What Could Be The Problem

[MightyMay]

Hello Good People !!! It's been awhile since I've commented but I urgently need your advice. In the evening about 4 pm , usually after I've eaten, I get weak, jittery, shaky and lightheaded. I'm wondering if it could have something to do with my thyroid. I am hypothyroid and I have pernicious anemia (I get B12 injections twice a month and take sublingual b12 in between). I take 175 mcg of Synthroid and Liothyronine 5 mcg twice a day. Here are my latest lab results taken in April of this year:THS- .051 (.400- 4.00) miu/ml

FT4- 1.4 (0.8- 1.6) ng/ml

FT3- 2.54(2.30 - 4.20) pg/ml

Folate >20 (3.0-16.0) ng/ml

Ferritin 75 (16-232) ng/ml

Vitamin B12 >2000 (230-1050) pg/nl

Would appreciate any response.

[Jaydee1507 Administrator]

Free T4 (fT4) 1.4 pmol/L (.8 - 1.6) 75.0%

Free T3 (fT3) 2.54 pmol/L (2.3 - 4.2) 12.6%

Your FT4 is fine but your FT3 is very low for someone on T3. So you likely need an increase, maybe even only 5mcg would do it. You could take that at bed time.

No vitamin D result?

Your ferritin could be a little higher. A level of 90-100 is said to be optimal for best use of thyroid hormone.

[MightyMay in reply to Jaydee1507]

No Vitamin D but I take 5000 mcg daily because the last time tested it was low normal within range.

[Jaydee1507 Administrator in reply to MightyMay]

As you had allowed 8-12 hours from last dose then the test is correct and an increase of T3 would help.

[SlowDragon Administrator]

Was last 5mcg dose T3 approx 8-12 hours before test

[MightyMay in reply to SlowDragon]

Yes it was Slow Dragon.

[SlowDragon Administrator in reply to MightyMay]

Then you need extra 5mcg dose T3 prescribed

3 x 5mcg doses per day

5mcg at roughly 8 hour intervals

Waking, mid afternoon and bedtime

[MightyMay in reply to SlowDragon]

Okay I will try that...thanks

[greygoose]

Do you also take a B complex to keep the Bs balanced?

[MightyMay in reply to greygoose]

Thank you for responding...yes I take the B Complex.

[SlowDragon Administrator in reply to MightyMay]

Did you stop B complex 5-7 days before test

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

Post discussing how biotin can affect test results 

healthunlocked.com/thyroidu...

[Bethea-Alice]

I have had episodes like this after eating on and off since childhood (now 69) and was fully investigated about 12 years ago following a prolonged bout. Turned out to be reactive hypoglycaemia as when my blood sugar rose after eating my body then overreacted and my blood sugar dropped to a lower level than it was before eating anything. Had a glucose tolerance test to confirm. I was advised then to eat little and often which is a nuisance when working. I have since found the answer is to limit carbohydrate intake considerably (I now only eat bread very occasionally) and have plenty of protein foods, vegetables, whole fruit (no fruit juices) and full fat dairy products. I can now easily go 5 hours between meals and get no symptoms. Toast for breakfast is an absolute no no and I will quickly become shaky. I really feel for you as it is horrible.

[MightyMay in reply to Bethea-Alice]

Thank you for replying...I will be looking into this reactive hypoglycemia.