To be honest, I strongly believe that will not change my doctors opinions. I don't think she's ever prescribed T3 before, which is why she's just left me to the specialists. I did read an article written by one of the endo's at northwick park who believes T3 is important, so really it depends on how my luck falls.
Although I don't mind travelling outside of London, but of course not too far.
Best I can do is a doctor near London. Would that be of any interest?
Also thought you might like to read this link. It is a form letter written by a good thyroid doctor for patients he is consulting with from a distance. The letter is sent to the Primary Doctor to help guide treatment. It gives a pretty clear picture of clinical treatment as opposed to treating test results. Could this have any influence on your doctor?
http://hormonerestoration.com/files/ThyroidPMD.pdf
I was thinking the exact same thing, but thought it's best left alone, because I don't think my GP would prescribe T3 regardless.
My referral is at Northwick Park, she suggested Ealing and Hillingdon but I didn't want to go anywhere local for some reason, maybe I felt that there was no chance I'd get T3 prescribed, because if it was possible, my GP would have said. She said she's only seen T3 prescribed for thyroid cancer patients.
Don't want to interfere here, since goolarra is providing great info and advice. I just thought how ironic it is that the GP felt that your iron was too low, even though within the range, yet your low FT3 was okay by her, since it was also within its range. How can they justify this?
I don't have a lot of optimism for the Endo either. Seems that most in the UK don't even want to test for FT3, much less treat for it. If you will tell us what part of the UK you live in, I have a few names for good thyroid doctors that I could provide to you, if lucky enough to be in the same area. I know it is a long shot, but let's see.
Here are my blood test results:
TSH: 2.57 [0.27 - 4.2]
FT4: 17.58 [12 - 22]
FT3: 4.4 [4 - 6.8]
Iron: 24 [13 - 150]
B12: 346 [191 - 693]
Folate: 14.5 [3.1 - 17.5]
My GP referred me to an endo as she cannot prescribe T3, and did want to increase my T4 as she fears I might go into hyper. She did feel my iron levels were low, so I am on iron tablets for 1.5 months. I told her that I felt my T3 levels were quite low, but she believed as they were in the ranges, it was fine. I have no idea what to do know, do I fight for the T3 if I find the endo will also not prescribe it? Through the NHS I will have to wait months for an appointment, but going private costs too much.
Unless your HR is already bordering on high, I'd doubt that T3 would cause your HR to get into dangerous territory (taken in appropriate doses). If it did raise your HR that significantly, it might indicate that you shouldn't take it. I know several people on T3 who still have very low resting HRs. Also, T3 could raise your BP somewhat.
T3 meds have a very short half-life, so if you find it necessary to discontinue, it will be out of your body in several hours.
Your FT4 is right at midrange. With that FT4, we would expect your FT3 to be in the upper third of its range. In the range you've given, 6.9 or above. (Be sure that this is the range your lab actually uses...ranges vary here from lab to lab and have to come from your own lab report.)
IF (the big, fat IF) your FT3 is low and you are not converting properly, there is a HUGE difference between increasing T4 and adding T3. T4 has to be converted to T3 before your body can use it. Your cells cannot use T4. If you convert slowly, T4 meds often have to be taken in massive doses in order to get FT3 levels high enough to relieve symptoms, and even massive doses may not do the trick. Very high FT4 levels can present their own problems.
I know there are always pros and cons to everything, but many of our members take meds with some form of T3 in them. T3 is usually given in very small doses (5-10 mcg per day), and many people don't believe how much difference it makes in how they feel. I just think it would be worth a try. If it doesn't help or you have any side evvects, you can always discontinue it...
My blood test results will be with me in a weeks time. I have also done some research and read the study comparing patients on T4 to patients on both T4 and T3. I read that those on both did have better results. I also read that it increased the pulse rates of patients. I have low blood pressure already, and I have just read that increased heart rate and low blood pressure is not good. You can see why from this link:
http://www.abloodpressure.com/articles/34/High-Pulse-Rate-and-Low-Blood-Pressure-Means-Danger/
So now I am a little concerned.
