how you go.

[Mikico in reply to Hidden]

Sounds good 👍 Thanks again.

[DippyDame in reply to Mikico]

No need, your T4 to T3 conversion is fine.

Exogenous T3 is not the panacea of all ills....unless the body needs it.... and yours doesn't.

Be grateful for that!

I need high dose T3-only to function and like many others here have to self source and self medicate, which can be challenging....and with no NHS safety net.

Increase your levo dose!

[Mikico in reply to DippyDame]

👍👍