Thyroid Disorders Community
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Avatar universal


Hello Medhelp Community, finished annual physical and have new labs for my thyroid Hashimotos. I demanded a full one despite my dr saying some were irrelevant. I am being bumped up on my levo to 88  but want to switch to nature throid since my insurance covers most of it. I am confused why my vitamin D is still super low were I was double dosing with 10,000 iu for over 3 mos. Labs below via quest diagnostics.

Ferritin 21  range: 10-154 ng/ml  (looks still very low dr said it is fine)
Tsh  1.73 range: 0.4-4.5 miU/L
T4 Free  1.0 range: 0.8-1.8 ng/dl
T3 Free 2.0 range: 2.3-4.2 pg/ml
Iron total 123 range: 40-190 mcg/dl
T3 Total 103 range: 76-181 ng/dl
vitamin b12 797 range 200-100 pg/ml
vitamin d 79 range 30-100 ng/ml

symptoms still persisting of my hair falling out/fatigue, my cholesterol slightly high, I did drop in my A1C but still slightly high. Should I be making a medication change. Dr seems to think I am doing well on levo
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Avatar universal
From the top, your ferritin is extremely low.  Having adequate ferritin is very important for good hair growth.  A good target is 70, so you should supplement with a good iron supplement like ferrous bisglycinate, ferrous fumarate, or ferrous sulfate.  I'd say you should start on about 25 mg and increase every week or so until you get to 75 mg.  Along with that you will need to take some Vitamin C or magnesium to prevent possible stomach issues.  Your B12 and D are good.  Why did you say D was low?

Your Free T4 is considerably below the target of mid-range, which is 1.3.  Your Free T3 is actually below range, so how can your doctor ignore that and say you are doing well, especially since you are still suffering with hypo symptoms?  I'd say you are directionally correct in switching to Armour or NatureThroid.  Although if you can get the doctor to agree, he would probably switch you to less than a grain.  In actuality, one grain of desiccated med is the equivalent of only 66 mpg of T4.  So in view of your increase to 88, that would mean you would need 1 1/3 grains of desiccated.  And in view of your low FT4 and FT3 I would push for a  switch to 2 trains of desiccated and start with 1 1/2 for 3-4 weeks and see how you feel before considering going up to 2 grains.  

If you try and talk the doctor into switching you and he has an issue with the conversion amount, you can point him to this link, which is the ATA/AACE Guidelines on Hypothyroidism.  On page 1002 it states that T3 is 3 times as potent as T4.  Since one grain of desiccated med contains 39 mcg of T4 and 9 mcg of T3, if you multiply the 9 times 3 and add the 39 you only get 66, which is the correct conversion.  

Gimel, my daughter is hesitant about the change and I agree that I don't think she know anything about the natural thyroid. I told her I would do two months on the increased levo after that I want to change if my labs aren't moving in the direction I need them to be. I will also look into a different iron supplement as I was taken a chewable every couple of days because of the extreme constipation I already suffer from.
649848 tn?1534633700
Hi dedelite... Both your Free T4 and Free T3 are too low in the ranges, so it's good that your doctor was willing to increase your levo dosage.  Those levels could/would account for the symptoms you report.

I'm not sure why you think your vitamin D is "super low", as optimal vitamin D is about 50-60.  You should probably be ready to switch to a maintenance dose of vitamin D now..

Your ferritin, on the other hand, "is" incredibly low... it should be, at least 60-70.  Are you taking an iron supplement?  You should ask your doctor for a full iron panel, not just the Total iron. Iron is necessary for the conversion of Free T4 to the active/usable Free T3.  

What dose were you on, prior to being increased to the 88 mcg?  It's a personal choice as to whether or not you switch to the Naturethroid.  You may do alright on the levo; your levo dose just needs to be high enough to be effective. Perhaps the 88 mcg will do it; you'll know when you retest in a few weeks.
Hi Barb (hope you are well) my previous dose was 50 mcg bumped to 75 mcg now going to 88 mcg. I am on iron but my doctor told me not to take it daily but every three days as I suffer from constipation. I was taking a chewable iron (I have been anemic all my life). I have switched my vitamin D to a lower dose. Doc told me it was low.
649848 tn?1534633700
dedelite... there are iron supplements you can get that don't cause constipation.  I also find that digestive enzymes and/or probiotics help alleviate constipation, as well.  You might look into those.  They're much better for you than taking laxatives.

How long were you on the previous doses of 50 mcg and 75 mcg?

Are you taking your medication as directed, with a cup of water, first thing in the morning on an empty stomach, then not eating/drinking anything for 30-60 minutes?
50 mcg for about a year and half and the 75 mcg for about 6 months now. I called the pharmacist months ago about the ingredients in the tablet and she agreed the change from time to time for synthroid. I wanted to know about the sugars, corn, wheat etc. I take my tab early morning and let it dissolve under my tongue. Rarely do I swallow it. I do this because synthroid is full of fillers and I didn't feel like I was getting it into my system. For the constipation I take the mag, I just started taking the disgestive enzymes but I think my belly is sad on the colon issues. The mag usually helps tremendously.
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