T3 adjustment and blood work

[Coachgeorge]

I had my blood draw this morning and will see internist the first of the week. I’m having shakiness, breathlessness, slow speech, burning skin like hot pins and needles, nausea, etc. I’m on a small dose of t3, 5mcg in the morning and 2.5 in the afternoon. I also take 50mcg of T4 once a day. Could I be getting too much t3? Should I stay on the same dose? I’m literally unable to function. It feels like I’m dying.

[Greekchick]

Hi Coach,

I would wait for my blood results before making any changes. See where the numbers are so you can decide which to raise, or if both need raising. I know you feel awful, but hang in till Monday. All the best.

[Coachgeorge in reply to Greekchick]

I know I keep asking but the brain fog is bad and I can’t remember what folks tell me. Is this normal? I’m so frightened. The Ativan helps but these other symptoms scare me.

[Greekchick in reply to Coachgeorge]

It’s OK to be scared. But these symptoms are experienced by many before meds are adjusted. I just had my T4 increased and I feel shaky and breathless. That will last for a week or so until I adjust. Everyone is different and the brain fog will lift once you are in the right dose. You will be OK - see your results Monday.

[Coachgeorge in reply to Greekchick]

Thank you. I need the encouragement more than most. As I’ve told you before, you are so strong. I hope some of it wears off on me.

[Greekchick]

🤗

[SlowDragon Administrator]

Burning skin and pins and needles is frequently low B12

What vitamin supplements do you currently take?

Important to keep vitamin D, folate, B12 and ferritin optimal while increasing Levothyroxine/T3,

[Coachgeorge in reply to SlowDragon]

Just vitamin D. She took me off folate and b12 because they were over range last draw. Tested for folate this morning. My ferritin is in the low range. Last time I talked to my doctor she’s concerned about my red blood cell counts so no supplements for anything related to iron. I’ll ask again when I see her this week. I have a lot to discuss. I can’t keep this up.

[SlowDragon Administrator in reply to Coachgeorge]

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms, although a placebo effect cannot be excluded, as a number of patients without B12 deficiency also appeared to respond to B12, administration.

ncbi.nlm.nih.gov/pubmed/169...

Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.

Folate supplements can help lower homocysteine

ncbi.nlm.nih.gov/pmc/articl...

Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.

[Coachgeorge in reply to SlowDragon]

Thank you. I’ll share with her. My homocysteine is high but the folic acid supplement didn’t help. I read that riboflavin might be a better option.

[SlowDragon Administrator in reply to Coachgeorge]

Common to have problem processing folic acid - may be better to take folate

supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low vitamin D and low B vitamins may be linked as explained here

healthunlocked.com/thyroidu...

Peripheral neuropathy can start after improving low vitamin D levels due to then needing more B vitamins

Do you suspect you have MTHFR gene variation?

thyroidpharmacist.com/artic...

[haggisplant in reply to SlowDragon]

Gosh I didn’t know this about biotin. Potentially very pertinent for women hoping to conceive, pregnant or breastfeeding as it’s in quite large doses in vitamin tablets designed to be taken during those times.

I’ve gone down a dose based on borderline tsh and high t4. As I had peripheral neuropathy and was a bit buzzy I agreed it could have been too much. I’m now a bit hypothyroid. But seems it may have also skewed b12. I’ve not been taking the tablets regularly though so I have no idea if I had before the test.

At least I know now!

[Coachgeorge in reply to SlowDragon]

I do gave the MTHFR gene variation. It was found in genetic testing when we thought I was reacting to steroids. I was not aware of the differences between folic acid and folate. We retested folate acid yesterday and am anxious to see the results. I’ll speak with my internist about supplements other than folic acid. Thank you. This information is so helpful.

[SlowDragon Administrator in reply to Coachgeorge]

If your doctor knew you have MTHFR gene they should have been well aware not to recommend supplementing folic acid, but to use folate instead

A good quality daily vitamin B complex may be best. This can help support all B vitamins

If testing blood you will be testing your folate level

[SlowDragon Administrator]

More links about MTHFR by Amy Myers

amymyersmd.com/2017/07/what...

amymyersmd.com/2017/07/test...

[silverfox7]

We lose Vit D, B12, folate and ferritin quite easily asrgyroid patients. It's a nasty side effect and that's why we suggest to get those tested asthey help our thyroid work much better BUT as soon as we stop then they plummet, especially Vit D.

So if we need to supplement is usually regarding as being lifelong. Once optimal though we may find a maintenance dose to keep it there. If you take Vitamin D then please take the co factors of K2 and magnesium.

When we take Vit D then our calcium levels also increase so we risk getting Kidney, Gall stones and calcified muscle and remember our heart is muscle. So we need to get this excess out of our blood. K2 sends this excess calcium to our teeth and bone and the Magnesium looks it in there.

[Coachgeorge in reply to silverfox7]

Thank you. I'm getting ready to post my test results and ask for feedback. I'm a little upset as I asked the lab for FT3 and they didn't do it.

[Greekchick in reply to Coachgeorge]

Make sure they do it before you get a dose adjustment even if you have to wait a day or two. It will be worth it because you need that reading to know what’s going on.

[Coachgeorge in reply to Greekchick]

I'm so frustrated. I talked to the lab technician about adding the test. I'll have to go tomorrow as phone calls go to an answering machine. I really wanted to see my doctor tomorrow but it will have to wait.

[Greekchick in reply to Coachgeorge]

It will be worth it - and I know how frustrating it is ! Has happened to me too.

[Coachgeorge in reply to Greekchick]

I'm particularly upset with my doctor for not ordering it. I had to ask, at the lab, so I suspect that's why I didn't get it. I'll go back tomorrow and pay for it myself. I'm concerned that it takes longer for results when the patient orders them. I may have to text my doctor. She'll do it, for sure. I'm trying to be understanding as I know she has 2400 patients and things happen. When she was completing the order, I thought I heard her say T4, T3, TSH, folate, and B. Oh well!

[silverfox7]

It the lab that often says 'no' even if the doctor asks for it. You may have to do it through an Endocrinologist or pay for private testing. Folks on here use Medichecks or Blue Horizon and they do have offers if happy to wait for what you are after. Wonder what the hospital would charge though?

[Coachgeorge in reply to silverfox7]

I’m in the US. I can check with the lab tomorrow or ask my doctor to add. Seems like it’s more of a problem in other countries. I feel lucky. I think it’s a bump in the road thank you

[silverfox7 in reply to Coachgeorge]

Great! It doesn't sound asthough you will have that problem!

[Coachgeorge in reply to silverfox7]

The US is considering universal health care. From what I hear from folks,on this forum, I’m not sure it’s a good idea. I like being able to make my own choices.

[silverfox7]

Think I agree with you!