Test results - please help!

[Tussa]

I really need help with my results. I have grave’s disease with no thyroid and hypocalcemia.

I take 75 mg Levo and 10 mg Lio.

75mg levo+ 5mg Lio in the morning and 5mg before bedtime.

What disappointed me with my last test result was that my tsh was so high (a year ago well below 1) and that my calcium was too low again.

My thought was to take the entire dose in the evening to be able to eat more calcium for breakfast but realize that I probably need to increase the T3 dose? But 15 mg of T3 at the same time, I don't think my body can handle it. My doctor thinks I should increase Levo to 100. She doesn’t know I’m taking lio. I feel so sad and confused right now and don't know what to do. I’m really not feeling good with high t4 levels.

[greygoose]

Well, you might be surprised by what your body can handle! But you won't know until you try.

That said, not a good thing to change two things at the same time. So, why not start by taking it all at night first - absorption might be better and you might not need an increase in dose. Give it six weeks like that and then retest.

[Tussa in reply to greygoose]

Thank you! You mean keep my dose 75 Levo + 10 lio. But in one go at night?

[greygoose in reply to Tussa]

Yes, that's right. Worth a try, anyway.

[Tussa in reply to greygoose]

That would solve a lot of my problems with the calcium issue. Do you think my T3 levels are too low?

[greygoose in reply to Tussa]

FT3: 4.2 pmol/l (Range 3.1 - 6.8) 29.73%

Yes, it is quite low. But then, so is your FT4: FT4: 14.2 pmol/l (Range 12 - 22) 22.00%.

Increasing your levo might raise both. But, as I said, only change one thing at a time. So, if you want to try taking it all at bedtime, so that you can eat more calcium for breakfast, then try that first and see what happens. It's all trial and error.

[Tussa in reply to greygoose]

Thank you for sharing the percentage numbers! Doesn’t look that great…

Yes, you’re right: only change one thing at a time.

[pennyannie]

Hey there again :

Did you not get on with NDT ?

Would it not make sense to ' own up ' and be honest with your doctor as at least then you would both be on the same page and likely feel more comfortable in her presence ?

I haven't really got any answers as I'm still finding NDT working well for me.

How are your core strength vitamins and minerals - ferritin ,folate, B12 and vitamin D ?

You must be dosed on your Free T3 and Free T4 readings - your TSH is of no value -

you have had a medical intervention - a thyroidectomy -

and your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop - on which the TSH reading is based - is now open ended and the circuit broken - as there is no thyroid in situ :

[Tussa in reply to pennyannie]

Hi again 😊,

No, I didn’t dare to try NDT back then but now I’m actually considering it again. I really would like to get rid of that horrible surge I get after 2 hours from taking the meds. I remember you said that the feeling is smoother on NDT? And I also would like being able to take it all in one go.

What dose of NDT do you think I would need?

The dr who prescribes the Cytomel ( t3) is actually pro NDT so I can easily get it there. The dr I saw the other day ( with the lab test above ) is a GP and I forgot to tell her that I’m taking Liothyronine ( I was there for another reason).

I don’t have any new numbers for vitamins and minerals. But I’m taking b-complex, vitamin D (2000 ie), magnesium, calcium and vitamin k.

[pennyannie in reply to Tussa]

Yes- you remember well -

I too felt that surge on synthetics - and one suggestion I've read since is to ease this surge is to take the T3 with food.

With NDT you start on 1/2 a grain and slowly build up your dose by 1/4 grain increments weekly - low and slowly over a period of weeks and would imagine you'll end up on around 2 grains

NDT is more slowly released in the body as the hormones are attached to thyroglobulin molecules and more slowly released into the blood stream.

Lucky you have the facility to get all the treatment options prescribed and presume you -and you will still need optimal vitamins and minerals whichever way you choose to go :

[Tussa in reply to pennyannie]

Thank you for your help! I will let you know how it goes if I decide to try NDT. 😊

[pennyannie in reply to Tussa]

Okey doke - please keep us in the loop :