Advice please on latest results after dose decrease

[Sandytango]

Dear all, for the last 3 months I've been taking 112 levo (eutirox) and 10ml T3 Liotir (liquid). A slight reduction from the 125 levo I was taking when I last posted.My results (using protocol advised here) are as follows:

Ft3 2.92 (2.30-4.20) 3 x months ago on 125 levo - 3.18

Ft4 0.93 (0.89-1.76) 3 × months ago on 125 levo - 1.07

TSH 0.03 (0.55-4.78)

Ferritin 46 (41-150 normal)

B12 524 (was 203 had some injections and felt great for a while! Tested for pernicious anemia but seems dietary)

I weigh 51kg now having put on a few kgs - for my weight my doctor says levo dose is still too high and tsh negligible - we know that's because I take t3 though she refuses to understand that. Need to change doc but at the moment im staying with her as atleast she prescribes the t3.

Symptom wise, I sleep better but feel generally lethargic, depressed, achey, puffy face, mild titinus - but my husband died at the end of november so obvioulsy ive been under stress and suffering, so its difficult to understand what is affecting what symptom wise - or probably its a combination of things.

From my results it would seem to me that I'm undermedicated - results for ft3 and 4 given above when on 125 levo but not a great difference? and I felt no different. Would it be an idea to increase t3 instead?

I am taking iron with vit c for the low ferritin which is creeping up, but everso slowly. Zinc is also near low end of scale at 864 (800-1600) at but copper ok (i was low) so I need to address that too. Vit d is ok - 100.

Any advice gratefully received. ThankYou

[Beads]

You say the low B12 is dietary, do you track your food? If not you can’t really say that with any certainty. Your weight is low; your doc says you’re over dosed with levo, yet your levels are relatively low; your ferritin level is low; and finally your B12. These combined could indicate you having issues absorbing nutrients, calories, medications. What do you think? Is it worth chatting with the doc about the whole lot together rather than each individual thing, maybe they’re all symptoms of something gastric?

[Sandytango in reply to Beads]

Thanks Beads - yes tried to do this with functional doc who has tested for just about everything. I probably dont eat enough...not vegetarian but never been able to eat much meat though try to get protein in. Did all testing for pernicious anemia. See my answer to SlowDragon. Probably is an absorption problem but dont know how to tackle it ...should I up my meds?

[Beads in reply to Sandytango]

What sort of relationship do you have with your doctor? If it’s the sort where you collaborate and can ask for things, maybe ask for a referral to a gastroenterologist, would they be the ones to investigate absorption issues?

[Sandytango in reply to Beads]

Thanks Beads, yes ive been to a gastro he did endoscopy etc and said mild gastritis but not active...said there was nothing to do!

[SlowDragon Administrator]

Free T4 (fT4) 1.07 pmol/L (.89 - 1.76) 20.7%

Free T3 (fT3) 3.18 pmol/L (2.3 - 4.2) 46.3%

On 125mcg Levo and 10mcg T3

Free T4 (fT4) .93 pmol/L (.89 - 1.76) 4.6%

Free T3 (fT3) 2.92 pmol/L (2.3 - 4.2) 32.6%

on 112mcg Levo and 10mcg T3

Very sorry for your loss. Yes grief and stress can affect thyroid.

Both results suggest you are under medicated.

Perhaps poor absorption in gut?

Is your hypothyroidism autoimmune.

Are you on gluten free or dairy free diet

[Sandytango in reply to SlowDragon]

Thanks SlowDragon - it has been a very stressful few years. Yes I've been gluten free for a couple of years and eat very occasional dairy but no cows milk or cheese. I was positive for antiparietal cell antibodies last year and thinking I may have had pernicious anemia, I had an endoscopy which revealed very mild chronic gastritis so absorption is probably a problem. Negative for parasites. Done heavy metal testing, mold etc. Since then ive worked on healing stomach and just tested negative for parietel cell antibodies - which I hope is a sign of improvement. Last thyroid antibodies June 2023 anti thyroid peroxidase >28,0 (<60) thyroglobulin <1,3 (<4,5) which I assume means negative? Or does the fact that i have even a low amount mean hashimotos? Levels have always tested low.