Would T3 benefit me?

[Mynx537]

Hi I was diagnosed with Hashimoto's in January this year but my TSH has been fluctuating since November 2011 and I received treatment in May 2013 with Levothyroxine at 100mcg.

TSH readings (they are all normal) for this year are:

January 2014 - 2.7 (0.2-4.2)

February 2014 - 3.6 (0.2-4.2)

March 2014 - 1.87 (0.2-4.2) FT4 at 16.6 (12-22) and FT3 at 4 (3.1-6.8) are included but only because these were done privately and my NHS doctor does not test FT4 or FT3 if the TSH is within range.

Is it worth me looking into buying T3? I doubt I will feel any better if I am not on this and the Levothyroxine doesn't make me feel much better either. I am still depressed, achy and tired. The doctor has now removed all other medication doses from my prescription script and my endocrinologist appointment isn't until the 20th May. Sorry, I think I put in other posts as it being the 25th.

Is it worth asking for T3 or is more testing needed to be sure? Last FT3 result was in November 2013 and was at 5.5 (3.1-6.8)

Thankyou :)

[Mynx537]

Thanks for your reply.

Yes, it does seem that way, that she has set up this practitioner account to make money from the supplements anyone buys (I have not bought any supplements from her, personally). I am even more inclined not to trust her now as I thought she was trustworthy - she works for a health center and her daughter has Graves', so I figured she would be a trustworthy source.

Maybe I ought not to trust her and instead simply stick with my doctor and endocrinologist for now. This nutritionist she insisted I see apparently makes no money or profit from her private session. All proceeds go to charity. I haven't seen her for over a month simply because I don't know what to trust or believe.

What I've done for now is that I've arranged my thyroid function tests, so TSH, FT4 and FT3 to be done privately as doctor would not approve it themselves. I attempted to book an appointment with my doctor to get my ferritin, Vitamin D and Vitamin B12, possibly full iron panel, tested before my appointment in May but their systems were updating and I have to now hold off until they are up and running again. Not sure when that'll be but it seems like it'll take some time.

As for this woman being a "practitioner" and is clearly not, maybe a good idea is to just not see her anymore despite her saying she wants to see me and let me know how the nutritionist appointment last month went. I didn't completely trust this nutritionist's advice...

The 24-hr saliva test will be done next week as I am worried about finances at present. But it will be done for definite, yes.

[Barb135]

Just because someone runs a thyroid support group doesn't mean she's a medical practitioner.  I'm a Community Leader, here, too, but I'm a patient, just like you, who has gone through very similar issues.  I happened to be lucky enough to dig my way out and stuck around to do what I can for others.

Perhaps she has her "practitioner" account set up to make money from the supplements you buy from a particular company?  

Recommending 15,000 IU of vitamin D should only be done by a doctor, since your levels were low, but not horribly so.

Many doctors don't even think about their patients, once you walk out of the examining room.  Nor do they consider hypothyroidism to be such a horrible condition that has to be kept tabs on.

I seem to remember your cortisol of 622; yes, too high, but a one time reading really doesn't give any information; that's why you'd need the 24 hr saliva test to confirm that.

[Mynx537]

Hi thanks for your reply.

The woman who recommended the spray is not exactly a practitioner as such but she runs the thyroid support group I'm a member of. So I took her to be some sort of expert as she also has a practitioner's account to buy supplements at a discount online.

Sorry, yes, the dosage of one spray of the Vitamin D is 3000IU.

I could contact my doctor to arrange for all the testing to be done prior to the meeting in May but she has not mentioned anything about when I can be tested which made me think I am not due. So in actual fact I am due these tests soon? I can't understand why doctors don't say anything. I would expect them to keep more of an eye on me since I have this hypothyroidism...

I'm quite happy to hold on a bit longer, no problem. :) Thanks for your help.

I thought I had cortisol issues since prior to the ACTH test in January my cortisol was quite high at 622 - apparently too high and healthy for a hypo person. So maybe no adrenal issue at all. This is so confusing...

[Barb135]

Is the woman who recommended 5 sprays of vitamin D, a doctor or medical practitioner of some kind?  If not, recommending that someone else take 5 times the recommended dosage, might be irresponsible.  What's the dosage of 1 spray supposed to be?  You said you bought a supplement that contains 3000 IU/dose - is that the spray, with 3000 IU/spray?  If so, she's recommending 15,000 IU/day... if that's the case, then yes, that's irresponsible.  That high dosage should only be recommended by a doctor.  While your level is low, it's not low enough to warrant that high a dose.

It can take up to 6 months for symptoms of vitamin D deficiency to improve, but that will happen only once levels are optimized.

I don't know if there's any hard and fast rule for testing ferritin, but I'd want to test, at least, every few months, until levels are optimized and stable.

Same goes for Vitamin B-12.

If ferritin, vitamin D and B-12 were tested in Dec, I'd say 6 months should be sufficient to test to insure that all 3 levels are, in fact, coming up as anticipated.  Could you contact your doctor and ask to have all the testing done prior to your meeting with her in May, so you don't have to make another trip to the hospital to get some done, later?

I haven't found any scientific studies to indicate a great effect of low vitamin B12 and D levels on cortisol -- doesn't mean they don't exist, just that I haven't found them.  In view of that, it probably doesn't matter when you take the saliva test.  If you want to hold a bit longer, I'll try to do some more research.

