Hey Everyone! This is my first post in here. I'm from Argentina so I'm sorry in advance if my english is a little off.
I got diagnosed with papillary thyroyd cancer and had a total thyroidectomy back in September 2021. Did the radioactive iodine and later on i was put on 100 levo, then 125, then 150, and finally 175 in order to keep my TSH supressed. During this perdiod that lasted around 6 months i felt like crap and gained 12kg of body weight. Once i finally was on 175mcg Levo, i started feeling better and managed to lose all the extra weight. Back on march this year, my doc reduced my dose to 150 since my TSH was <0.01 and told me it was bad for my health to keep it that way for too long.
Now on 150 levo i feel like crap again and gained back those extra 12kg. Here are my lab results from yesterday.
Results Range
T3 = 0.94 ng/ml 0.60 - 1.81
FT4 = 1.18 ng/dl 0.80 - 1.50
T4 = 6.1 ug/dl 4.5 - 11.9
TSH = 0.17 uUI/ml. 0.40 - 4.0
Ferritin = 145.9 ng/ml. 20 - 320
Vit B12 = 408 pg/ml 180 - 914
Folic Acid = 15.2 ng/ml. Above 5.3
Vit D = 37 ng/ml Above 30
Iron = 101 ug/dl 70 - 180
Mangesium = 2.1 mg/dl 1.7 - 2.3
I'm still waiting on the Selenium, Vit A, and Zinc results.
In Argentina they don't measure FT3 since the result is not reliable.
Thank you so much!!
Written by
iceman1984
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I had Follicular thyroid cancer and radioactive iodine ablation in 2012.
I’m struggling to interpret the reference ranges you’ve given as obviously they’re very different to those in UK.
All I’m going to say is that they kept increasing my Levo to get a reasonable FT3 (which is probably the most reliable blood test!). They finally achieved this with a Levothyroxine dose of 200 mcg which made me very ill indeed.
Eventually a sensible medic saw that I wasn’t converting to FT3 and gave me a small dose of Liothyronine which fixed things - albeit very slowly. He went as far as to say that anyone without a thyroid needs Liothyronine (T3). However it’s a very controversial issue in this country.
Edit iceman1984
I can see that your FT4 isn’t that high. You may manage on just having an increase in Levo and following the advice of SlowDragon
However, the T3 issue remains. I know four people without thyroids (they’ve been either surgically removed or chemically removed for Graves Disease ) Each of them requires Liothyronine in some form .
Yes. It was a painstakingly slow process as my T4 levels were so high. There was a lot of trial and error involved.
Eventually comfortable and optimal levels on 75 mcg Levo and 20 mcg T3. Be aware that taking Liothyronine (T3) will suppress your TSH below the reference range
Most people split T3 into two doses; others take it all together in the morning. How we dose and what we need is a very individual thing. However the principle remains the same.
welcome to the forum …….all the way from Argentina
was this test done early morning and last dose levothyroxine 24 hours before test
What vitamin supplements are you taking
Free T4 (fT4) 1.18 pmol/L (.8 - 1.5)
Ft4 only 54.3% through range
Suggest you request small increase in dose to 162.5mcg daily
Cutting a 25mcg tablet in half
Retest 6-8 weeks later
Meanwhile improving vitamin D to at least over 40ng/ml
And suggest you look at improving B12 with separate B12
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
I had a B12 much as yours is now. I raised it quite quickly to more than top of range with a B Complex which contains 100 mg B12 in Methylated form. As you should always use a B12 vitamin in conjunction with a B complex to avoid vitamin B imbalance, it would make sense to find a good B complex.
Hey SlowDragon, i ended up buying the B12 supplement you recommended and i see that each tablet contains 1000mcg of b12 vitamin... Is it enough to take just one per day? Thanks!
Wow, Slow Dragon! this response is awesome. Thank you so SO much!!!
I did this lab test 24 hours after taking the levo and early in the morning. I forgot to mention that my cortisol results where on the high limit.
So you do not recommend taking T3?
I'll look into what kind of supplements I can get my hands on here in Argentina. Can't the B complex alone get my B12 where i need it? I'll get started on those articles you just mentioned!
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100mcg :
T4 is a pro-hormone and needs to be converted in your body into T3 which is the active hormone that runs the body and said to be around 4 times more powerful than T4.
Conversion of T4 into T3 can be compromised by non optimal levels of ferritin, folate, B12 and vitamin D - and conversion of T4 into T3 can also be down regulated by inflammation, antibodies, any physiological stress ( emotional or physical ), depression, dieting and ageing.
We generally feel best when the T4 is up in the top quadrant of its range at around 80% with the T3 tracking just behind at around 70% through its range - or put another way - once the T4 is up the top quadrant - the T3/T4 ratio should be around a 1/4 ratio T3/T4.
