Help with how to proceed

[Chumchum]

Delighted to report that after 6 months trying and trialling different levels of Eltroxin, I have at last persuaded the GP to agree to adding t3 back into my prescription. I’m not sure how best to take it though, whether to reduce eltroxin or not. And the GP really didn’t know but gave me 10 Thybon as that was what I was taking last year before an Endo suggested I stop it and see if t3 raised naturally with just eltroxin. I stopped t3 gradually between May and July. I also started hrt then.

This same endo , who I attended for pituitary testing not thyroid, diagnosed empty sella via mri. Symptoms were terrible brain fog. This has since settled with hrt.

August on 125 eltroxin. January on 112 Eltroxin

TSH. .21. (.27 -4.2). 1.82

T4. 19.5 (12 -22). 17.5

Ft3. 3.3. (3.1 -3.6). 2.6

Eltroxin was reduced in September because I wasn’t feeling well on the higher dose and wasn’t sleeping. The result though, was I became very unwell with fatigue and muscle pain, black circles under eyes and inability to excercise in any way other than very short walks. I have since raised the eltroxin back to 125.

So - currently on 125 eltroxin since last Friday AND prescription for Thybon 10 plus reduced eltroxin to 100 given yesterday. A bit of a muddle, but advice would be great on how to proceed.

[Charlie-Farley]

Hi Chumchum (lovely pseudo name🤗)

So you were taken off T3 to see what would happen 🙄Hmmmm hopefully they are satisfied now??? They really make my blood boil. It is obvious you were not converting. Make sure you keep a dossier, meticulous records so if you change doctor ever you do not have to be put through the same nonsense again....

'So - currently on 125 eltroxin since last Friday AND prescription for Thybon 10 plus reduced eltroxin to 100 given yesterday. A bit of a muddle, but advice would be great on how to proceed.'

so you were taking 125 Eltroxin + 10 Thybon (ug?) since when?

and yesterday reduced to 100 Eltroxin +10 Thybon (ug)

If you have just changed dose leave everything to settle of about 6 to 8 week before even considering testing again. Some people take all together some people split the T3 and take in afternoon or evening to get a steady effect. You may need more T3, but will only know once this latest change has 'settled'.

August on 125 eltroxin. January on 112 Eltroxin

TSH. .21. (.27 -4.2). 1.82 Loads of full stops confusing the data is that 0.21 or 21?

NOT THAT IT MATTERS least important measure when managing dose (TSH was originally devised as a diagnostic).😉

T4. 19.5 (12 -22). 17.5 That's clear

Ft3. 3.3 (3.1 -3.6). 2.6 I've removed a full stop off 3.3

Well looking at your last set of results one would wish for a higher FT3 and it is below range (not good) you are undermedicated and would never have converted a sufficient amount of T3 from T4 looking at these results....

How are your vitamins and minerals Chumchum? And how are you feeling now? Symptoms are so important and frequently overlooked as are vitamins and minerals. Have you had these checked? You need the vitamins and minerals in sufficient levels to mediate metabolic processes including the utilisation of thyroid hormones🙂

[Chumchum in reply to Charlie-Farley]

Thanks for your reply Charlie-Farley. I think I may have confused things! Since last Friday I am on Eltroxin 125. it was only yesterday the Doc agreed to adding Thybon on to the prescription. I haven’t started it yet. He added 10 Thybon, but doesn’t really know how it’s taken. My question is how do I proceed from 125 eltroxin to adding in Thybon. I’m wondering should I reduce Eltroxin to 100 and add 5 Thybon (to start) or stay on 125 eltroxin and add thybon?

August on 125 eltroxin.

TSH. .21 (.27 -4.2)

T4. 19.5 (12 -22)

Ft3. 3.3 (3.1 -3.6)

January on 112 Eltroxin

TSH. 1.82

T4 17.5

FT3 2.6

November Vitamins

B12. 683 ( 197-771)

Folate. 7.1 (3 - 26.9)

Vit D. 80

Ferritin 66.6 (13-200)

Iron 24 ( 5.8 -34)

Transferrin Sat (46%)

I feel very depleted and fatigued, sore shoulder muscles (always a hypo indicator for me) excercise is challenging some days and undoable others. Black circles under my eyes and generally wrecked.