If you really have reason to believe you  have cortisol issues, you'll probably want to take that test prior to broaching the subject of T3 with your doctor, since adrenal issues can make thyroid meds harder to take.  Since you're at 100 mcg levo and tolerating it well, I'd question if you have an adrenal issue.

[Mynx537]

Thanks for your reply.

The woman I see who recommended the Vitamin D supplement to me said that she supplemented with 5 sprays a day compared to the RDA of one spray a day (it's in spray form) and she didn't have any adverse effects after doing this. So what she did is seen as irresponsible?

Good job you said, thanks for letting me know. I haven't done this as of yet, I think the maximum number of sprays I've ever had in one day is 2.

My endocrinologist has said for my Vitamin D levels to be retested in June as they were tested back in December. She put in my medical report that it can take up to 6 months for Vitamin D symptoms to improve so I can only assume she will retest in 6 months - so she is likely to book me in for another blood test after this appointment with her in May. Seems silly to me as the hospital I go to for this isn't exactly local.

How often would someone be retested for ferritin? It seems a long time ago since I was last tested in all honesty and they were still low anyway but I could be wrong. I'm no expert on this.

Is it a good idea to hold off on the saliva cortisol test or get it done anyway? Not a problem for me to do either. :)

[Barb135]

If you're only taking 40% of the RDA daily for iron, it will take a very long time to bring your ferritin level up.

800 IU of D3 is usually not sufficient to increase Vitamin D levels; I, personally, take 2000 IU/day.  Do be careful, though and test at regular intervals, because vitamin D is a fat soluble vitamin and can be toxic at too high levels.

Yes, at 363, your vitamin B12 was too low.  Anything below 500 can cause symptoms, and I, personally, have to keep my levels at the very top of the range, or I don't feel well.  I do this via weekly injection because I have Pernicious Anemia.

After supplementing ferritin, D3 and vitamin B12 for a few months, you should have them retested to make sure levels are coming up adequately.

[Mynx537]

Thanks for your reply.

I'll hold off on getting the antibodies tested in that case. They have been high in the past so I take it that what I have makes them wax and wane anyway.
That can be done later. I don't know when but my endocrinologist can test for them if she feels they need to. If not then I can get them done privately but this will not be confirmed until during my appointment in May.

Sorry, my bad. I thought I posted my results in the other thread regarding ferritin, Vitamin D and B12 levels. Here they are:

August 2013

Ferritin - 15 (30-400) Started on ferrous fumerate 210mg but I did not like taking this and I didn't want to tell my doctor that I didn't like taking something they gave me so I stopped and then started a liquid supplement which I believe contains 40% RDA of iron and also Vitamin C.

December 2013

Ferritin - 21 (30-400) Continued to take the liquid supplement. Doctor was happy for me to continue taking the supplement I found as they believed that was what had caused my ferritin levels to increase.

Vitamin D - 43.6 (>75) - Doctor put me on 800IU D3 Fultium tablets but I did not like taking these either so I bought a supplement that contains3000IU of Vitamin D.

Vitamin B12 - 363 (180-900) - Doctor did not prescribe me a supplement for B12 but I have been told by friends that my B12 levels were low, so I bought a supplement that contains 1000mcg of B12.

[Barb135]

Typically, when one has recently started a thyroid medication, testing is done at approximately 6 week intervals, until levels are optimal and stable.

I understand that your NHS doctor would disagree about testing FT3 and FT4, because that doesn't fit into the NHS guidelines, which tend to keep people ill.

Once antibodies have been tested and are positive, they do not need to be tested again.  Yours were just below the upper limit, so you could have them retested, at some point, in case they just hadn't ramped up yet, but I'd not say it's necessary this soon.  

What are your actual ferritin, Vitamin D  and B-112 levels?  I didn't see them in your other thread.  Are you supplementing to bring those levels up?

[Mynx537]

Hi thanks for your reply.

Sorry, I had the bloods taken in March. Does that mean to say they're due again?? They should be tested as often as a month, is that correct? Seems a lot...

I've been doing them privately. Well, the last one was private hence why more results have come through. Is it a good idea to get them tested again even though the results are normal? My NHS doctor would disagree with me about being retested for FT3, FT4 and TSH. Are antibody levels not worth being retested, too?

With the saliva cortisol test I have not done it as none of my other levels (iron, Vitamin D, Vitamin B12) are anywhere near normal and I was told by someone else that the cortisol test would be better when these levels are normal. Is this not the case? If not then I will happily do the testing tomorrow. I have the kit on me and it's still all packaged ready for me to use, I just want clarification on whether there is a right time to start using the cortisol home kit.

Thanks :)

[Barb135]

Looking back at some of your posts, I see that goolarra covered this quite extensively with you on another thread:

http://www.medhelp.org/posts/Thyroid-Disorders/Hi-there--help-with-bloods-please/show/2134463#post_10196118

It's been a while since you had the above posted labs, so it may be time to get labs again, to see where you are now.  You'll need the FT3, FT4 and TSH.  Your FT4 was previously at 46% and your FT3 was at 24%.  Testing is, typically, repeated at 5-6 week intervals to see if your levels are changing.  As goolarra noted in the other thread, FT3 often lags behind FT4.  It takes your body some time to heal after being hypo and symptoms rarely just "go away".  Often it's a gradual change that we don't even realize is taking place, until one day, we realize that we no longer have a certain symptom.  

In your other thread, you said you had a saliva cortisol test.... did you take that?