Some people can get by on T4 only :
Others find T4 seems to stop working as well as it once did and that by adding in a little T3 - likely at a similar dose level to that their thyroid once supported them with - they are able to kick start their metabolism and their health and well being restored.
Some can't tolerate T4 at all and need to take T3 only - as you can live without T4 but you can't live without T3.
Whilst others find their health and well being restored taking Natural Desiccated Thyroid which contains all the same known hormones as that of he human thyroid gland and derived from pig thyroids, dried and ground down into a powder which is than made up into tablets referred to as grains.
NDT is the original treatment for hypothyroidism and used successfully for over 100 years prior to Big Pharma launching T3 and T4 synthetic treatment options in the middle of the last century on the back of NDT -
I do not know what treatment options are readily available in your country let alone South America - NDT is manufactured in the USA, Canada and Thailand - though banned in some countries, nor not easily procured in some other countries within the World.
I meant to add that it is essential that you are dosed and monitored on your Free T3 and Free T4 readings and not on a TSH seen in isolation or to be in the range -
You have had a medical intervention and no longer have a thyroid -
so your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop -
on which the TSH relies on as working well - is now open ended -
as you have no thyroid in situ to complete this internal feedback loop -
the result of which is a very unreliable TSH reading.
Welcome to our forum and sorry to hear you have been so unwell.
You have already received great info from SlowDragon so my response refers to your saying
"In Argentina they don't measure FT3 since the result is not reliable."
The point of measuring FT3 levels in someone only replacing thyroid hormones with T4 is to ensure your body is able to convert enough and sustain FT3 levels.
Once we are medicating FT3 the point of testing is too ensure levels don't go too high, which can be dependant upon how the T3 meds are taken and the testing time after the dose.
I had another question, suppose I want to up my dose to around 170 of levo and still have a lot of 150 tablets left... Can i just take 150 every day and one day take an extra 150 one? This would mean 6 days x 150 and 1 day x 300. This is 1200mcg a week, divided by 7 days is 171.42mcg...
I think you’ve been given lots of really useful information and advice by several members.
I can only reiterate my original point and I don’t want you lose sight of it. You say that FT3 isn’t measured in Aregentina as it’s not thought to be reliable. In fact, it’s the most important blood result we have.
You’ve had surgical removal of your thyroid so it’s highly likely that you’ll need to take T3. If you’re going to do this, it will in my opinion be a ‘backward step’ to increase Levo now. It will almost certainly have to be decreased if you do start T3
Whichever path you choose to pursue the advice about vitamins and nutrients should be followed. Be aware though that you can’t ‘fix’ a problem like yours with vitamins alone
Since your T4 is only at around 54% through its range - I think this ok - in the short term -
T4 is a storage hormone and have read of some taking a weeks worth of T4 at one time -
but they are not you - and suggest you chop the 150 mcg T4 tablet - at least into 2 - and space out the taking throughout the week.
At least this gives you some time to work on your understanding of your medical condition and give you some time to find a thyroid specialist / endocrinologist who works from T3/T4 blood test results and knows how to support you with T3 - if and when T4 monotherapy does not fully restore your health and well being.
I think you may need to start looking for a thyroid or in reality a ' without a thyroid ' support group within your own country - not that we are trying to get rid of you - on the contrary -
as I can't believe there is no help out there, on the ground, where others have already trod a path to doctors supporting treatment options of T3/T4 thyroid hormone replacement.
Bienvenido al foro. No puedo añadir nada a los consejos clínicos que te han dado, pero puedo felicitarte por tu inglés. Ojalá mi español fuera tan bueno😁
English translation added by admin:
Welcome to the forum. I can't add anything to the clinical advice you've been given, but I can congratulate you on your English. I wish my Spanish was as good😁
Please, if you are going to politely reply in another language, include an English version? Admins have limited understanding of other languages so have to use an automatic translator to check it is OK. And other members might like to feel included.
Welcome to the forum. I can't add anything to the clinical advice you've been given, but I can congratulate you on your English. I wish my Spanish was as good😁
English teacher here. Your English is excellent 😊 I loved Argentina when I visited many years ago. Hope you feel better soon.
I have central hypothyroidism and on Levothyroxine my TSH will always be suppressed because of this cause - at the moment around 0.06. I can foresee a constant battle to maintain my dose at the level I feel best. Doctors are fixated on TSH and always trying to lower the dose on the basis of that alone...
I'm glad you liked Argentina! Used to be cheaper but it's always worth visiting! You're absolutely correct about doctors being fixated on TSH. Wish I could prescribe myself. I'm thinking of going to med school just for that haha
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