[Charlie-Farley in reply to Chumchum]

Hi Again Chumchum

I'm not blooming surprised poor love. Your FT3 is below range! Do you have any other health issues at all that might impact? As for exercise please stop or at least dial it down - other than gently moving around (so you don't rust up), keep it low for the time being. Your body is sooo depleted and you are potentially depleting it further with exercise.

You could try splitting dose of T3 as I mentioned above to avoid any surge effect, but honestly at those levels I'm not sure you would even notice. You may need more T3 but that is in the future ....

Both Folate and Ferritin are low and vitamin D? Does vitamin D have a range because I know labs are changing ranges so important to see result in context. Do you take any supplements at all?

Vitamin D is best taken in conjunction with co-factor K2-MK7 it directs the calcium in your blood stream to the bones - bit like traffic controller, otherwise there is a risk of your vascular system furring up.

Quite a few balls in the air to juggle, but as each factor is addressed and optimised it becomes easier. One thing at a time with regards to introduction of supplements.

I'm going to tag SlowDragon in for her info links and advice on vitamins and minerals. I'm in process of creating a reply myself with a lot of input from SlowDragon but I won't inflict my unfinished work on you 😉 I'm apprentice to the master!

[Chumchum in reply to Charlie-Farley]

Thanks Again for responding. Yes, I’m on B vits methylated to raise folate and eating black pudding to try to raise ferritin as iron is high. There are no ranges given for Vit D but I do take it in spray form with added k2. I don’t have any other conditions that I know of.

[SlowDragon Administrator in reply to Chumchum]

I’m wondering should I reduce Eltroxin to 100 and add 5 Thybon (to start) or stay on 125 eltroxin and add thybon?

I would stay on 112.5mcg Levo

FT4: 17.5 pmol/l (Range 12 - 22)

Ft4 only 55.00% through range

Likely to drop a little when T3 is added

Is this always same brand levothyroxine at each prescription?

Initially add 5mcg Thybon waking

Assuming that is ok ….after 5-7 days increase to 2 x 5mcg …2nd dose approx 8-10 hours after first dose

hold at that for 6-8 weeks and retest

Depending on results…..might be looking eventually at adding 3rd 5mcg dose…..changing timing of doses to roughly equal 8 hour intervals

Waking, mid afternoon and bedtime

Many members find small dose T3 at bedtime improves sleep

Or if last dose at bedtime keeps you awake

6am, noon and 6pm

[Chumchum in reply to SlowDragon]

That’s GREAT - I needed that direction Slowdragon. Thankyou. I’ll begin that tomorrow with fingers crossed🤞🤞

[TiggerMe]

I wouldn't lower your T4 dose before adding T3 as on 125mcg you had been at 75% and this will likely drop with the addition of T3 (often best kept above 50%) many are made to reduce T4 by too much when adding T3 and it makes you feel awful 😕 I'd just add in 5mcg of T3 for a couple of weeks and then add the other 5mcg

I see you tackled your low folate but Vit D was also lacking, did you up your supplementing? Aiming for 100-150 this link is useful to work out dosing.... 🤗

grassrootshealth.net/projec...

[Chumchum in reply to TiggerMe]

Thanks Eeyore - that link was v helpful. I’m on 3000 daily vt D & K2 spray so might need to up it. I’ve started the Thybon 5 and will stay on it for 2 weeks …… but noticing a very fuzzy ringing feeling/sensation in my brain since I started it on Wednesday. Is this familiar to anybody else beginning t3. Brainfog was one of my worst symptoms for so long and I definitely don’t want it back!

[TiggerMe in reply to Chumchum]

🤗 I have to up mine to 5000 at this time of year... I would imagine the sensation is some of the cells doing a little happy dance as they come back to life 😁 bit like Heineken Lager "reaches parts fT4 cannot reach"!

T3 is fast acting but as things gradually fire back up the improvements steadily continue

[Chumchum in reply to TiggerMe]

Cheers to that Eeyore🍺THANKYOU