T3 Level Up and I'm still not Losing Weight...

[Franny2016]

Hello there!

It's been a while...I've been working on feeling better overall since Total Thyroidectomy 6yrs, 10 months ago. My last post was May 10, 2017.  Since then, through a series of increased T3 by 5mcg every 3 months, and by 10mcg in August 2018, my energy level is up - but I also drink expresso coffee most days. The following issues remain - weight loss is very, very slow, despite moderate exercise, supplements and eating reasonably healthy.  As soon as I slip up following a rigid low carb, low sugar, high protein diet - the few pounds lost come back!  Anyhow, other symptoms are left eye spasms-sometimes for a few days, numbness in balls of feet, short term memory loss, low bladder capacity, occasional muscle weakness and piercing spasms in mostly left hand, unmotivated to do much other than necessary, sometimes my right hand falls asleep at night or while on the mouse while working on computer. I'm dragging to get up in the morning even though I take thyroid meds at 3am.  I no longer crave fried fast food. Currently taking probiotics, Vitamin D, and use coconut oil for cooking.

I took the following labs at 10am on 11/9, except for thyroid labs - taken at 3:30pm. I take 100mcg of Tirosint and 50mcg of slow release compounded T3 at 3am daily. I take it at 3am in case I need to eat around 6am before going to gym.

Here are results from Labs taken 11/09/18:

Free T3 - 3.9 (range 2.3-4.2)
Free T4 - 1.4 (range 0.80-1.8)
TSH--0.07 L (range 0.4-5.5)
RT3 – 14 (range 8-25)
Vit D - 39 (range 30-100)
Vitamin B6 H – 145.9 (range 2.1-21.7)
Vit B12 - 1012 (range 200-1100)
Potassium--3.2 L (range 3.5-5.2)
Chloride Serum – 100 (range 98-110)
Sodium serum – 139 (range 135-145)
Iron - 73 (range 40-190)
Ferritin – 120 (range 10-232)
Iodine – 70 (range 52-109)
CRP – 20.8 H (range 1-3 is average; 3.1-10-higher)
Cortisol AM – 8 (range 4.6-20.6)
Cortisol FREE AM - 0.22 (range 0.07-0.93)
DHEA Sulphate – 169 (range 19-231)

My doctor told me to use Niacin to bring down my elevated B6. This was due to my multivitamin supplement having excessive amounts.

I appreciate any insight you can provide that can help me get to an efficient level with weight loss and resolve other symptoms.  Thank you.

[telus2]

Fran,
very interesting. I am also using slow release T3. Would it be feasible for you to post your labs for each step up from 100+10? Did you record date started and date tested for each dose? thanks.

[Franny2016]

Hello Telus,

I wish I can post a spreadsheet with thyroid results to show, but it wouldn't allow me to paste a part of a spreadsheet. Too much to do manually.  Keeping a spreadsheet is helpful to look at the big picture...and the details at the same time. I did not record the start date for increased dosages on the spreadsheet. That would have been perfect. My doctor and I would review together...and he had the T3 amounts handy.    
But not sure how this will be helpful though - because as I understand it, the results of increased meds is not only dependent on the amount of thyroid hormone taken, but so many other variables - vitamins, minerals, diet etc.  

[telus2]

thanks Fran. Maybe you could keep us posted on how you're making out next time you get labs.

[Franny2016]

Sure.  Yes indeed.  Will do...

[Barb135]

Did you take your thyroid medication(s) at 3:30 am on the day you had these labs collected?  

We have seen, in the past, that compounded, slow release T3 medications don't seem to work as well as regular T3 medications, such as cytomel because they're often not absorbed as well, especially, if one has Hashimoto's or a gut issue.

Your vitamin D is too low in the range and we need adequate vitamin D to metabolize thyroid hormones properly.   In addition, your actual iron level is quite low in the range... iron is needed for conversion of Free T4 to Free T3.   Higher Ferritin levels can be caused by inflammation, which is indicated by your elevated CRP level.

There is such a thing as too much protein in the diet, which can cause inflammation.  You might try adding more of the healthier fats, such as those found in avocados, olive and coconut oil (I see you cook with coconut oi), butter, etc.  Sometimes, reducing the amount of dairy and/or gluten in the diet will reduce inflammation in the body.  This can go a long way toward helping with weight loss, as well as the overall way we feel.  

[Franny2016]

Hello Barb!
Great to hear from you!

Yes, I took thyroid meds at 3am on day labs collected and everyday.

Interesting - I tried the Cytomel and oh how awful I felt! Oh my goodness - it was horrible. That's when we decided to try T3 as a last resort.  Naturetroid didn't work for me either.  Ah-compounded T3 doesn't absorb as well. I think I have an absorption problem...maybe that's part of it.

I'm working on the Vitamin D. Its up from 24 in August 2018 to 39 in November 2018.  Slow and hopefully sure. I'm using Vitamin D drops - between 4 and 10 drops daily (1 drop = 1000IU).

Need to work on Iron supplementation more.  Iron rose from 54 in August 2018 to 73 in November 2018. Free T4 rose from 1.3 in August 2018 to 1.4 in November 2018.

So higher Ferritin levels are an indicator of inflammation? Hmmm - because yes, the CRP went from 16.5 in May 2018 to 20.8 in November 2018, while Ferritin went from 115 in August 2018 to 120 in November 2018.

