I haven’t been very active here since being acutely unwell in October following my diagnoses of Hashis/Hypo. Long story short, following a trial of Levo 50mcg in July, by October I had severe physical and psychological symptoms of over replacement despite the low dose. I stopped levo after discussing with an Endo privately and am making a gradual return to being out of bed, caring for my family and walking the dog again.
I’ve worked so hard on optimising B12, Vit D, Iron, gut health, diet - you name it, I’ve lived and breathed it for the last 5 months, so today’s bloods are very disappointing. One problem is despite supplementing every other day with a good quality high dose iron biglycinate, and taking with vit C, my iron has fallen by half and I now have a folate deficiency too. I can’t make sense of that?
Comparing my results from October 24 to today’s results, my T3 level has never changed despite my Free T4 being in the top half of range in October. Ironically this is when I felt at my worst! Does this indicate a conversion issue?
I have a Thyroid review tomorrow with the GP and want to get the best from it so would appreciate any thoughts.
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Runcmc
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Your ferritin is now lower than October despite supplementing and this really does need investigating further with at least an iron panel and probably an internal investigation of an endoscopy and colonoscopy and if nothing unforeseen is found you need an iron panel immediately .
Maybe I should have looked back before I wrote and found these investigations have already been actioned ?
but whatever you have been prescribed is not working and your treatment plan for iron deficiency anemia needs rethinking with immediate action.
Your core strength vitamins and minerals - ferritin, folate, B12 and vitamin D are much too low and likely compounding your ill health further :
I now aim to maintain ferritin at around 100 - folate 20 - active B12 125 ( serum B12 500++ ) and vitamin D at 125.
No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels - and I read ferritin needs to be at least over 70 for any thyroid hormone to work -
So I don't think it was the T4 - Levothyroxine making you feel over medicated but that your body is not able to absorb and utilise the thyroid hormone replacement as it should -
or you might have experienced ' hyper type ' symptoms from your immune system attacking your thyroid as what happens when you have a diagnosis of Hashimoto's AI disease.
Did you try liquid T4 - as I imagine you likely have gut and absorption issues -
and you been checked out for pernicious anemia, celiac and certain foods intolerance ?
Your TSH is now over the range shouting out for more thyroid hormones -
and your T4 thyroid hormone now under the range and you must be feeling horrible.
Your over range TPO antibodies are confirmation that you are dealing with Hashimoto's - a thyroid Auto Immune disease that attacks your thyroid and causes transient ' hyper type ' symptoms -
but the T3 and T4 fall back down into range themselves and longer term the thyroid becomes disabled with reduced thyroid hormone production with you becoming increasingly unwell and dealing with hypothyroidism and having to be medicated with T4 - Levothyroxine - thyroid hormone replacement.
There is little point talking of a T3/T4 conversion issue at this point in time - as it only applies when taking T4 - to see how well you are converting the T4 Levothyroxine into T3.
In October- T4 was 18.60 around 66% with a T3 at 4.30 around 32% - through the ranges:
Now your T4 is under the range and your T3 hanging on as best it can at around the same base level - 4.40 - which is around the very minimum the body needs - just to function - which is putting your body under extreme stress -
as there is not enough T4 circulating to maintain your T3 at a high enough level for you not to feel so ill -
as most people need their T3 up at around 70/75% through a range - so on this range we would be looking at your T3 over 5.00 and around 5.30 :
You might like to read around the research and suggestions of Dr Izabella Wentz who has Hashimoto's and whose research and suggestions are followed by some forum members-
Hi pennyannie, thanks for replying. I’ve been working really hard on improving vitamins and minerals and this is why I’m so discouraged because whilst there are small improvements in B12 and Vit D the rest have gone backwards. I don’t know what else I can do.
I’m gluten free, alcohol free, low sugar, low dairy etc.. I reduce toxin load via organic fruit and veg where possible, eat whole grains, lots of good quality protein, seeds, nuts, good fats. Feel like I’m ticking all the boxes nutritionally and supplementing on top!
Self care is top of my agenda, been off work 6 months, in therapy, doing nervous system regulation stuff and movement every day.
I’ve had 4 different doctors tell me that my ferritin levels are fine - I know this isn’t the case, and have said so only to have them stare blankly at me - hence treating myself with a good quality supplement and trying to follow an iron protocol.
I know, no one is coming to save me but I need some help - fingers crossed for tomorrows appointment. I’ll push for iron panel and absorption investigations.
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.
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 2 per day and/or 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 3-5 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)
having had a quick look at your previous/ and profile ,,, while it's abundantly clear you do need to be taking thyroid hormone replacement because you have autoimmune hypothyroidism ,which is not going to go away , or get any better by itself ... i think that because you have been left untreated for so many years , and also had other deficiencies. that these issue's are what made it so hard for your body to tolerate even modest doses of Levo......so i'm wondering that since you are feeling as bit improved recenty off levo ( before you saw the latest results !) maybe you should just continue to work on the deficiencies for now ~ got them all fixed first ,,,let body do what it can with that for a while .... and then retry some levo again in a few months time, when hopefully body may be able to tolerate it better than it did last time ?
my feeling is that people who have been left with unrecognised/ untreated hypothyroidism for many many years ... it is likely to take their body a very long time to be able to handle having increased levels of thyroid hormone .. and they may have to do it incredibly slowly ..not sure if this is so, or not , it's just my instinct .
Hi Tattybogle, thanks for your reply. Yes I think this might be relevant but I just can’t seem to crack the vitamin / mineral barrier. See my reply above.
Hi SlowDragon, thanks for reply. Cortisol was tested in both blood panels, latest results here. See my reply to Pennyannie re diet/nutrition/supplememts. Not vegan or veggie. Gluten free. Endo didn’t seem bothered by cortisol results but interestingly when I first fell ill, I was worried it was an adrenal issue but was dismissed by GP. Results are within lab ranges but I don’t know how to interpret otherwise.
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