Excited! New bloods, need advice... change T3? ... - Thyroid UK

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

FallingInReverse profile image
•6 Replies

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)

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FallingInReverse
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SlowDragon profile image
SlowDragonAdministrator

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 profile image
FallingInReverse• in reply toSlowDragon

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 profile image
SlowDragonAdministrator• in reply toFallingInReverse

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 profile image
SlowDragonAdministrator• in reply toFallingInReverse

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 profile image
Lalatoot

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

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

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