low ft3 on block and replace treatment for graves

[kirkimou]

Hi

I diagnosed with graves July 2023

TSH 0.01IU/ml (0.35-4.94)

FT4 2,48 ng/dl (0.70-.1.48)

FT3 15,62 (1.58-3.91)

TSHR 4,060 <0.550

vit d25-OH 45ng/ml

selenium 141 ng/ml (70-150)

My endocrinologist priscribe 20 methimazole/ day, vit d+k2 5000/day, selenium 200 mcg , morning+200 mcg afternoon propranolol 40mg morning+40mg afternoon and after long time i felt great!!!

August 2023

TSH 0.01IU/ml (0.35-4.94)

FT4 0,96 ng/dl (0.70-.1.48)

FT3 2.78 pg/ml (1.58-3.91)

vit d25-OH 45ng/ml

My endocrinologist priscribe 25 methimazole/ day, levethyroxine 62mg vit d+k2 5000/day, selenium 200 mcg morning+200 mcg afternoon propranolol 40mg morning+40mg afternoon . I felt good enough but i felt better without levothyroxine

September 2024

TSH 0.05 IU/ml (0.35-4.94)

FT4 0.89 ng/dl (0.70-.1.48)

FT3 2.21 (1.58-3.91)

vit d25-OH 45ng/ml

My endocrinologist priscribe 30 methimazole/ day, levethyroxine 75mg, vit d+k2 5000/day, selenium 200 mcg morning+200 mcg afternoon, propranolol 20mg morning+20mg afternoon. After 20 days on those medication I had joint pains and i asked from my doctor to come again at the dosage 25 methimazole/ day, levethyroxine 62mg and i felt good enough but i felt better without levothyroxine.

December 2023

10 days after become ill with covid 19 TSH 4.18 IU/ml (0.35-4.94)

FT4 0.98 ng/dl (0.70-.1.48)

FT3 2.34 (1.58-3.91)

vit d25-OH 49.40ng/ml

TSHR 1,200 IU/I <0.550

My endocrinologist priscribe 30 methimazole/ day, levethyroxine 100mg, vit d+k2 5000/day, selenium 200 mcg morning+ 3 brazil nuts afternoon, propranolol 20mg morning . After 30 days on those medication I some restlessness and i add 20mg propranolol at afternoon and i felt good enough.

At my last visit to my doctor on April 24 i told him that for a month i was feeling a a lot of nervousness, restlessnes, anxiety and always cold on feet and hands and my labs was:

TSH 0.64 IU/ml (0.35-4.94)

FT4 1.32 ng/dl (0.70-.1.48)

FT3 2.07 (1.58-3.91)

vit d25-OH 44.30ng/ml

iron 90mg/dl (50-170)

feritin 37 ng/dl (4-204)

TSHR 1.790 U/I <2000

selenium 90 ng/ml (70-150)

My endocrinologist priscribe 30 methimazole/ day, levethyroxine 88 mg vit d+k2 5000/day, selenium 200 mcg morning+ 3 brazil nuts afternoon, propranolol 20mg morning. Almost one month on those medications i had a reduction on nervousness, restlessnes but i have anxietey and something like depression.

My doctor told me that my labs is perfect and now i am eythyroid!!!!! But i told him that i am not feeling perfect and he told me that it's not from my thyroid disease !!!

I understand that my FT3 is low FT3 2.07 (1.58-3.91) and my FT4 is high FT4 1.32 ng/dl (0.70-.1.48) thats why i am feeling bad.

Could you tell me your opinion.

Thank you

[humanbean]

i have anxietey and something like depression.

This might be caused by your low ferritin (iron stores). It would be better if your ferritin was mid-range.

If you decided to try and raise your ferritin with iron supplements you would have to keep tabs on your iron levels. Sometimes people can find that their ferritin may stay low while serum iron shoots up. And that should be avoided.

...

Selenium :

Jul 23 selenium 141 ng/ml (70-150)

Apr 24 selenium 90 ng/ml (70-150)

I don't know much about selenium but yours is doing weird things. Perhaps it is an effect of being hyperthyroid. Your supplemental dose is very high. Do you know why you were prescribed such a high dose? It would be worth you researching selenium, and knowing what the signs and symptoms are of both deficiency and toxicity.

en.wikipedia.org/wiki/Selen...

en.wikipedia.org/wiki/Selen...

en.wikipedia.org/wiki/Selen...

You might want to look up selenium on this link :

en.wikipedia.org/wiki/Dieta...

There is a relationship between selenium and iodine. Perhaps you could ask about getting your iodine levels measured. Don't supplement iodine without being tested first because it can make thyroid problems worse in excess.

The best form of iodine test is a non-loading test for iodine in urine or blood. Avoid loading tests - they are flawed :

zrtlab.com/blog/archive/fla...

townsendletter.com/Jan2013/...

[kirkimou in reply to humanbean]

About Selenium doctor prescribed this dosage to avoid eye disease due to graves. When selenium was in range i used another supplement not the one that doctor prescribed me. I think that the new one has bad absorbion. Thank you

[PurpleNails Administrator]

Welcome to forum.

Please put country in profile many may offer advice on options in UK, eg private blood testing companies available.

Doctors say anything in range is acceptable. Your instincts are right, low FT3 will cause symptoms.

TSHR (often written as TRab) 1,200 IU/I <0.550 confirms Graves.

Optimal nutrients can help conversion.

Do you have range for vitamin D ng/ml?

Ferritin / iron looks very low. Are you male/ female? Vegetarian?

Propranolol lowers FT3. Often prescribed along side antithyroid temporarily, helps with symptoms particularly palpitations. Never stop abruptly, always gradually reduce when symptoms allow.

[kirkimou in reply to PurpleNails]

I am a female and i am not vegeterian. Vt d ranges 30-100 ng/ml. Propranolol was prescribed fro my high heart rate and is now slowly reduced. Thank you

[SlowDragon Administrator]

Free T4 (fT4) 1.32 pmol/L (.70 - 1.48) 79.5%

Free T3 (fT3) 2.07 pmol/L (1.58 - 3.91) 21.0%

was test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

My endocrinologist priscribe 30 methimazole/ day, levethyroxine 88 mg vit d+k2 5000/day, selenium 200 mcg morning+ 3 brazil nuts afternoon, propranolol 20mg morning.

Propranolol will lower uptake and conversion of Ft4 to Ft3

low Ft3 results in low vitamin levels

When were folate and B12 last tested

feritin 37 ng/dl (4-204)

Ferritin is low

Aim for ferritin at least over 70

Look at increasing iron rich foods in 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

List of iron rich foods

dailyiron.net

[kirkimou in reply to SlowDragon]

Hi

Today i test folate and b12 and again thyroid hormones after lowering levythiroxine from 100mg to 0.88mg 4 weeks ago and from 0.88mg to 0.75mg 2weeks ago and lowering methimazole from 30mg to25 mg /day

results

(TSH) . . . . . . . . . . . . 1.74 μIU/mL 0.35 - 4.94

(FT3) . . . . . . . . 2.17 pg/mL 1.58 - 3.91

(FT4) . . . . . . . . . . . . . . 1.06 ng/dL 0.70 - 1.48

folate 4.2 ng/mL 3.1 - 20.5

B12 692 pg/mL 187 - 883

The most important about it is although lowering levythiroxine reduce ft4 but increased a little ft3 which is what i was looking for. Its so strange........

[SlowDragon Administrator in reply to kirkimou]

Folate is low

Look at adding a good quality daily vitamin B complex

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[kirkimou]

Tests just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test. Unfortunately i haven't test B12 and folate. Thank you