I am wondering whether these latest results might shed some light on me waking very early in the mornings 0430 at the moment with night sweats and unable to get back to sleep and high blood pressure results at various times of the day. I am currently on 115mcg Levo and 10mcg of T3. I have an appointment next week with The Thyroid Clinic and they will talk me through the results but as it is only a 15 min slot any thoughts and opinions on the results would be appreciated. She wanted me to be taking 20mcg of T3 daily alongside the Levo but I found I couldn't tolerate that much. I felt fantastic last month but the last week has been troublesome. Should T4 still be within range when on combination therapy? Does it sound right that I should be on the same dose of Levo now during combination therapy as I was before adding in T3?
No meds taken before early blood draw.
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Turquoisenona
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When did you take last dose of T3 before the test? Recommended timing is 8-12hrs before test, usuallly need to delay last dose or split day before test.
FT4 is over range, so reducing Levo would be a good plan by 12.5 or 25mcgs. Some people can stay on their previosu Levo dose but it depends how high in range FT4 was and very individual.
What supplements are you taking?
Low vitain levels are often the culprit for not tolerating thyroid hormones, especially T3.
Folate & vit D are good, well done.
B12 is far too low. Are you vegan or vegetarian? If not:
B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...
If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.
If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.
Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc
Thanks for all of that. I took my last dose of T3 around 15 hours prior to the test. I have been taking 'PinkTribe' Liposomal vitamin B complex 1 per day. I am not vegan or vegetarian but was doing the keto diet for 9 weeks prior to this test. Have now added in light carbs over the last 10 days or so. I don't think I have many symptoms of low b12. Hair gets greasy very quickly and insomnia lately but I think the sleep thing is more thyroid levels. Will look at ordering b12 spray.
For future tests split T3 dose and take half morning and delaay last half until 8-12hrs before test - usually after 9pm. otherwise your results show a false low as T3 doesnt stay in the system that long.
You seem to be needing a lot of B12 but see how it goes with the extra B12 spray or sublingual. The Pink Tribe B complex has only 500ug of B12 so seems you need more.
See how you go with that but some people only do well with injections as opposed to sublinguals etc
Would doctors be interested in my b12 levels as they are technically within range or is this something I would have to sort out privately if I wanted injections?
Your current levels are on the low side but most GPs would say they were OK, but remember you have been taking a supplement.
It would be interesting to see an active B12 test at the moment and I suspect would be very low. GPs often dont know the difference between the 2 tests.
If you have been supplementing it can take 3 months for levels to return to baseline.
Many people source B12 injections for themselves as GPs often not interested in low, within range results.
Recommend you post on the pernicious Anaemia group here on HU.
The advice about delaying your T3 might not work in your favour because the sleep disturbance and overheating you are describing could be too much T3. Or perhaps taking the last dose of T3 too late in the day? My endo tells me not to take T3 after 5 pm or it will interfere with sleep and it does make me hot (I take it late if doing a long drive to keep awake). You mentioned perhaps you are being over replaced, as a comparison, my thyroid is, in top consultant terms "doing absolutely nothing", TSH was over 95 in a range up to just 5 with 95 being coma level and I am prescribed 50 mg Levo and around 20 mcg of Liothyronine which is a lot less than you. Of course I am not arguing with your prescribing doctor, our bodies are different, just offering something to think about.
Yes, the more i think about it I am definitely experiencing symptoms akin to when my thyroid used to go overactive before surgery. Even my dry itchy eyes were back. I think I hit my sweet spot about a month ago and felt brilliant but something/levels building up has changed since then. I suspect my doc will tell me to decrease my Levo when I speak to her on Thursday. We went out for a few drinks the other night and my resting pulse was much much higher than normal the next day so am going to avoid alcohol until my levels have settled. On the plus side my t3 levels are now the highest they have been since my thyroidectomy 4 years ago.
JD has covered most bits... I shall add that I needed a slight increase of T4 once on T3 to keep it just above 50%.... having been at 95% before adding T3... you've the headroom to add another 5mcg T3 even though this result is slightly false and likely lower than it would be after 12 hours, but I'd be surprised if you needed 20mcg 🤷♀️
2-4am wake up is classic adrenal fatigue giving you a shot of adrenaline which can be exacerbated when initially starting T3
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