Advice on new results please?

[ceramo]

As I am not currently using a thyroid treatment recognized in France I am now labelled ‘untreated’ by the lab. In fact I have tried all sorts of brands and combinations of hormones over the years and didn’t really get on with any of the synthetic ones. I was comfortable with Erfa, which before Brexit I managed to source from the UK, but am now on a brand sold as a diet supplement. (I posted about this recently in a comment.). Now after a period of accidental underdosing, I am better informed about how to calculate the equivalent strength (eg as equivalent to Erfa). My current (corrected) dose is equivalent to 75mg Erfa. 

In October last year I had a very helpful explanation from Seaside Susie on how TSH is flattened by T3  in natural thyroid medicines, and the necessity for keeping an eye on Free T3 and T4 levels, which remain low.I was forbidden to discuss this with my then GP here in France, who wanted me to reduce dose, as TSH below range. I switched to a different brand,  and to what I wrongly thought was actually a slightly higher dose, as suggested on this site.Following that period of accidental under-dosing, I am finally approaching you to check what picture my current results give? Any advice or suggestions?

These are my test data from 6 June 2023  (split into 2 halves due to a page break). I asked my (new) prescribing GP to check antibodies, as I don’t know whether or not I have hashis.I have longterm ME/CFS and am 79, now with v low energy reserves, unrefreshing sleep.I take loads of supplements as is usual with ME/CFS…(I am also gearing up to do a cortisol saliva test with Genova shortly).

My last thyroid dose prior to testing was on waking the previous morning (24 hrs).I realize this distorts the results slightly with T4/3 combos and  NDTs.

TSH ultrasensible                                 0.29 mUl/l                                           (0.35-4.94)

Triiodothyronine libre (T3L)              3.3 pmol/l                                             (2.4-6)                                                                       2.1 ng/ l                                                   (1.6-3.9)

THYROXINE libre (T4L) 11.8 pmol/l (9.0-19.1)

9.17 ng/dl (6.99-14.84)

ANTICORPS anti-thyroperoxydase. 6 Ul/ml (<34)

ANTICORPS anti-thyroglobuline 14 Ul/ml (<115)

[Brightness14]

I live in France too but have no thyroid. I do visit the GP for my medication Levo plus T3 but have been using NDT for years now. I am lucky in a have a letter from my professor surgeon who removed my thyroid. It states that my TSH should always be suppressed. I think that your FT3 is much too low when mine is that low I have many aches and pains. Mine is usually at 6plus to feel well.

[ceramo in reply to Brightness14]

Thank you Brightness, I wonder if I should increase present dose or add in T3. I did try Cynomel on its own at one point and felt awful, wonder if I am resistent, or maybe haven’t found the right combo or dosage. I do still have my t hyroid! Glad you have a helpful professor, good luck.

[Brightness14 in reply to ceramo]

What dose are you on now?

[ceramo in reply to Brightness14]

75mg porcine hormone

[Brightness14]

It depends on how you feel but your FT3 is low and even if you tested 12 hours prior as you should have it's still very low. To feel well mine is always over 6 then I feel perfect. I would think that a small increase maybe good too. Which porcine hormone are you taking now. I am a similar age to you just coming up to 77 years. Sometimes it feels like 177.

[ceramo in reply to Brightness14]

Taking the one sold as diet supplement, because no longer able to access Erfa which I used to have on UK prescription. I could increase my dose to see how I feel! Yes, thanks for your support.

(Could private message you if you want details of this one)

How do you access natural dessicated hormones in France?

[ceramo in reply to ceramo]

Brightness 14, I am just trying to understand, are you still actually prescribed a natural thyroid in France, which naturally contains T3, or is it a synthetic equivalent that you have now? I had levo + cynomel at one point, Euthyral at another, but never found the dose or combination that did the trick, so started getting Erfa prescriptions over in London. (Until that option was removed.) It is clear that natural suits me better. The diet supplement option may work out for me, and is at least accessible, and this morning I increased to 90mg porcine, ie. 15mg higher. Thank you for your advice to increase, I really need to find a solution and I think should go on how I feel rather than risk any tests that show up a further reduced TSH (- can it actually go negative?) In any case many thanks for encouraging me to aim for a higher FT3 such as your metric of 6, measured or not. However, I also need to understand better what my low scores imply.