If I do need to add T3 to my meds, would the T3 result be low? The UK range is 4-8.3. Also, is there a big difference in just increasing T4, rather than adding T3?
There is the possibility of weight gain, but it's almost impossible to control weight when hypo due to lowered metabolism. It becomes easIER if meds are adjusted properly! It's also easier to exercise.
Levothyroxine is T4 or thyroxine. T4 is the only active ingredient in levo.
T4 takes weeks to build in your system. Your FT4 levels rise, and then the pill you take every morning maintains that FT4 level. T4 just basically floats around in your bloodstream until your liver (mostly) converts it to T3. T3 is the active form of the thyroid hormones that your cells can actually use. If T3 is not used promptly (within a few hours), it's neutralized by your body. So, most people find that in order to not have peaks and valleys in FT3 levels during the day, it's best to split the dose. Most people take half with their T4 in the morning and the remaining half in the late morning or early afternoon, depending on schedule, etc. You can experiment with what time works best for you, but most people avoid taking it after about mid-afternoon since it can disturb sleep.
Good luck with your GP. I have to warn you that if you're dealing with NHS, it can be VERY difficult to get FT3 testing and equally as difficult to get T3 meds, if that turns out to be what you need. I'm just warning you to be prepared to be very persuasive! Let us know how it goes...
I also read that selenium can be dangerous, so I will definitely ask for a blood test checking all those deficiencies too before taking anything. Although I do take Vitamin B-complex as I heard it helps with periods etc.
My first ever blood test showed a T4 of 16.43, the one 2 months before I started thyroxine showed 15.49, and the only blood test I have had since starting the meds showed a T4 of 17.09. So yes, you're right it has risen!!
Lol I like curvy too, I don't mind that as long as I don't get fat. That's why I'm going to use the rest of this year post-May to get fit, as I get tired after just jogging for 5 minutes. A personal trainer at my gym who also has hypo, said that its due to the hypo, so I will have to work on that. Is there a possibility of weight gain even whilst you're on meds, whether they're balanced or not?
Does that mean the levothyroxine I take has T4 in it? Would this T3 pill be able to be taken straight after the thyroxine?
I will hopefully be going to see my GP tomorrow, and I will definitely ask for everything. Thank you so much! I should have done this so much sooner. I already feel better :)
It has been suggested that selenium lowers TPOab. This has never been demonstrated in a large scale study of a heterogeneous population. The enzyme that helps convert T4 to T3 is a selenium-based enzyme. It would be worth testing. Keep in mind that you can overdose on selenium, so follow label directions carefully...more is not better. Vitamin D, B12, ferritin and magnesium deficiencies also often go hand-in-hand with thyroid issues.
Has your FT4 level risen since starting meds?
I like curvy...so does my husband, luckily! LOL Your symptoms sound very hypo still.
T3 alone is very seldom prescribed on a long term basis. However, many people, like pippermint, find that taking T4 alone does not relieve all their symptoms. (Thyroxine and T4 are synonymous.) This is because many people convert T4 to T3 too slowly, so their doctors will add a little T3 meds to go along with their T4 meds. T3 meds can be synthetic. You take a separate pill every day (usually more than once a day), or you can take dessicated porcine thyroid (e.g. Armour), which is a combination T3/T4 pill.
To find out if you need to add T3 or just need an increase in T4, FT3 must be tested. It should be in the upper half to upper third of the range. If you have FT3 tested, ask for results of that and FT4 and reference ranges (which vary lab to lab and country to country). If you post those, members will help you interpret them.
Given your continuing symptoms, I think it's clear that your meds are not adequate. That's probably throwing your periods off. Also, stress is a major factor in triggering the onset of Hashi's or precipitating a flare-up.
