New test results, still feeling very very very bad...(Hashimoto, Hypothyroid for more than 30 years)

[Katerina64]

LT4 16,6 (11,5-22,7)

LT3 4,88 (3,50-6,50)

TTH 3,039 (0,550-4,780)

VitD 25-OH (μg/l) 27,4 (<20,0 Deficiency ,20,0 - 30,0 Insufficiency , 30,0 -100,0 Sufficiency) -although I'm taking for years 25.000 units per week

Zink 9,27 (10,71-18,36) Although I have been taking supplement for two months now

Ferritin 13,2 (10,0-291)

Fe 21,4 ( 9,0-30,40)

FOL 12,60 (> 12,19 Sufficient)

I have been taking 100 mg T4 per day and for three months my doctor added 10 mcg T3 divided in two doses 5+5.. it didn't work for me.. gave me arrhythmias, tremor, sweats, brain fog. So back to 100 T4 . Feeling as if I have been beaten even after a good nights sleep. I know many of us here feel the same. Any ideas please? I'm dragging myself to work but cannot perform and I cannot get my head together..

Thanks for bearing with me

Best Regards to all

[pennyannie]

Hello Katerina and welcome to the forum -

No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels -

I know now I need to maintain my ferritin at around 100 active B12 125 ( serum B12 500++ ) folate around 20 and vitamin D up at around 125.

What is fe ? Guessing Fol is folate :

Your ferritin level is very low - this would be investigated with at least an iron panel or possibly an endoscopy / colonoscopy in the UK :

cks.nice.org.uk/topics/anae...

Everywhere I researched suggested that ferritin needed to be at least over 70 before any thyroid hormone replacement worked well :

You don't appear to be absorbing or taking enough of the vitamin D or Zinc supplements ?

Absorption issues are often linked to those with Hashimoto's - have you had any tests to rule out for celiac, pernicious anemia, food intolerances - are you gluten intolerant ?

You might like to read around on the suggestions and research of Dr Isabella Wentz who writes as thyroidpharmcist.com

[Katerina64 in reply to pennyannie]

Thank you so much for the time you took to reply to me, I feel grateful for any response as there are days I feel so bad and alone.. I will read everything and try to persuade my doctors for further research

[elaar]

"my doctor added 10 mcg T3 divided in two doses 5+5.. it didn't work for me.. gave me arrhythmias, tremor, sweats, brain fog. "

How long did you try it? It can be a bit daunting at first. Pounding heart beats, increases in heart rates, head aches, internal tremors etc.. are all common. The general advise here seems to be to start at 2.5-5mcg first, and slowly build up. I gave up with T3 after similar issues, and then went back to it a month later and it's finally having a positive impact.

As pennyannie says, your iron needs investigating. I'm guessing "fe" is serum iron? Which is fine, but ferritin is very low, so that would suggest to me that there's an issue with iron homeostasis. Did they test your transferrin levels? I would suggest a full blood count to look for signs for the various different types of Anemia.

[Katerina64 in reply to elaar]

Thank you for the reply, I really appreciate the time you took to help me. I took T3 for 3 months, but if ,finally, all this is due to iron deficiency I might give it another try after I have fixed the anemia.. Grateful for your response

[Highland49]

Hi Katerina,I'm not surprised you're feeling so beaten with folate and ferritin levels so gravely low. There's a huge difference between being in range and being optimum. That's good that pennieannie has given you the optimum levels. Because your levels are so low, it's highly likely that your b12 level is very low too.

Unfortunately, diagnosing b12 deficiency is difficult as any supplements containing b12, plus energy drinks or food fortified with b12 will falsely raise the b12 level and make it appear that it is in range.

Do you any have neurological symptoms of b12 deficiency? These can include balance problems, tingling, numbness, brain fog and even depression. Due to the hashimoto's and under active thyroid, your stomach acid levels will be low which causes malabsorption of nutrients. B12 tablets are almost useless, as you won't be able to absorb but they will falsely raise the b12 blood result. More accurate tests are available, such as MMA urine test.

To treat b12 deficiency, patients need b12 injections every other day, plus 5mg daily of folic acid, as the two work together. You'll also need to increase your ferritin level, as low levels reduce absorption of the b12. In the UK, the guidelines are B12 injections every other day until no further improvement with neurological symptoms. Retesting of b12 once treatment has started is not necessary as it's so inaccurate. The blood test won't show how much b12 is actually reaching the cells.

I needed both thyroxine and T3 to function but also a real turning point for my health was starting b12 injections. As already mentioned by elaar, maybe start low and build up the T3.

All the best,

Fiona

[Katerina64 in reply to Highland49]

Thank you so much for the reply, my B12 is good, 260 (normal range 162 to 672) . Perhaps I will give T3 another try later on, after fixing my anemia problem.. Thanks again for the contribution, I really appreciate it, makes me feel less lonely. Have a great day dear!

[pennyannie in reply to Katerina64]

As well as asking about your low ferritin level - please ask about your B12 as well -

As if the B12 range is 162-672 - we need a good 50% through on the range of the core strength vitamins and minerals and currently your level at 260 is only around 19% :

Many forum members who have Hashimoto's find the research and suggestions of Dr Izabella Wentz of value - and she writes as thyroidpharmacist.com -

and healing the gut is paramount - as many Hashimoto's patients have absorption issues - which first need to be rectified before any thyroid hormone replacement is going to work well for you.

[Highland49 in reply to Katerina64]

You're very welcome! But as pennyannie has replied, your b12 level isn't good. Your true level is probably much lower than that in reality, as so many foods and drinks have b12 added, giving a false result to blood tests. All the best!

[MY04zzz]

Hello Katerina

Are you on medication for any other issues which may affect testing?

Importantly both your T4 and T3 are only 45% through range - I would firstly ask to trial a rise in your levothyroxine to get the T4 up to 75-80% through range - if my T4 is under this I get all the classic symptoms plus plantar fascilitis! Hopefully as it looks like you convert T4 to T3 efficiently you may find that all your symptoms improve . This is certainly the case with me - and there is nothing wrong with my conversion rate - I just need to have enough T4 to start with.

Vit D - what brand do you take - I take Aavalabs Vit D3 + K2 - and also Better You Magnesium + Zinc. These work for me - and with any Vitamin supplements some are better than others.

Vit B12 - PennyAnnie has mentioned this and I agree yours is low and needs to be much higher - The active B12 test is more accurate as it tests the metabolically active form and Medichecks will test this if you go down the private test route.

I hope you feel better soon