HELP WITH TEST RESULTS

[Luckylady2]

Hi

Hoping for a little help with these results please

I see an endo privately and he prescribes Erfa for me - these are my most recent blood results which the private hospital did. He has looked at them and said they are what he would expect taking Erfa.

However I have put almost 2 stone in weight on since December- and my joints hurt which are the symptoms I had when I started with this thing 16 years ago. I’m peri menopausal and wondering if it really is all that? I was diagnosed with breast cancer November 2022 but was very lucky as it was very early and I’m all clear I know have been comfort eating a little but not to the extent of 2 stone! Any guidance or help would be really appreciated! My last vitamin D test was 92 nmol and B12 was good too but no folate test done yet I have really bad Achilles tendon pain at the moment and have had it for about 5 month now- any help advice would be really appreciated Apologies for the photo - it’s not the clearest and I have tried to zoom it in and make it bigger Thanks guys

[greygoose]

Well, I would have said they were exactly what one would expect when not taking enough Erfa. Looks like you need an increase in dose. Your FT3 is still very low, so not surprising you have hypo symptoms like weight-gain. Achilles tendon pain is also a hypo symptom.

[Luckylady2 in reply to greygoose]

Thank you for replying - I’m going to have to see if he will increase my dose but I’m not optimistic!

[greygoose in reply to Luckylady2]

You have to insist that you still have symptoms because your FT3 is too low in range. It should be at least over 50%, more likely around 75% to make you well. Just getting back within the range just any old where is not good enough.

[Luckylady2 in reply to greygoose]

I will really push for this and explain how I feel I do have a feeling he will blame the perimenopause but I’ll insist It’s just so frusta’s it took a while to find an endo who would even prescribe NDT - just awful that we can’t get decent thyroid care easily after all this time!

[GlowCoach Administrator]

Your TSH is still within range which is an indicator when on NDT that you need more hormone. Anything containing T3 will lower TSH , often to the point of suppression.

If your Endo is treating you by TSH then you may have a struggle to get an increase, but an increase you do need.

[Luckylady2 in reply to GlowCoach]

Yeah my endo has mentioned previously that he doesn’t want me to have a suppressed tsh so I might have a struggle 😕 Thank you for replying

[Brightness14]

You will need an increase both FT4 and FT3 are much too low. I have pain also when my levels are low. These disappear when on the correct dosage.

[Luckylady2 in reply to Brightness14]

Thank you

[DippyDame]

Both Frees are far too low which will in turn lower your metabolism and cause weight gain.

We aim to have both Frees roughly approaching 75% through respective reference ranges.....not yours!

TSH is not a reliable marker beyond initial diagnosis.

FT3 followed by FT4 are the important results

BUT also vitally important is how you feel....medics often forget this!

How much NDT are you taking?

Bear in mind 1 grain NDT contains 38mcgT4 and 9mcg T3

The worst pain I ever had ( cocyx) was when my T3 level was far too low....on T3 only it never bothers me now!

You need to re-evaluate your hormone dose and to ensure supporting nutrients are optimal.

Your endo's ability to evaluate lab results is flawed and isn't going to help you!

[Luckylady2 in reply to DippyDame]

Thank you so much for well replying. Looks like I might have a problem getting my endo to increase my dose but I’ll see what he says he has said previously he doesn’t want me to have a suppressed tsh but from what I’m reading this can be the case with erfa? I find it difficult to get my head round dosage etc with Erfa 😕

[pennyannie]

Hello Luckylady :

When optimally medicated on any NDT your TSH will likely be low/suppressed and your T4 likely lower than when on T4 monotherapy BUT your T3 proportionately higher than when on T4 monotherapy.

Your T4 is under the range and your T3 struggling at just around 32% - and you are on too low a dose - or possibly having absorption issues.

No thyroid hormone works well until your core strength vitamins and minerals are up and maintained at optimal so do you have any readings / ranges for ferritin, folate. B12 and vitamin D.

What dose of Efra are you taking and do you have any blood test results/ ranges prior to switching to NDT - such as from taking T4 - Levothyroxine only ?

What were you diagnosed with - sorry - should have looked back at previous posts but forgot and now would loose what I've written ?

[Luckylady2 in reply to pennyannie]

Thank you so much for your reply I take a 60 mg tablet of erfa in the morning and then a 30 mg tablet in the evening as advised by endo. I was on 100 mcg when on levothyroxine Each time I do a Thriva blood test I always have high TPO antibodies- can’t seem to lower them I have Hashi’s My vit D was 92 nmol but I do need to get fresh panel of blood tests for vitamins and minerals but but B12 is quite high my GP said but not to stop supplementing. My endo has mentioned he wants to avoid a suppressed tsh 🥴

[SlowDragon Administrator in reply to Luckylady2]

High thyroid antibodies

Are you on gluten free or dairy free diet

NDT can raise antibodies in some people

My endo has mentioned he wants to avoid a suppressed tsh

Then likely need new endocrinologist

[Luckylady2 in reply to SlowDragon]

Thank you

[pennyannie in reply to Luckylady2]

Do you have any readings / ranges from when you were on T4 ?

High antibodies is Hashimoto's - and suggest you read around the research and suggestions of Dr Izabella Wentz who this thyroid auto immune disease.

Look to first get tested for food intolerances - as cutting out gluten, wheat and dairy likely worth considering as healing the gut a necessary first step in order to properly absorb and utilise the thyroid hormone replacement. thyroidpharmacist.com

Some people find treating with animal glandular increases their antibody interaction and do better on a T3 + T4 synthetic combo.

If the intention is to keep your TSH in the range you will likely never find your optimal dose of any thyroid thyroid hormone replacement.

[Luckylady2 in reply to pennyannie]

Thank you