Could the wise ones on here have a look at these results and see if anything jumps out at them? Figures below, and also graphs above if I can work out how to attach them, in case they are helpful. All bloods taken as per advice on here. All taken with Monitor My Health.
TODAY’S RESULT
TSH 0.02 (0.27-4.2) LOW
T4 17.1 (12-22)
T3 3.4 (3.1-6.8)
AUGUST 2024
TSH <0.01 (0.27-4.2) LOW
T4 22.4 (12-22) HIGH
T3 4.5 (3.1-6.8)
APRIL 2024
TSH <0.01 (0.27-4.2) LOW
T4 21.1 (12-22)
T3 4.6 (3.1-6.8)
SEPTEMBER 2023
TSH <0.01 (0.27-4.2) LOW
T4 19.5 (12-22)
T3 4.4 (3.1-6.8)
APRIL 2023
TSH <0.01 (0.27-4.2) LOW
T4 27.2 (12-22) HIGH
T3 5.1 (3.1-6.8)
I have had hashimoto’s for past 30 years (now 61). I’ve been on levo generally pretty happily (at varying levels, more when I was pregnant), and with the odd tricky patch, particularly during very stressful times. My GP has been happy for me to have a suppressed TSH so long as T4 within range as he recognised that that’s how I feel best. He’s great - tho I fear on the verge of retirement/burn out.
I also have well-controlled coeliac disease and am under investigation for microscopic colitis for ongoing regular bouts of diarrhoea / pain / weight loss etc. My gastro consultant took a look at my thyroid stats and said “a-HA your TSH is suppressed that might be why you have ongoing diarrhoea, weight loss”. I pointed out that even when my TSH went though the roof a couple of times over the years, I’ve still had the same issues with my guts. However out of curiosity (and I guess wondering if he might have a point) I’ve dropped my levo since August from 175 which I've been on for years, to 150. My TSH has gone up a tiny bit but my T3 noticeable dropped (as has T4).
I definitely feel more weary in the last few weeks and am suffering with ridiculously itchy arms (enough to keep me awake at night), and low key a bit miserable (but my guts are pretty awful most of the time which I’ve been blaming). There's been no improvement in my guts since dose change.
Any advice? I’ve always assumed I was one of the lucky ones who got on fine with levo and didn’t have to wonder about T3 - any reason to think I should be reconsidering? Or shall I just put my dose back up and carry on as I was?
many thanks in advance for any advice
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Megaloo
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Even on your previous dose of 175mcgs your FT3 was too low at 38% of rnge and now its even lower. Suggest you think about adding some T3 to raise your FT3. Conversion does drop as we age.
You can email info@thyroiduk.org for a list of T3 friendly Endo's. Pick a couple and post asking for feedback via personal message only.
FT4 is now only 51% through range, you could go back up to previous dose in the mean time.
How are vitamin levels and what are you supplementing with?
Ok, good advice re endos thank you (tho was desperately hoping I wouldn’t have to involve another consultant 🙄). Interesting re adding T3.
I’m afraid I’ve not tested vits for an age and don’t supplement anything - partly thru laziness and partly don’t want to add too many variables to my poor guts. Thanks again.
Thanks Jaydee. I’ve not been prioritising my thyroid health as gut issues have been so much more problematic but I realise this is short sighted. Thank again.
hi Jaydee, yes, it's crossed my mind, but it was all so extreme with the untreated coeliac (symptomatic for decades before finally getting a diagnosis) that there's been a (possibly wrong) assumption that we start with the gut. More joined up thinking would be amazing but unlikely I guess sadly. I'll definitely work on it anyway as you say.
Your thyroid levels are sooo similar to mine - almost spooky!
I have had hashi's for over 20 years, my TSH has been suppressed right from the start (and never come up) and my T4 was always at the top end with my T3 between 65-75% through the range. I am also on levo only (100 mcg).
Over the last two years, I have also noticed that my T4 is coming down ever so slightly and the gap between T4 and T3 seems to widen (TSH unchanged). My conversion seem to be still okay and I have no health issues, but I do test my nutrient levels regularly and supplement with 3000IU Vitamin D3 + K2 + Mg all year round. Also take a Vitamin B complex and zinc on occasions. I actually do notice when I forget my Vitamin D for a couple of days, achy bones and legs, but that disappears again when I am more conscious with my supplementation routine.
I know it can be a pain, but I would start to supplement again and see if that will help you. But in the long term, and when the gap widens further, you might need a small addition of T3 (as will I probably, but I will cross that bridge... :-).
Thank you! Who do you use to test levels? And any recommendations for which brands to take? I get overwhelmed with the choice and end up getting nothing 🤣
Thyroid UK have some good choices when it comes to testing and when you apply a discount code, you get 10% off the price. If you are testing more than one thing, look at combination packs, they do work out cheaper than single tests. Monitor my health have some good tests (anaemia and vit D), but others may have some good offer too.
With supplementation, different people respond to different supplements, its trying out what suits you best and which ones you can tolerate.😉
I take Igennus Vit B complex (says 2 per day, but I get on well with one or one every other day as highly concentrated). I also take 3000IU of Vit D + K2 (brand I use is Nutravita, 3000IU Vit D3 plus 100 mcg K2, on Amazon), I have Magnesium citrate powder which I mix into juice (careful, in some people Mg citrate can be laxative, you can also get Magnesium glycinate ot taureate). I also take a zinc complex on occasions, however zinc is a difficult one as it needs to be balanced with copper, and some people may have more of one and less of the other.
