help with latest results please

[Chell1]

I’ve just had my results back, I’m due to see my dr next week and would like to have some understanding of them. For reference I have Hashimotos, am gluten and dairy free, my vitamins and iron are ok after a long time working on them. I’m on 2 grains of Armour and have been on this dose for 6 weeks. I started on Armour on a low dose in March gradually working up to my current dose. I’ve never had medication prior to this. According to my latest results is my dose too high? I have seen improvements with my energy and weight is coming down. I felt very well but the past 2 weeks have had some brain fog, and less energy again.

TSH 0.007 (0.27-4.2 mIu/L)

FT3 5.6 (3.1-6.8 pmol/L) 67.6%

FT4 22.2 (12-22 pmol/L) 102%

T4:T3 Ratio 3.964

Thank you in advance.

[greygoose]

how long was the gap between your last dose of ndt and the blood draw?

[Chell1 in reply to greygoose]

12 1/2 hours

[greygoose in reply to Chell1]

ok, so no, I don't think your dose is too high, I think the high ft4 is more to do with the hashi'e than your dose.

[Chell1 in reply to greygoose]

Ok. I’m not sure what you mean that it is more to do with the hashis…My fT4 has never been this high before. The nurse at the practice has already hinted that as this is over range they will likely lower my dose. How is it Hashi s related? Sorry for my lack of knowledge on this.

[greygoose in reply to Chell1]

Well, as I'm sure you know, Hashi's is an autoimmune disease that slowly destroys the thyroid. Every time your immune system launches an attack on the thyroid, they dying cells release their stock of hormone - T4 and/or T3 - causing levels edicto rise. This time, for you, it appears to be just T4. And it's only temporary, the level will go down by itself.

If you were over-medicated, your FT3 would also be high, not just the FT4. But your FT3 is just where one would expect it to be on two grains of NDT. It's just your FT4 that is high - much higher than one would expect it to be on two grains - it would normally be lower in range than the FT3. Therefore, I don't think your results have anything to do with your dose, and if the practice nurse wants to lower it, it just shows how little she knows about thyroid.

[Chell1 in reply to greygoose]

Ok thanks, it’s good to have this information for when I have my appointment

[SlowDragon Administrator]

when were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you taking

[Chell1 in reply to SlowDragon]

My last test for these were 26/4/24

Ferritin 121 (30-207 ug/L)

Folate Serum 24 (>7 nmol/L

B12 73.1 (37.5-188 pmol/L) this had dropped a lot from my previous test which was 26/2/24 with Thriva 1119 (145-599), my nutritional therapist recommended I stop supplementing, which I did. I now realise that I need to supplement otherwise my levels just fall. I’ve been supplementing again with Betteryou B12 spray , so I’m sure these will have raised again as I’ve been testing regularly for years and as long as I supplement it’s ok.

Vit D 112 (50-250 nmol/L my previous test was 26/2/24 with Triva 143, I have increased my dose now but this is historically harder for me to get to optimally higher levels. I take the Betteryou vit 8000 iu - 12000 iu and the k2

I take a B complex, vit c, magnesium and selenium m, NAC daily

[pennyannie]

Helo Chell :

The ratios are for T4 only medication and have no relevance when taking T3 or NDT.

On NDT we track on the T3 and you are in range and if you feel well - stay there.

Did you increase by 1/4 grains - and did these symptoms just start creeping in after the last increase you made - maybe your best dose of NDT is 1 + 3/4 grains ?

Your T4 looks much too high for 2 grains so agree with what's already been said and that there is likely some AI attack going on - which might explain why you have felt less well these last 2 weeks.

6 weeks is not long enough to allow the NDT to bed in - wait another couple of weeks - and if things do not improve maybe add a further 1/4 grain or maybe drop a 1/4 grain ?

No thyroid hormone replacement works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal levels -

I now aim to maintain to ferritin at around 100 - folate around 20 - active B12 125 - ( serum B12 500++ ) and vitamin D at around 125.

[Chell1 in reply to pennyannie]

Thanks for your reply, really helpful. I went from 1/12 grains in March to 2 grains in May. So I may have missed the sweet spot. I was feeling so tired, dr felt I might be unmediated so went up to 2. Felt loads better for around 4 weeks then have felt tireder again. I think the AI attack makes sense as have been under stress which usually knocks me. I’ll see how I go and see what the clinic suggests. At least I have more knowledge to go to my appointment. Thank you

[pennyannie in reply to Chell1]

There are some people with Hashimoto's who find introducing Natural Desiccated Thyroid triggers their immune system response - and they do better on synthetic T3 and T4 treatment options. ???

Buy a pill cutter and just go with 1/4 grains up or down -

though usually after an AI attack the thyroid is further disabled and a dose increase in thyroid hormone replacement the logical next step.

[Chell1 in reply to pennyannie]

Ok thanks, that’s worth keeping in mind.

[pennyannie in reply to Chell1]

I was still rewriting when you landed in my laptop !!

Maybe reread and see if it makes sense ?

[Chell1 in reply to pennyannie]

That makes sense thank you