Regarding inflammation - interesting, because I've been on a high protein diet since October 17, 2018. I fell off since Thanksgiving. Ive been using a lot of milk though - and I believe my body does not tolerate milk, but I still use it. I will try again to eliminate it and see how I feel, and how my numbers look next time I do labs. I will go back to gluten free also. I considered going vegetarian/gluten free and no dairy...just need to commit to this.  

Yes, I need to feel better. I think my craving for coffee is to help my body feel better, but that is just a band aid.  I need to resolve the root of the issue.

Plus the B6 issue is troubling, but I'm pushing through...

Thank you for your thoughts! :)

[Barb135]

You could give almond or coconut milk a try...full fat coconut milk makes wonderful protein shakes and the fat is actually good for you.  I use almond milk for cereal (non wheat types) and either almond or coconut milk for things like hot chocolate, etc.  I do eat a little bit of cheese once in a while and I eat butter, but those are the only dairy I eat.  

I'll also eat a slice of bread now and then, but I've found quite a few things that take the place of bread quite nicely so, although I'm not completely gluten-free, I'm pretty close to it.  

Sugar is also a biggy when it comes to inflammation - as bad or maybe even worse than gluten or dairy unless one is sensitive/intolerant to the them... too much sugar, for me, is like getting run over by a Mack truck.  

I do eat a lot of meat, especially, chicken and I try to eat as much fish as I can because wild caught fatty types of fish (omega 3's) are very good at helping to eliminate inflammation.

I do "half-caff" on the coffee - only half the caffeine and that seems to help as well... but a lot of doctors say to eliminate the caffeine completely.  

These are just a few suggestions that work for me and as long as I stay with them and exercise regularly, I do lose weight.  They might be worth a try, although I realize we're all different.

I agree that the B6 is an issue.  I can't take that either - it causes vivid dreams/nightmares...

[Franny2016]

Hi Barb,
Thank you for the suggestions.  I'm curious to know what are your bread substitutes...I like being "almost" gluten free, just so that occasionally I can have a treat or two :).  Hmmm I'm going to try to use less stronger coffee. I've been bringing it on and it tastes so good!!  I bought almond milk from Costco recently. I plan to start making my own also.  I will try the coconut smoothie - I use it for cooking and have the frozen coconut in freezer :). Yeah, I do butter too - no margarine. I will definitely try these suggestions - thank you much!!

[Barb135]

I have several recipes for gluten free bread... you might try one option called "Cloud bread".  it's made with egg whites and a couple other ingredients, then baked for a few minutes.  I also use sturdy lettuce leaves for sandwiches or scoop seeds out of cucumbers and pack my sandwich fixings in the hollow; you can make gluten free tortillas, etc.  There are a lot options and most of them aren't too difficult.   I also sometimes buy gluten free English muffins to eat with eggs or use for burger buns; when toasted, they work just a regular bun.   I often go for weeks at a time without eating any bread or white flour products (pasta, etc) at all.  Once you get used to it, it's not so difficult.

There are a couple of name brands of coffee that sell coffee with half the caffeine... one is called "half-caff" and the other called "Lite".  My very favorite coffee, though, is Dunkin Donuts - I buy a package of regular and a package of decaff and pour them together, then brew my coffee as usual. It's yummy and I can't even tell it's only got half as much caffeine!!  

Oh definitely, no margarine... that's almost plastic... lol  

Anyway,  these are all things that work for me and may work for you, too, but as I said we're all different; at least, it won't hurt to try them; you won't be out anything.  Good luck.

[telus2]

Hi Fran
100 mcg T4 + 50 mcg T3 is certainly an interesting dose for thyroid hormone replacement. A lot of doctors and patients would be afraid to go to 50 mcg T3, for fear of going hyper. But your labs are not extreme, with your fT4 at 61% and fT3 at 79% of reference range, and no problem with RT3.

I certainly will be interested in hearing how this works out for you. I am currently taking 100+15 and my labs are near 50% of reference range. I have been contemplating going higher.

You didn't say how long you have been on that dose. Are you planning to stay at that dose for an extended period and evaluate? What does your doctor think? Would he go even higher? Do you split up the 50 mcg thru the day?

[Franny2016]

Hi Telus,
I have been at this dose of 100mcg T4 and 50mcg T3 since August 2018. My doc is not going higher than 50mcg.  I use a compounded slow release T3.  Taking it twice daily did not work for me, since I have to be careful with what I eat and when after taking the meds.  I truly think I have an absorption problem.  Trying to get to the bottom of that. I think my thyroid meds dosages are good. I've come a long way. Started trying other forms of Thyroid meds - didn't work.   So switched to Tirosint at first. My RT3 was really high - 27, and had little energy. After a while, we upped Tirosint to 100mcg and introduced T3 starting with 10mcg in April 2017, and working up to 50 mcg in August 2018.  I keep a spreadsheet of my labs results, and this has been very helpful in looking at the performance of the thyroid meds over a period of time.  I think in terms of going higher, it depends on how your body responds to the increased dosage. My body is accepting the Tirosint. I've had a few palpitations when I took the first dosage - but no more.  I've had increased sweating when I exercise...and I used to sweat a lot prior to increasing dosage. I am willing to work with that...

[Franny2016]

*My body is accepting T3...

[Red_Star]

Your symptoms should hopefully all resolve when B6 levels are back to normal. Hopefully B6 toxicity has not caused permanent nerve damage. Likely the high B6 has caused hypokalemia (potassium deficiency). Check out the article: Discover how potassium can help you lose weight and become healthy.

[Franny2016]

Thank you Red_Star! Wow, I didn't realize the B6 affected potassium levels also. I will check out that article now...