How is your iron? I don't need iron supplements, as I eat meat regularly and my iron stores have always been naturally on the higher side. But if you are low, people recommend Three Arrow heme iron (well absorbed) or ferrous sulfate, ferrous fumarate or ferrous gluconate. Apparently ferrous citrate is another form, but I think it is prescription only for people with kidney disease.
Get tested and see which ones are deficient. Then start with one and then add something else in and see how you are getting on. The biggest difference for me was when my Vitamin D level went above 100 nmol/L, much more energy and immune system seems to be working pretty well, especially with all this Covid that's around again.
I very much doubt it will ever respond in the manner most doctors believe is the answer to everything ' thyroid ' :
All you will do is compound your already poor conversion of T4 into T3 and make yourself more unwell.
So yes - you could lower T4 and add in a little T3 to solve the poor T3/T4 conversion - but - we know that T3 lowers TSH anyway -
so chasing a TSH reading into the range - a fruitless exercise and a waste of your time, health and well being.
No thyroid hormones work well if the core strength vitamins and minerals - those of ferritin, folate, B12 and vitamin D are not up and maintained at optimal levels - which we can advise on :
Conversion can also be compromised by a inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing - so think we have acknowledged issues here - which will likely impinge on your overall health.
A low TSH does not cause diarrhoea. (Your gastro is referring to the usual accompanying high levels of thyroid hormones in hypERthyroidism that might initiate bouts of diarrhoea). Stupid man!
With hypothyroidism we are more likely to suffer a slowed gut motility and constipation. However, also changes to a healthy gut microbiome which allows higher risk of conditions such as SIBO, H. Pylori, etc. The medical profession are quick to label gut issues but can never give a reason why. Have you had an investigations for gut infections?
When hypothyroidism is caused by Hashimotos we have two conditions to consider, an under active thyroid gland and an autoimmune condition. With dietary changes and careful supplementing, many of us have managed the Hashimoto side well and reversed any problematic gut issues.
I would raise your Levo dose back to original dose and look to acquiring back that good conversion you had in the first set of test results. I would also recommend you reading The Root Cause by Isabella Wentz for good understanding of Hashis far retching tentacles.
I am late diagnosed coeliac and hypothyroid too…..and similar age.
You don’t mention any other dietary restrictions than gluten free ?
I was having episodes of diverticulitis, and through painstakingly excluding certain things, have eventually pinned down certain foods as causing my gut issues.
In my case, lactose intolerance is the worst (not dairy allergy), so I can have hard cheeses/butter, but milk/soft cheese is a disaster, plus you need to look at your medications to see if they contain possible problem fillers….many do. . Tomatoes, for some reason also give me issues.
Also my gut is better when my T4/T3 are well up in the range.
I take vitamin d as a mouth spray , and b12/folate as tablets to chew/dissolve in the mouth to avoid gut issues!
i've spent decades chasing dietary solutions (FODMAPs, an extremely thorough exclusion diet worked through with an NHS dietitian - though I saw her privately) and have come to the conclusion that - thankfully in some ways, though I would love a solution - diet itself is not the cause (though certainly when I'm flaring, for want of a better term, many things will make it worse). When I'm not flaring I can pretty much eat anything without consequence (apart from gluten obviously). Though absolutely a good suggestion. I also did take vitamin d as mouth spray and b12 etc but have somehow stopped bothering. Will start again. Thanks for your input.
Wow - amazing resource, thank you. Can you remind me what percentage is good for t4/3? And should they be similar if t4 conversion is working ok? - or is that too simplistic? thanks again
Hi. I'm the author of the thyroid calculator. Your post at helvella.blogspot.com/p/hel... lists articles on ft3:ft4, not ft4:ft3 as in the calculator. Can you remind me why? I can easily add ft3:ft4 to cover both bases.
Yes - because the whole darned thing is confusing (not you, not your fault in any way!)
Tania's article has this:
Converting these averages to pmol/L and then dividing the one by the other yields the following “ratio of averages”:
Women FT3 4.62 pmol/L, FT4 16.09 pmol/L = FT3:FT4 ratio of 0.287
Men FT3 5.21 pmol/L, FT4 17.25 pmol/L, = FT3:FT4 ratio of 0.30
(If you divide the FT4 by the FT3 to invert the ratio, you get 3.48 for women and 3.31 for men, but this is not advisable because most ratios now use FT3 as numerator, FT4 as denominator.)
Therefore, after converting to pmol/L properly, it will no longer be a 0.25 ratio calculated with ng/dl (nor will it be an inverted ratio awkwardly expressed as a dose ratio of 4:1. It is closer to 3:1 in mol/mol).
I was diagnosed coeliac about 8 years ago and recent ish biopsies show my villi completely healed (as compared to totally flat when diagnosed). Which is great. In fairness I always tested negative on coeliac bloods but showed severe damage on biopsy (after an awful lot of begging to have one). I have no reaction to dairy. Thankfully.
I’ve ordered vitamins blood tests from Medichecks - will be interesting to see how they look (and I’ll no doubt be back on here checking what is optimal).
I was diagnosed coeliac about 8 years ago and recent ish biopsies show my villi completely healed (as compared to totally flat when diagnosed). Which is great. In fairness I always tested negative on coeliac bloods but showed severe damage on biopsy
Snap…..I was diagnosed after (private ) endoscopy and 2 negative blood tests in 2016
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Help with blood results
New blood tests
All test results...could really use some help please for a newbie
T3 taken away, looking for a new source please :)
Suppressed TSH
