I have been steadily gaining weight (6kg in 6 months, which is more than 10% of my weight!!) and am feeling tired, frustrated, tearful and don’t enjoy my life (which is really good). I am always hungry but monitor calories and don’t eat more than I am supposed to burn. I exercise and don’t eat junk. I am dairy and gluten free, but eat soya, which my Endo says is fine if eaten 60min away from meds.
I have secondary hypothyroidism, (so TSH is of no relevance). I take 4.5 grains of NDT, which used to work very well but clearly seems to have stopped working. I also take 1 pump of Oestrogel (HRT). I take Vit B and D and last test showed vits as really good.
My recent bloods are ‘perfect’, so I have no idea why this is and what I can do to help myself.
My Endo has suggested going on 4 grains of NDT and 20mcg of T3, which I have started 4 days ago, so it’s to early to say.
Does anyone have any idea what else I could try? I am at the end of my wits.
thank you so much
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PixieElv
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but eat soya, which my Endo says is fine if eaten 60min away from meds.
There may be many here who don't agree with your endo.
Even the British Thyroid Foundation say
Soya
Soya interferes with thyroxine absorption, therefore if you are taking thyroxine you should try to avoid soya. If you wish to take soya, there should be as long a time interval as possible between eating the soya and taking the thyroxine.
NDT is still T4 with added T3 so it's still replacement thyroid hormone so may be susceptible to the same absorption issue. Also although the hormone comes from pigs' thyroids, I believe I read somewhere that Armour adds synthetic hormone if necessary to get the correct amount of hormone if the balance isn't correct when testing batches in the production process. Maybe other brands do too, who knows.
I've never wanted to use soya in my diet (although I do admit to ignoring the fact that it's listed in the ingredient panel for chocolate!) so no advice as far as that's concerned.
Usually when on combo meds of any sort we tend to see FT4 lower and FT3 higher so your FT4 being at the top of the range isn't what we generally see. I take Levo plus T3 which gives me the freedom to tweak each individual hormone to the combination that suits me, maybe the ratio of T4 to T3 in your NDT isn't quite right for you.
Can you have proper cow or goat milk? Of all the other options only soya works in tea or coffee and only oat milk tastes nice. The rest are dire in every way. For cereal I’d definitely use oat milk. For cream substitute I used coconut cream or milk. I gave up trying to find something palatable for hot drinks that wasn’t soya. Eventually, having proved dairy was not an issue I went back to it with joy.
Who said your labs were perfect? If you still have symptoms, then they obviously aren't perfect, are they. Optimal is not a number, it's how you feel. If you don't feel well, then your dose isn't optimal.
Thyroid 'meds' can't stop working. They're hormones not aspirin. But, for them to 'work', you have to take enough of them, so that brings us back full circle - i.e. your labs aren't perfect.
However, it could be the soy. When one says that soy interfers with absorption of thyroid hormones, we are talking about absorption at the cellular level, not in the gut. If it were just in the gut, leaving a long enough gap would be fine. But, at a cellular level, it doesn't matter how wide the gap is, once that soy is in your system, it's going stop thyroid hormone getting into the cells. And, when that happens, your labs may look 'perfect' - although I would dispute that - but it doesn't matter what's in the blood if it's not getting into the cells, where it's active - it doesn't do anything in the blood. So, if I were you, the first thing I would do is go soy-free and see if things improve.
Fair point about the ‘perfect’ 😊 I guess a lot of people would be happy/feel well on these results. And I’ve felt well on them before but that’s not lasted, hence my comment about ‘stopped’ working.
I’ll give the no soya another try as I’ve only recently started eating it again, so my decline actually started before that. But I’m pretty desperate so will try anything. 😔
If you felt well at that level, and then you didn't, you probably need an increase in dose. That's the way it works. You still have a little room to increase your FT3, although you don't want your FT4 any higher, so full marks to your endo for adding T3. Some people need their FT3 right at the top of the range, or even slightly over.
Your estrogen dose is not very high. Have you considered increasing it to see if that helps? Could it be you are not absorbing the gel form very well? If you do, you will need to watch your thyroid levels closely.
I am trying to sort the thyroid and estrogen thing out, so I can empathize.
I started on the patches but didnt absorb them well. Then went onto the gel. I was on 4 pumps which made me SERIOUSLY ill. So I’ve gradually reduced the amount of oestrogen to see if any menopause symptoms would come back (night sweats, achiness etc) but so far nothing materialised.
I had to try all kinds of combinations and not sure if what I am doing is working, but leaving it alone while working on my thyroid. I take 2mg of oral estrogen at night and use 1 pump in the mornings. When I tried the gel form only, I didn't absorb it well at all.
The patches make me crazy! It is like I absorb it all at once, so jittery the first day and then feel nothing the rest of the patch life. Plus I didn't like something attached to me. I was constantly checking it.
I hope you get it figured out soon. I increased my T4 to 100mcg last week, so I am not feeling that great either.
Gel felt like an instant hit for me, made me jittery and then it wore off before the end of the day. Patches - same as you. I now use Bijuve capsule which is 1mg oestrogen plus Utrogestan at night and 2 sprays of Lenzetto. That combination works nicely.
oh that’s good to know. What and how much do you use?
So sorry you’re struggling. If these were my bloods and treatment and I still felt unwell I would look at adrenals and rt3. Some on the forum don’t agree that rt3 is an issue, but I personally think it does play some kind of role in some people because it pushes D3 up which blocks T3 access to the cell nuclei, 3.5 grains is likely to make quite a bit of rt3. In your position I would reduce my NDT to 1.5 grains, add in direct T3 and test adrenals. If you have a negative reaction to T3 then it is likely an adrenal issue - my bio has some citations on this 🙂 good luck x
I don’t really know anything about Rt3. I’ll check out your profile!
my adrenals showing as ‘fine’ on all the NHS tests (like synacthen test) but 2 saliva tests (4 point) show my cortisol is sky high. I have not been able to get that under control. There is very little advice on high cortisol and what it does plenty for low cortisol
I’ve added 20mcg of T3 now too 4 grains of NDT. It’s only week 2 but i am sorting better but have huge energy crashes mid morning and afternoon. I think it’s the T3 wearing off
If cortisol is sky high then usually need to take something like PS100 for whichever times are high, can you show me your results? Might be able to suggest something 🙂 there is evidence that high cortisol blocks T3 from entering the cell at all, so it is a good idea to try and get it down.
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