I'm in surgical menopause and have not felt 'well' for a number of years now. I won't bore you with the backstory of my trials and tribulations with HRT, all in the pursuit of feeling well enough to fully function.
I've questioned Thyroid for some time, I had tests last September and posted them on here. I then went under the care of a Functional Medicine practice as my symptoms of chronic fatigue, cognitive dysfunction and low mood (amongst many other symptoms) had reached the point where I couldn't function.
I had a DUTCH test which confirmed adrenal issues - low cortisol and low DHEA. I have been working on supporting my adrenal glands since December, focused on improving bowel movement and detoxification, as my Oestrogen levels are very high and I have lots of Oestrogen dominant symptoms.
I have spent a lot of money on this care and there's been little to no improvement. I have mentioned my Thyroid a number of times to the doctor, but because my TSH is good, it has been dismissed. I had bloods done again last week and these are my Thyroid results:
TSH 1.19 Miu/L (0.27-4.20)
FT3 4.4 pmol/L (3.1-6.8)
FT4 13.8 pmol/L (12.0-22.0)
From my understanding, neither my FT3 nor FT4 results are optimal. I therefore shared them with my Functional Doctor and pointed this out. I've heard back from her today, and she's referred to the ratio of T3/T4 which she's said should be 0.33 and mine is 0.31. She asked for my RT3 results, which I have from a previous Thyroid blood panel, Reverse T3* 16.0 (10 - 24 ng/dL)
She has suggested we could add in a Thyroid support complex such as Metavive or Porcine Thyroid.
I'd welcome your opinions on my results, as well as the suggested approach by my Doctor. I have spent a lot of money so far, and I am concerned that I am going round in circles. My symptoms of chronic fatigue, cognitive issues, constipation, hair loss, cold hands/feet (amongst others)continue.
Thank you.
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Sunnyyellowlady
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Are you now getting B12 injections or on daily B12 supplements as well as good quality daily vitamin B complex
what are most recent B12 and folate results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Thanks for your reply. I have been using Ultranflamx which includes B12 & Folate as well as other vitamins. I've also been using Liposmal Methyl B Complex. I haven't had B12 or Folate tested recently.
Yes, I know it is. It was prescribed by the Functional Medicine doctor. I was so ill, I was prepared to try anything that would possibly help. I'm also using Methyl B. Thanks
Thank you. My doctor isn't offering Levothyroxine, she's suggested a Thyroid Support Complex and Metavive.
From my results and symptoms, do you think my Thyroid isn't optimal and needs support? And, what is your opinion on my Functional Medicine Doctor's suggested approach? I am reluctant to spend more money if her suggestions aren't going to address my issues.
My doctor isn't offering Levothyroxine, she's suggested a Thyroid Support Complex and Metavive.
A cynic might say that’s because they are much more expensive than Levo and you would be tied to private prescription/supply rather than option to transfer to NHS
Hi, I saw an NHS Endricronologist on Friday and he said I absolutely don't have a Thyroid issue as my TSH is good and he thought my T3 & T4 were too. He wasn't interested in my symptoms. I don't have the option of NHS and as I'm already under the care of a private doctor, I'm questioning if their suggested protocol is worth trying. Alternatively, I'll have to go elsewhere. Thanks.
Suggest you get vitamin thyroid and levels retested
See where B12 and folate are now
Medichecks usually the cheapest
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
come back with new post once you get new test results
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
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz
Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots,
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
Lactose free brands - currently Teva or Vencamil only
Teva makes 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Vencamil (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
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
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