I posted for advice about a month ago and increased my T3 to 10mcg . I have felt some improvement as in not as achy but not sleeping very well. I am in Australia visiting my daughter so took advantage of their cheaper blood testing
I started T3 as my doctor thought I wasn’t converting T4 but having researched it more it could be that I just needed a dose increase of T4 ? I have only ever taken 50mcg which I am still on now with the T3 10mcg.
TSH 0.88 (0.5- 4)
FT4 11( 10-20)
FT3 4.4 (3.5-6.5)
Reverse T3 317(170-539)
Ratio of T3 to RT3 13 (>20)
Zinc 16.4 (10-18)
Selenium 1.73( 0.80-1.99)
I realise ideally bloods should be done at the same lab. I followed the usual protocol described on here regarding medication prior to testing . The ratio of T3 to reverse T3 is lower than it should be. Does this indicate a conversion problem ?
My question is do you think I should ask my doctor to increase my Levo from 50mcg or increase my T3 from 10 .
Would really like some advice. Thanks
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Poppygriff691
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Thanks for your reply that’s really interesting . Do you feel better with this ? I realise it takes longer for improvement with T4 but definitely less complicated and cheaper if it works for you !
I'm not sure if it technically takes longer to improve on T4. I see getting my T4 to optimal as the very first pillar in my dosing.
50 Levo (even with the 10 Lio) wasn't bringing me to the mid/top of range at all (of either, but def not T4). There are discussions here about whether those on Lio with optimal FT3 need to worry about a low T4. I am not 100% read up on it, but my conclusion is that not everybody needs an optimal T4 when T3 is OK, but for me, while I adjust everything, I would like to know that my body has a reserve of stable and optimal T4 to draw on regularly.
The big thing for me is that as long as I convert well, and until I give myself a chance to, there was no reason to start the Lio.
I wish I had followed this plan - said succintly below, But here I am.
Yes I think you’re right . It would have been better if my doctor had increased my Levo originally. I will probably do what you have done and see how I go . Thanks so much for sharing your experience with me . Hope we all feel amazing soon !
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten.
Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
When you get home……While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Guidelines when ONLY on levothyroxine is that most people will need to slowly increase levothyroxine, usually in 25mcg steps, until on approximately 1.6mcg per kilo of your weight per day
Unless extremely petite that will be at least 100mcg levothyroxine per day
Some people need a bit less…..some a bit more
Once on approx this dose …..Ft4 towards top of range, vitamin levels optimal…..if Ft3 remains low
When T3 is added ….. dose levo may be reduce by 25mcg.
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