Excited! New bloods, need advice... change T3? T4? Vitties & Iron adjustments?

[FallingInReverse]

Hi all, I have waited out the 6-8 weeks! Hurray! All info below and in profile

Looking for advice what my new numbers mean for my next med change:

🔸T4 and/or T3: Can we tell if I'm a good converter? I know I have some room to go with the T4 (target by weight could be 100 mcgs), and my doctor started me on T3 way too early. I have hopes one day I can revert back to just T4 because T3 is so complex to take. But of course I'm afraid I'll feel worse if I reduce anything. So maybe increase T4 to 75 mcg??? Less??? Prob no change to T3 yet?

🔸D3 - Thinking to double my supplement from 1 to 2 of these: (2500 IU (62.5mcg) Can I do this at the same time as anything else here?

🔸Regards to Iron, is it safe to say that it's chicken livers for me... Ferritin rock bottom but Iron 90% through range. Do the other iron panel numbers tell me anything useful?

Symptom check:

After a few weeks of utter hopelessness, turned a corner in the last couple weeks... dare I say... I feel "better" and actually pretty good. Scale of 1 - 100 I'd give myself an 85! So relatively speaking I'm "functional" vs being dysfunctional so much of the time, but I know I have a little bit more to go as I'm still experiencing a smaller slice of the usual symptoms - fatigue, brain fog, some joint/muscle pain, cold, and other random hypo stuff.

So here's what I tested:

30OCT2023 Thyroid (below), Vitties (below), Cortisol (in profile), Celiac (looks negative - in profile)

14NOV2023 Iron Panel (below), EBV (positive in past)/Mono (negative)

Comparison to 6 weeks ago

🔸TSH: 0.553 (.550 - 4.780) dropped from 2.2

🔸FT4: 0.97 (.89 - 1.76) 9% in range up by 25 points FROM 0.76

🔸FT3: 3.3 (2.3 - 4.2) 52% in range up FROM 42% (3.1)

* Vitties compared to 4 mos ago

🔸B12: 800 (211-911) 84% FROM 64% (652)

🔸D3: 56 (31-100) 36% DOWN FROM 79 (70%) Despite adding once daily 2500 IU (62.5mcg) vit D this summer, I also stopped drinking a lot of milk at the same time to avoid the calcium! ha!

🔸Folate: 21.1 (>5.4 ng/ml) was 10.6 > 6.59 NG/ML

🔸Ferritin 7 (7-271) - first time testing; YIKES, GOT FULL IRON PANEL!

* First Iron Panel (on 14NOV 2 weeks after the above)

🔸IRON:158 (50-170 ug/dl)

🔸UIBC 211 (130-375 ug/dl)

🔸TIBC 369 (250-425 ug/dl)

🔸% Saturation 43 (12-50%)

🔸CRP, Sensitive 0.7 (0.0 - 2.9 mg/L)

🔸TRANSFERRIN PENDING

🔸B12 878

🔸Ferritin 13

My current meds daily:

T4/Synthroid 50mcg taken 6:30 - 7:15 am

T3/Cytomel... 10 mcg total

2.5 6:30 - 7:15 am


2.5 11:30-12:30

5mcg at 11-1 am

An allergy pill (Zyrtec), Glucosamine/Chondroitin, Vit D gummy (2500 IU (62.5mcg)

[SlowDragon Administrator]

Yes next steps

Increase levothyroxine by 25mcg

Work on ferritin level b increases in iron rich foods

You may find you can reduce T3 to 3 x 2.5mcg after next test

[FallingInReverse in reply to SlowDragon]

Sweet. Thank you!

A nice simple 25mcg increase for T4. Nervous and hopeful.

Will work on diet-related iron increase - going to jump on this immediately too.

You didn't mention D3... keep it at 2500 IUs or double it to 5000 ius a day? I feel like I should double. Not sure if you agree, but maybe if you do you'll suggest stagger it by a couple weeks vs the levo increase? Or no?

[SlowDragon Administrator in reply to FallingInReverse]

Yes generally only make one change at a time

But it’s probably fine to double dose vitamin D now as well as increase levothyroxine

you could initially increase levothyroxine by 12.5mcg daily if you feel adding 25mcg might be too big an increase to tolerate

vitamin D

Always take vitamin D tablets at least 4 hours away from levothyroxine

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Are you taking magnesium supplement too

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator in reply to FallingInReverse]

Excellent profile

Concise and plenty of info

High thyroid antibodies confirms Hashimoto’s

It’s always worth trying strictly gluten free diet

High cortisol levels should reduce as dose levothyroxine/T3 is fine tuned

[Lalatoot]

As you are on t3 you cannot judge how well you convert. Agree that ft4 is low and an Inc in t4 needed.

[FallingInReverse]

For my own recollection, here's my course of action.

The goal for this round is to titrate towards a target daily dose:

T4/Synthroid: INCREASE +25 (from 50 to 75/ taken 6:30 - 7:15 am)

- For at least 2 weeks or maybe more + 12.5 (so 62.5 daily) (started 11/18)

- Might do this until next test, might increase sooner. I know I have a target of 100 mcgs, but I am so scared to overshoot.

T3/Cytomel... NO CHANGE (10 mcg total; 2.5 wake up & noon + 5 at bedtime)

NO CHANGE Allergy pill (Zyrtec), Glucosamine/Chondroitin, Vit D gummy (2500 IU (62.5mcg)

AFTER NEXT TEST consider:

1) Vit D3 increase to 5000 iu daily (4 hours away); ADDING K

2) Chicken livers!

3) T3/Cytomel decrease by 2.5 (still might increase to optimal T4, but will have to really think about whether I do a T4/T3 adjustment at the same time later) (will reference advice here: healthunlocked.com/thyroidu...

4) Other: magnesium? and try gluten free