update from endocrinologist

[lynnwin]

hi just to update my results 22nd May were

T4 20.9 ( 12.0 - 22 )

T3 3.2 (3.1-6.8)

TSH 0.13 ( 0.27-4.2)

Thank you everyone who commented on my last post

Private appointment today and he has given me a 3 month trial of Liothyronine

My normal dose of Levo was 100mcg a day now I’m to take

50mcg levothyroxine

10mcg Liothyronine

I asked how do I take them he said together in the morning ?

he said I might feel jittery at first ?

He also said I should take over the counter b12 ? my B12 is over top of range since b12 injections years ago 🤷‍♀️ I’ve got a private prescription but he is writing to my GP to add to my repeats

Thank you everyone for your help

Xxxxxxx

[SlowDragon Administrator]

Starting T3

We always recommend doing so SLOWLY

Reduce levothyroxine by 25mcg …..wait 3-4 days before adding 5mcg T3 in morning

Or if you have 5mcg or 10mcg tablets

Cut 5mcg in half to get 2.5mcg …..add 2.5mcg in morning and 2.5mcg mid - late afternoon

Assuming that’s ok

After few days….reduce levothyroxine by further 25mcg

Wait 3-4 days and add 2nd 5mcg dose T3

So taking 5mcg waking and 5mcg late afternoon

Wait 6-8 weeks

Retest early morning, last dose levothyroxine 24 hours before test

Last 5mcg dose T3 Approx 8-12 hours before test

Wait for test results

Likely to see Ft4 has dropped too much (50mcg is large dose reduction)

You may then need to tweak dose Levo up a bit ….

Looking at previous posts

Do you always get same brand levothyroxine at each prescription

are you now taking a daily vitamin B complex?

If not start taking vitamin B complex a week after you start on B12

Have you increased vitamin D and added vitamin k2

Are you also taking daily magnesium afternoon or evening (at least 4 hours away from levothyroxine)

Many members find magnesium beneficial

You’re coeliac

Gluten free diet is low in magnesium

What was ferritin result

[lynnwin in reply to SlowDragon]

OMG he just said take together in the morning 😳 I will print this off as I won’t remember it .. I use transdermal magnesium and had it tested Venus sample and it was high

Not taken any B12 for years as my GP told me not too as my B12 was 2000 ..

I do take b2 b6 if deficient as being a coeliac they often are .. I always have Accord My vitamin D is way high last result 224 🤦‍♀️ .. I will print off your recommendation as I’m going to get confused 🤦‍♀️ thank you xxxx

[SlowDragon Administrator in reply to lynnwin]

how much vitamin D have you been taking !

High B12 can be deceptive

Paradoxical B12 deficiency 

b12oils.com/paradoxical.htm...

Low B12 symptoms 

b12deficiency.info/signs-an...

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

If 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 

natureprovides.com/products...

Or

B12 sublingual lozenges 

uk.iherb.com/pr/jarrow-form...

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 folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until B12 over 500

Post discussing how biotin can affect test results 

healthunlocked.com/thyroidu...

How other member saw how effective improving low B vitamins has been 

healthunlocked.com/thyroidu...

[lynnwin in reply to SlowDragon]

I have t taken any vitamin D for a few weeks but was taking nutri liquid only 1000iu a day which obviously I e stopped .. I will look at B complex as I says my B12 was at 2000 I was surprised he said take over the counter b12 🤷‍♀️ I will look at all your links thank you xxx

[SlowDragon Administrator in reply to lynnwin]

personally I would initially only take a good quality vitamin B complex

Retest B12 and folate in 6 weeks

Follow advice on stopping complex Week before test, instead taking a separate folate and B12 that week

[130396]

Hi Lynn

I think you should start with just 5mcgs as you’ve still got ft4 converting to ft3 so jumping in with 10mcgs as a starting dose is too much straight away.

Then give it a week and add the other 5mcgs

Text me later if you want to

[lynnwin]

but I’m hardly converting darling by my results 😳 .. it’s confusing me now 😭

X xxxxxxxx

[130396 in reply to lynnwin]

I’ll chat with you tomorrow.

Get to sleep now as you’ve got a very early start

[Brightness14]

I have no thyroid and if I was taking 50mcg Levo plus 10 T3 I wouldn't be able to get out of bed. As for taking them two together well I can never take them together but people do. I have just changed makes of Levo and read the long instructions in the packet. It clearly states that people with no thyroid should be on 150mcg of Levo. You could try taking the 10 T3 in two lots split am and pm. This would be a much slower way of starting it. Maybe 10am and 2pm. They have reduced your Levo by too much. This is only my opinion, someone without a thyroid.

[Brightness14]

I forgot to say that taking 100mcg of Levo without a thyroid is much too little and therefore you FT3 would be low anyway.

[lynnwin]

hi thank you for your comments 🙂 I still have my thyroid although antibodies has destroyed it 😞 This is my first prescription for T3 so I doubt I can argue it’s too little already ?? He wants to see me in 3 months .. I will start by splitting the T3 5 in the morning with my levothyroxine and 5 later if that’s the best way ? Xxxxxx

[Batty1]

He dropped your levo from 100 to 50 thats a big drop …. 10mcg T3 isn’t a lot.

[lynnwin in reply to Batty1]

ahh thanks but I have no choice .. I didn’t even think he would prescribe it to be honest so have to go with what his prescribed as I can’t change it 😬 seeing him in 3 months to see how it’s going ? Xxx

[Batty1 in reply to lynnwin]

I would be more concerned with the big drop in levo.

[lynnwin in reply to Batty1]

like l said Batty1 I have no choice this is a starting dose 🤷‍♀️ my T4 is high so I expected him to reduce my levothyroxine as from advice on here doesn’t look like I’m converting? So if my intake of levothyroxine was higher surely it will push my T4 higher as this is the storage hormone to convert into T3 ? It seems it has to be suck it and see ?

What do you think my Levo should be with the added T3 ? I wish I didn’t have to take the T3 I’ve been ok with Levo for around 10 years but gradually my T3 has been dropping .. It’s a minefield and I have no choice but to start as he prescribed I can’t change it 😞

Xxxxx