Hello. I wonder if you would be kind enough to give me your views on my latest results please.
I currently take 100mcg thyroxine at bedtime.
My GP withdrew my T3 ( 5mcg) around 5 years ago. Apparently it doesn't work and was too expensive.
I feel dreadful. I'm underweight with a BMI of 18 and on top of everything else l have been told I'm prediabetic. HBA1C 42. I've had three oral fungal infections in the past year and so l saw an oral surgery consultant yesterday for my burning mouth which is very painful. I use vagifem, no other hrt. Last period 7 years ago. I have followed an anticandida diet for 25 years. Feel desperate.
Was test done early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test
assuming yes…..
You are not on high enough dose Levo
Request 25mcg dose increase in levothyroxine
Which brand is your 100mcg tablet
Ideally don’t change brand for 25mcg tablets
Retest in 8-10 weeks
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Significantly increase iron rich foods in your diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Thank you SlowDragon. I really appreciate you taking the time to reply. I take mercury pharma thyroxine and yes the test was done 24 hours after my last dose as l'd rejigged the timings just as you have suggested. I was under an endocrinologist (Dr Skelly) for many years who initiated combination therapy. I was prescribed 20mcg liothyronine which l would cut into four to get the 5mcg alongside my 100mcg thyroxine.
I stopped all supplements around 6 months ago so as not to interfere with any blood tests l may have to have for burning mouth. I've never supplemented iron or B vits, just a multi vit and omegas. I am prescribed calcichew 500 d forte which l take x 2 for my bones. I take morning and lunch time.
I have no idea why my B12 levels are so high. A year ago they were over 1000. I queried it with my GP but she wasn't concerned, she said it was probably the VSL #3 probiotic l was taking at the time increasing the levels.
When l last saw my GP l asked how they had the right to go above a consultant and stop the T3. He found the letter on the system as said he would consider prescribing again as I'm struggling. I do also feel iron deficient and have all the symptoms, including burning mouth, prickly itchy skin, brain fog and an exhaustion I've never know before, depressed, so thank you for highlighting my low ferritin, l had no idea about that.
Will Spatone help? I have to be careful with my tummy. Thank you again.
Multivitamins never recommended on here. Most contain cheap poorly absorbed ingredients, and iodine, not recommended for anyone on replacement thyroid hormones
Many (most?) on replacement thyroid hormones need a separate vitamin D, separate magnesium and a separate vitamin B complex
Aim for Ft4 (levothyroxine) up around 80% and work hard on improving ferritin
all four vitamins need to be at OPTIMUM levels
Vitamin D at least over 80nmol and 100-125nmol might be better
Ferritin at least over 70 and around 100 maybe better
Folate and B12 are good - presumably you supplement?
If Ft3 remains in 3-6 months low then look at getting T3 represcribed
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
My GP withdrew my T3 ( 5mcg) around 5 years ago. Apparently it doesn't work and was too expensive.
Dear god, when will they ever learn!!! T3 is a hormone, not a drug. It's can't not work. But, you have to take enough of it. 5 mcg was probably far too low. But I doubt if your GP even knows what T3 is! The old adage comes to mind about knowing the price of everything but the value of nothing. The correct dose of T3 is worth its weight in gold.
Now, your FT3 is below range, so not surprising you have problems. But, your FT4 is also too low, so we can't really tell how well you convert. You need an increase in your dose of levo.
Thank you greygoose. It's madness isn't it. I actually feel quite angry about it now. I have replied above to SlowDragon with a little more detail and l shall be revisiting my GP next week for increase in levo.
I am prescribed calcichew 500 d forte which l take x 2 for my bones. I take morning and lunch time.
One thing you really have to understand and that is that doctors know absolutely nothing about nutrition. They've all been brain-washed by yoghurt adverts to believing that all you have to do to get strong bones is throw calcium at them. This is far from true. Calcium is not, and never has been, a cure or a prevention of osteoporosis. So, unless you are very deficient in calcium, supplements can do more harm that good. Excess calcium can make bones brittle, and as the supplements are very difficult to absorb, they can also build up in the soft tissues and arteries, causing problems.
What is more important for bones is T3 - another reason he should reinstate yours, if he's worred about your bones! Also vit D and magnesium. Taking vit D increases absorption of calcium from food, anyway, and we take vit K2-MK7 to make sure it gets into the bones and teeth, and doesn't build up in the soft tissues and arteries.
When did you last have your calcium checked? If taking supplements it should be checked regularly.
Just a comment following a response to my need for a levo increase after MMH private blood test+input from our lovely+knowledgeable admins. Told GP that Thyroid Uk suggested I needed an increase in levo from...and to.... and I had no argument from her, though she was cautious. Thyroid UK input carries weight in the GP surgery - and so it should as their understanding on matters of thyroid+all it's vagaries is far superior to most GPs I am sure!
I am so sad for you, ... You doctor is apparently clueless! ... Anything else you take MUST be converted to T3 to work! ... I am currently taking Thyroid S which is a full spectrum Natural Thyroid supplement. ... I also take Estrogen AND Projesterone. ... I am 84. I feel great!
Have some reference books on your shelf so that you can study and understand how the #%&*@!# Thyroid works and why you feel so terrible. Knowledge is power. I recommend Paul Robinson's books (he's got a bunch of titles). The one I have is The Thyroid Patient's manual. He also has a website, and FB page. How can you be Hypothyroid and be underweight???? Could you possibly have a tape worm???? The lower the TSH number means that your Thyroid is suppressed, right Admins? I feel so bad for you! Why the #$*% are these doctors (worldwide) so frightened to prescribe T3 for us???? God bless you. I hope that you can find some answers soon. How easy is it to switch doctors in the UK?
Impossible to switch and GP’s know nothing about thyroid issues, and worse still they don’t want to know! Same with pharmacists too. GP’s now let their pharmacists check their prescriptions and test results and demand alterations to them without being seen! It is a real joy being hypothyroid!
andreab - Burning mouth syndrome and or lichen planus is linked to gastric parietal cells antibodies and both conditions improve w/ adequate B12 injections. I would request parietal cell antibody test, although can be positive in thyroidism & B12 deficiency. The B12 from your vitamins "would" increase your serum levels but do "little" to improve burning mouth, as oral B12 supplements do not produce a positive outcome w/ burning mouth. Attached supporting article. sciencedirect.com/science/a...
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