Do endocrinologists as a rule only believe in Levothyroxine to treat hypothyroidism? I am about to be referred for the second time by my GP.

[Jenny49]

I had a partial thyroidectomy 34 years ago, and have been diagnosed as hypoactive, and have taken 100-125 mg Levothyroxin for the last 9 years, however recently, although my T3 is 4.5, T4 18.8 and TSH .03 appearing normal, I have a multitude of hypothyroid symptoms which are gradually increasing and are now seriously impinging on my lifestyle. Will I be wasting my time with an endo. again of should I seek alternative help for vitamins, minerals and T3 perhaps?

[Hidden]

Hello,

Your T3 seems quite low. Do you have the reference ranges for all of the results you have mentioned above?

You could also have tests for Vitamins B12 and D, ferritin, folates and magnesium. These might give us a clearer picture.

Most GP's and endos prefer levothyroxine as treatment, but some will give you T3 and/or Natural Desiccated Thyroid.

Firstly though could you please let us know the reference ranges for the tests you mention.

Jane x

[Jenny49 in reply to Hidden]

Many thanks for your comments. The ranges I have just taken from Thyroid UK reference are:

FT4 10-24 (mine is 18.8), FT3 4-8.3 (mine is 4.5) TSH 0.4-4.5 (mine is .03)

I will persevere with a referral to an endocrinologist to try to get a fuller deficiency tests and T3 from him.

[PinkNinja]

Do you have the reference ranges for those results? It looks like your T3 is in the lower half of the range but I can't be sure without a reference range. It may be that you either need an increase in thyroxine, a different thyroid replacement (e.g. T3 or NDT) or there is a problem with certain vitamin and mineral levels.

Iron is very important for using thyroid hormones in your cells. If your iron levels are not optimal, you will feel hypo even if your thyroid bloods are good. Most people feel best with a ferritin level above 70-90.

Vitamin B12 is also important in order for your cells to use thyroid hormone. Although the NHS reference ranges for B12 start at around 180, this is way to low; you really need it to be above 500 and, if you are supplementing you would expect it to be at the very top of the range. Folate is also important so is worth getting tested.

Vitamin D is important in hundreds of metabolic processes and vitamin D deficiency is quite common in this country. Please ask for this to be tested. It can also cause many of the symptoms similar to hypothyroidism.

If you endo is not keen on increasing your thyroxine or adding in T3, ask for the above tests. It may also be worth asking for your adrenals to be tested. Adrenal insufficiency not only causes symptoms similar to hypothyroidism but can prevent your cells from converting T4 to T3 efficiently.

I hope this helps a little

Carolyn x

[Jenny49]

Thank you so much Carolyn. These are the references I have taken from Thyroid UK.

FT4 10-24 (mine is 18.8), FT3 4-8.3 (mine is 4.5) TSH 0.4-4.5 (mine is .03). The comment from pathology, was that these were normal.

I will persevere to have your suggested deficiencies checked out when I get my appointment with the endocrinologist or GP whichever can do them earlier, unless you have any other thoughts please.

[Hidden in reply to Jenny49]

Hi Jenny

You need the ranges for your particular tests, I'm afraid. They vary lab to lab and the ones on the TUK website are as examples only.

Louise

x

[Jenny49]

I understand now and will enquire.

many thanks

J

[helvella Administrator Thyroid UK in reply to Jenny49]

And also make very sure that is a Free T3 test - not a Total T3 one!

[Jackie]

Hi All above very true. makes sure you research who you want to see first, hospital web site and individual CV`s and ask every one, good essential , nice preferable, some people confuse the two! A lot of endo`s like Thyroxine and T3 but a few rare ones will let you have NDT if you cannot tolerate levo.

Jackie

[Barbaraj]

I can send the 2012 European Thyroid Guidelines in pdf format along with one of studies that demonstrates the combination T4/T3 replacement therapy is effective in many instances where T4 alone has not brought about resolution of symptoms. They have been drawn up by five of the leading endocrinologists in the World and all UK endos should be taking note! .I would be really happy for you to pass this information on to wherever you think it may be useful. I will pm you with my email address so if you send a blank one I can then attach the documents and send them. They would be very handy to pull out of your bag if the consultant dismisses the idea of T3!

Kind Regards,

Barbaraj

...

[Jenny49]

Dear all,

Many thanks for your constructive comments.

I got the defined results below from my GP, and my uneducated understanding is that they are more or less normal, despite still having 13 out of 14 hypo symptoms.

Thyroid test references from laboratory

FT4 9-24.  Mine 18.8

FT3 3.5 -6.5. Mine 4.5

TSH 0.35 -5 Mine 0.03

J