I was diagnosed with hypothyroidism in June last year. I’m 70 and can’t really say I had any significant symptoms. My results were TSH 6.67 (0.27-4.2). T4 10.3(10.8- 25.5). T3 4.6(3.1-6.8)
I was started on 25mg Thyroxine and then 50mg which was increased to 75mg in November after blood tests TSH 3.66. T4 13.1. T3 3.7 ( done at 08.30 fasting and 24 hours after meds).
My recent results areTSH 1.08 T4. 15.2. T3 3.3
My endocrinologist is open to triallingT3. If I decide to go that route I think I would like a small adjustment to start- what would be advised? My vitamin D level is good but B12, ferritin and folate are in range but not optimal. ( Neither GP or endocrinologist concerned about that and don’t advise taking supplements. )
My weight has now stabilised and I do have a few aches and pains but then I also have hyperparathyroidism so that confuses things.
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Bluesew
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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 if last test result serum B12 was below 500 or active B12 (private test) under 70
Post discussing how biotin can affect test results
so 62kilo suggested daily dose Levo is approx 100mcg per day
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
Graph showing median TSH in healthy population is 1-1.5
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
High CRP (test for inflammation) results in false high ferritin level
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
If ferritin drops further……Suggest you do a full iron panel test for anaemia
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 5-7 days before testing
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Should I start NDT?
HELP PLEASE. I need good reasons on why my Endo should not pull the plug on my T3 treatment. 
Do I risk taking T3 medication?
