Low T4 & T3 1st Endo follow up soon

[Otto11]

Hi

I’ve posted here several times & had enormous amount of help from all on this group. I had a partial Thyroidectomy in 1995 & have taken Thyroxine since 1997. I started with symptoms of exhaustion in 2010 after a virus & never really recovered. They got progressively worse which my GP diagnosed depression & anti depressants for. I never took them. From 2017-2022 my life was virtually non existent unable to do most things for myself. I eventually saw an Endocrinologist who said I had been under medicated for years & increased my Thyroxine dose from 75mcgs to 125 mcgs in stages. As my levels were improving he discharged me & then retired. I managed to get a re referral last October & saw a registrar who prescribed a 6 month trial of T3. It’s almost a year now & have not yet been seen by an Endocrinologist as my appointment keeps getting cancelled. I now have an appointment for October.

all my previous results are on previous posts. I could do with some advice prior to my appointment please as my T4 is not budging from 14 & T3 is still not great. I’m back to having exhaustion & serious brain fog again. Currently had the last few days in bed due to exhaustion. Last bloods done August were

TSH 0.02 (0.27-4.2). T4 14.(11-22). T3 4.7 (3.1-6.8)

Previously in July TSH 0.02. T4 14 & T3 5.2.

I’m currently taking B Complex tablets every few days & separate Methylfolate as the ones I bought have only Folic Acid. I have 6 monthly B12 injections & also take zinc tablets as it was below range earlier this year. Vitamins tested in August at the same time were

B12. 952(197.0-771.0). Ferritin 104. (30-260) & Folate 14 (>3.9)

Suggestions for my appointment would be appreciated.

[SlowDragon Ambassador]

TSH 0.02 (0.27-4.2).

T4 14.(11-22).

T3 4.7 (3.1-6.8)

How much T3 are you taking

Which brand

Same question re Levo

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

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Suggest you increase B complex to most days if not daily

Remember to stop 5-7 days before any blood test

B12 injection - only one every 6 months seems too infrequent

Vitamin D result?

[Otto11 in reply to SlowDragon]

Hi sorry forgot to say yes all tests followed protocol. I’m on 75mcgs Thyroxine & 10mcgs T3 in morning & afternoon. GP never tested Vit D. I’ve also been taking B12 sublingual spray. I meant to also say I’m still loosing weight & body fat. Weighed 60-62kgs before T3 now 50kgs. At 5ft 8 ins it’s way too thin & all clothes just dropping off me. All things I need to ask endocrinologist about. Thanks

[SlowDragon Ambassador in reply to Otto11]

Looking at your profile

Thyroglobulin Antibodies 131

This is over range?

Thyroid Peroxide Antibodies <9

Obviously negative

Your hypothyroidism is probably autoimmune with high TG antibodies only

Weight loss

Have you had coeliac blood test ?

Or are you already on strictly gluten free diet

Some people loose weight when hypothyroid

Either lack of appetite or poor gut function and poor absorption

Which brand is 75mcg levothyroxine?

Teva brand upsets many people

Suggest you try small increase in levothyroxine to improve low Ft4

And/or

Try splitting your T3 as 5mcg 4 times a day ……waking, before lunch, late afternoon and bedtime

also test vitamin D

[Otto11]

Thanks I have Accord 50 mcg & Wokhart 25mcg. I was negative for Coeliac. I did try a small increase in Thyroxine a few months ago but got shaky hands & palpitations so reduced back to 75mcgs. I will try & split the T3 for a while. My blood test will be in 2 weeks time prior to my appointment.