I forgot to mention, I was diagnosed with hypothyroidism after I complained about irregular periods. Since starting thyroxine, I did get my periods every month, but there has been one or two times where I havent. I don't know if thats due to my thyroid, or stress from studies/exams.
So does that mean you take thyroxine, T4 and T3 everyday? Also, what hormones were affected before you started taking them? I don't even care about regrowth at the moment, I just want the hair loss to stop. I'm taking a gap year before I start looking for a career just so that I can focus on my health 24/7 in terms of diet and exercise. There's so much to know. I should have joined this website a long long time ago
I have heard that selenium brings down TPOab, I was thinking to ask my doctor to check if I may have any deficiencies for selenium or anything else. I was also thinking to ask to do a blood test for everything, i.e. including T3 and maybe another TPOab.
Before I started taking thyroxine, only my TSH was affected, my T4 has always been in the ranges.
Here are all my symptoms: Feet are always cold, hands too, but less extreme. Dry skin. Hair loss from: extremities, eyebrows, eyelashes, nose and head. Patches on arms and legs, but now regrowth on leg seems to have disappeared. Also where there is hair, be it arms or underarms, it is always coarse. My weight is ok, but I have definitely gone more curvy i.e. love handles. Constipation, which results in me looking like I have a belly. I get twitches all over my body sometimes.
I took the thyroxine the doctors told me to take and just left it at that. I, sadly, don't understand what you mean when you say add T3. Do you mean taking medication of just T3 everyday? I will definitely ask...demand my doctor to get these blood tests done.
You are taking T4 but what about T3? I have no idea why doctors seem to forget about T3. I take both and would not be able to get along without BOTH, My hair was stringy and thin but after 5 months on T3 and T4 my hair is growing back thick and healthy just like it was. I see a ton of new hair growth around my hairline. You need to get yourself on T3 (I think) :)
Here are my results from 13/12/2010:
TSH: 2.84 range [0.27-4.2]
Free T4: 17.09 range [12-22]
Thyroid Peroxidase antibody level: 337.3 (this is from august last year, they have not done it for my last blood test. I got confused with all my blood test papers so I do not know my current TPO level)
I did research on the internet and thought that increasing my dosage might help as I am on 25mg currently, but my GP said that as I am in the middle of the range, it is not really needed. However, I am quite scared of an increase as I have read others' stories and how an increase sometimes negatively effects them. My GP's are just med school textbooks so it is usually me asking them to refer me to endocronologists or dermatologists. I am also in my last term of university so I am stressing also as I have to work my butt off to get a decent grade as when I was diagnosed I put my education in the back seat. I recently ordered mira hair oil as an attempt to stop the hair loss. Does this mean the hair loss is purely due to my thyroid, or could it be alopecia as I am losing hair practically from most of my body?
It sounds like you could be undermedicated. Do you have the results of other recent thyroid blood work? If so, please post with reference ranges since these vary lab to lab and have to come from your own lab report.
Is that TPO antibodies that you say have been 333.7? TPOab numbers are very volatile. It would be highly unusual for TPOab to be the same more than once.
I'm betting your hair loss could be stopped by a meds increase.
Your GP sounds like he knows more than the usual GP about thyroid. Midrange is the rule of thumb for FT4 (most doctors don't know this and think anywhere in range is acceptable). However, that being said, the whole range can be used if that's what it takes to relieve symptoms. So, you do have room in your FT4 level for an increase.
Do you have other hypo symptoms?
Your doctors are not testing FT3, however. T4 is the "storage" form of the thyroid hormones. It has to be converted to T3, the "active" form before cells can use it. Some people convert too slowly. If you don't convert well, you can still be very hypo with stellar FT4 results.
When I was hypo, I lost body hair. In fact, I lost very little head hair. So, I think your thyroid could be the culprit.
I would have FT3 tested (and repeat FT4 and TSH on the same blood draw) if I were you...this will be difficult in the U.K. Your FT3/FT4 balance will let you know which way to go in terms of meds...increase in thyroxine or adding in a bit of direct T3.