Long time member advice required on recent thyroid blood test after starting HRT.

[Peanut31]

I’m just after some advice on my recent blood test I had taken myself.

I know the drill no levo 24 hours before. NDT gap of 8 hours. Vitamins stoped week before

My test was taken at the same time as all other blood test 7.10am. I always stick to this routine to ensure consistency.

I decided to take this blood test for a few reasons, I am feeling cold again, my skin is very dry and circles under my eyes are bad.

November 2023 results

TSH 0.017 (0.27-4.2)

T3 4.9 (3.1-6.8)

T4 12.2 (12-22)

I started taking HRT back in July 2022, and after some tweaking managed to find a good balance.

This blood test is the 1st one since taking HRT

I take in the morning 1 Grain NDT & 37.5mcg of levo (this is a 25mg levo and then 25mcg split in half the make is Wockhardt.

2pm I take another 1 grain of NDT

My dosage daily is 2 grains of NDT & 37.3mcg of levo.

I have tried levo on its own and it didn’t work, NDT on its own and too much sends my T3 too high and I end up jittery and anxious.

To get to a happy medium I added some levo and this worked well for some years.

However, I know I need to increase my T4 and T3 results and don’t know whether to add some more NDT or T4.

I prefer adding NDT, but I’ve discovered after years of experimenting (even tried T3 alone on ended up in hospital with terrible migraines) that too much T3 for me is a no no.

I was thinking if I increased my levo it will increase my T4 but then convert to T3 to help bump the T3 results up, I just don’t know what to do.

I take vitamins (not multi) everyday and take a range to support my thyroid.

I have Hashimoto’s and have been gluten free for over 5 years and this helps no end.

As mentioned I’m on HRT and peri menopausal, I know it was not thyroid symptoms so on HRT.

Thank you in advance.

[Lalatoot]

What you don't tell us is how those results compare with your previous ones partic ft3. If your ft3 level has dropped then you could consider Inc NDT. If it hasn't dropped that much then add levo When were on combo therapy it is very much trial and error. You have to go with what you feel will be right for you.

[Peanut31 in reply to Lalatoot]

Hi

Thank you for your advice.

Best wishes

Peanut31

[pennyannie]

Hello Peanut :

I'd be inclined to increase the NDT slowly in 1/4 grains -

weekly/fortnightly

and track yourself on bench mark readings of blood pressure, pulse and body temperature twice daily - am and pm and if nothing else you should see your body temperature start to improve -

See how you go - and when you feel you're gone a bit too far and

' those symptoms of too much T3 for you ' appear -

drop back down the previous last increase that you felt well on - let this settle and bed into your body -

and then if you feel the need add a little T4 into the mix to ' water down ' the T3/T4 ratio in the additional NDT dose you have settled on.

Does that make sense ?

[Peanut31 in reply to pennyannie]

Hi Pennyannie

Thank you for your advice, you it all makes sense.

Best wishes

Peanut31

[SlowDragon Administrator]

I would increase levothyroxine initially to 50mcg

You might need further increase after next test 8 weeks later

Important to retest vitamin levels at least annually too

Have you tried dairy free too

[Peanut31 in reply to SlowDragon]

Hi SlowDragon

Thank you for your reply

I think I will definitely go by your suggestion on increasing levo.

I’ve had chance to look back on increases I’ve tried in the pass with NDT and it was too much.

Can you guide me to the best vitamin blood test please.

I’ve did try no dairy about a year ago for a month, and didn’t notice a change like I did when I went gluten free.

Best wishes

[SlowDragon Administrator in reply to Peanut31]

I found it took about 3 months to notice any improvements on dairy free diet

[milkwoman]

When I began HRT, my endo said I may need to up my Levo as it’s all a balancing act with hormones. He was correct and we did slow increases of Levo until my symptoms were alleviated and thyroid tests showed good results. It can take some time to achieve the right balance so be kind to yourself during the process.

[Peanut31 in reply to milkwoman]

Thank you for your advice.

Best wishes

Peanut31