At my last endo appt early Dec, the consultant kept his same stance that my blood tests were all in range and my symptoms were all due to perimenopause. He said there was slight room for a small increase in levothyroxine so ive gone from 125x5/100x2 to 125x6 /100x1 and told me to speak to my gp and tweak my hrt. ( Ive already tried 2 different combos and added in testosterone over last 18 months) Gp changed my progesterone in Dec which has actually helped with the heavy bleeding ive experienced since having Rai 2 years ago. My estrogen was increased to 75 in Feb and this has made me feel absolutely wrecked. Terrible sleep, puffy eyes, angry, tearful, depressed, like I was having a nervous breakdown. So ive reduced back to 50. This has made me feel that hrt is not the issue.
I called my endo and he suggested we may need to add in a small amount of fast acting T3 and to come in for blood tests. Results below.
TSH 0.47 mIU/L (0.27 - 4.20) 5.1%
Free T4 (fT4) 22 pmol/L (10.8 - 25.5) 76.2%
Free T3 (fT3) 3.9 pmol/L (3.1 - 6.8) 21.6%
T4:T3 Ratio 5.641
Folate - Serum 12.5 ug/L (3.89 - 19.45) 55.3%
Vitamin B12 101 nmol/L (35.5 - 150) 57.2%
Vitamin D 119 nmol/L (50 - 200) 46.0%
Ferritin 64 ug/L (13 - 150) 37.2%
Is there any room for more levothyroxine or would I be better off adding T3? Are my vitamins/minerals at an acceptable level yet for making T3 worthwhile? Any thoughts?
Levo taken at night, blood test rules adhered to, supplements: Thornes Basic B, Vit D3/K2, \magnesium Gly, Ferrous fumerate
Thanks as always!
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JUUJOO
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As you normally take levothyroxine at bedtime...you adjusted timings as follows prior to blood test to give 24 hours between last dose levothyroxine and 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
assuming you tested like this ….yes time to look at adding small doses of T3
Yes - for sure - a little T3 should do the trick and kick start your metabolism of the T4 :
Your results are very similar to mine when on T4 monotherapy after RAI thyroid ablation -my conversion ratio was 5.50 but this fact ignored and as I was in the ranges I was refused T3 and NDT and told I was over medicated as my T4 was at the top of the range with my TSH stuck down at 0.01 where it needs to be if I'm to be well .
After finding no help within the NHS I started self medicating and initially tried T3 with a reduced dose of T4 - and found 6.25 mcg T3 + 100 mcg T4 daily a vast improvement as it was like a light bulb going on in my head - and the heaviness and reduced cognitive functions I was living with were virtually eradicated, over night.
Your T4 is just in the top quadrant of it's range so there is no need to reduce your dose and your TSH is in the range -
so just be aware that when adding in T3 you may see both the TSH and T4 levels fall - it's just what happens when you start taking T3 and it does not matter - what matters is now finding a dose of T3/T4 that works for you and relieves your symptoms of hypothyroidism.
I know now I feel at my best with a ferritin at around 100 - folate around 20 - Active B12 around 125 ( serum 500++ ) and vitamin D at around 125.
I can't remember if I've written all this to you before but just for a recap ;
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T, T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg - with T3 said to be around 4 times more powerful than T4 :
Some people can get by on T4 monotherapy,
Others find that at some point in time T4 seems not to work as well as it once did - and that by adding in a little T3 - likely at a similar dose to that ' lost ' by having had a medical intervention such as thyroidectomy or RAI thyroid ablation for Graves they are able to restore T3/T4 hormonal balance and feel better ;
Others can't tolerate T4 at all and need to take T3 - only - Liothyronine.
Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland and derived from pig thyroids, dried and ground down into tablets and referred to as grains.
I apologise if I have sent you these research papers before :-
Of all I researched - some 10 years after RAI thyroid ablation which I had in 2005 when I became very unwell - I found Elaine Moore's books and website the most rounded of all I read. - elaine-moore.com
wow, I think this reply you wrote might just change my life. I’m going to try this too and I’m going to be more observant of my ferritin and b12 levels. Thank you 🙏 My only Qn is how do I obtain t3 when my GP doesn’t even seem to know what it is?
I've just looked back and read your post from 5 years ago:
There is one reading for T3 which shows your level at the bottom rung of the range.
As I understand this these results from 5 years ago were before you started taking any thyroid hormone replacement.
No thyroid hormone replacement works well until the core strength vitamins and minerals are up and maintained at optimal levels so suggest you start off running a full thyroid blood panel to include TSH, Free T3 Free T4 inflammation, antibodies, and ferritin, folate, B12 and vitamin D and post the results and ranges back up in a new, own post and you will be talked through what it all means and your next best steps back to better health.
I would think if you saw a endocrinologist and a specialist in their field they would know that the original successfully used treatment for over 100 years for hypothyroidism is NDT - which contains both T3 and T4 - but as to what is allowed to be prescribed in Spain - I do not know - and think some other forum members who live in Spain are self souring but I could be wrong.
You’re very kind to answer my reply and to look back at my old post. I shall certainly update it since so much has changed. For one, I live in berlin now and the endo I see here is very traditional and poo poos iodine and NDT and she won’t test for reverse T3 at all. She told me I have a very tiny thyroid and that with Levo my thyroid is now in range and all is well and I should stop focusing on it. I do feel better buut the Levo has made me pile on weight (I was always underweight until taking it), and my hairloss has only worsened over time on it. My face is bloated and the brain fog still hovers. My vit d is above optimal, as is my b6 but my ferritin is low and so im supplementing again. I did not test for folate though and last year my b12 was okay, I’ll have them retested. I also take magnesium religiously.
I think I’d like to try t3 myself and see how I do. I did try NDT but I felt very panicky and low energy and without proper guidance I felt lost and my endo was appalled. I haven’t been able to find another endo here who might be more opened minded. Im considering flying to london to see Dr Trevor Wing.
anyhow, i’m getting new bloods a week on Tuesday and so I’ll know more then.
Sending you all the very best on your own health journey, I’m always so inspired and impressed when I come across people, like yourself, who through research and dogged perseverance fixed themselves. I long to get to the bottom of my auto immune issues, especially the severe hairloss. I exercise every day and I eat a balanced diet, so let’s see.
In order for the person to know you have written to them - you need to use the reply tab within their post to you and that their name comes up in your reply to them :
Best to start your own post when ready - update your profile - and we are not allowed to openly discuss any medical professionals on this open forum - and have the facility of a Private Message page - look at the paper plane Chat icon - and that is used when wanting feedback on any medical professional.
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finally added blood work. What’s a good % + ratio?
Hypothyroid new blood test results - high antibodies
Blood Test Results
Blue Horizon Results
Blood results help
