# Anyone want to help..thyroid, anemic, vitamin D def...hmmm...



## Melnwest (Aug 31, 2009)

Hi everyone,
So I am new to this board and would like some advice, and I will see if I can start contributing to other's needs as well on this board... A few years ago my thyroid antibodies were tested and were slightly elevated at I believe 43 which above like 35 was abnormal, though my TSH had always been in the 1.0-2.5 range and T3 and T4 normal, though my doc started me on Armour thyroid a few years ago saying I had Hashi's, and then gradually over the few years I was needing some increases in my doses to get my TSH close to 1.0, and then was switched to Levothyroxine eventually and bumped up gradually to 175 mcg tablet/day (last increase was done in March because my TSH was like 2.8 at 150 mcg dose).
SO, in July my TSH was around 0.54, and so she made no changes, and then I had to change doctors and on Aug 13th my thyroid tests were done again, but I had run out of my meds for about 1 1/2 wks, almost 2 weeks, the results are as follows:
TSH: 1.91 (0.3-3.0)
Free T3: 1.31 (1.45-3.48)
Free T4: 0.80 (0.71-1.85)

Other labs are: Hemoglobin is now: 12.0 (11.5-15.0), hematocrit: 36.8 (35.0-48.0), RBC 4.22 (4.3-5.4), RDW 15.0 (11.5-14.5)

Iron level is up from 20-24-39 (35-155 normal) and my ferritin was not tested (was 8 back in March 09 and under 50 is low) Everything else including electrolytes and liver function tests were normal, except my LDL was elevated at 122 (5-100), and my Vitamin D is still low at 20.8 (32.0-100.0); my vitamin B12 level is 442 (211-911)

So, my questions would be:
1. Should I be on a T3 medication in addition to my levothyroxine or just switch to Armour again? My PCP just refilled my med, but didn't address the low T3, and my symptoms are still there (very fatigued, hair loss, cold); Also I would like to know if it is recommended to have thyroid antibodies checked periodically if you have Hashi's, and if so, how does that effect changing the dosages in meds if they are increasing?

2. I have heard there is a coorelation between hypothyroidism and iron def anemia, and just curious if anyone has both, and has any ideas about my labs and what to do about them; I have been on Ferrous Sulfate 325 mg tablets twice a day for 3 months now; My labs havn't changed a whole lot, and I am still having fatigue and restless leg symptoms...wondering if I should ask about seeing a hematologist and/or iron infusion to get my ferritin level up and have my ferritin level checked again? I am concerned this is affecting my thyroid also.

3. Does anyone else happen to have Vitamin D deficiency also? If so, How are you treating it; do you know if the low Vitamin D effects Hashi's at all also? I am on Vitamin D drops in juice everyday (4,000 I.U. everyday), but wonder if that is adequate?

Thanks so much!!!!


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## Andros (Aug 26, 2009)

Melnwest said:


> Hi everyone,
> So I am new to this board and would like some advice, and I will see if I can start contributing to other's needs as well on this board... A few years ago my thyroid antibodies were tested and were slightly elevated at I believe 43 which above like 35 was abnormal, though my TSH had always been in the 1.0-2.5 range and T3 and T4 normal, though my doc started me on Armour thyroid a few years ago saying I had Hashi's, and then gradually over the few years I was needing some increases in my doses to get my TSH close to 1.0, and then was switched to Levothyroxine eventually and bumped up gradually to 175 mcg tablet/day (last increase was done in March because my TSH was like 2.8 at 150 mcg dose).
> SO, in July my TSH was around 0.54, and so she made no changes, and then I had to change doctors and on Aug 13th my thyroid tests were done again, but I had run out of my meds for about 1 1/2 wks, almost 2 weeks, the results are as follows:
> TSH: 1.91 (0.3-3.0)
> ...


Hi, Melnwest!!

Thank you for posting the ranges w/ your lab results. That is so important! Now, do I understand correctly that these labs were done at the time you were not taking any thyroxine replacement for almost 2 weeks? If that is the case, I think it would only be down to which thyroxine replacement do you think you feel best on? For me, it is Armour but I definitely am a non-converter.

Once you know you have the antibodies (I assume you mean TPO which is antimicrosomal antibody), it is really not necessary unless you feel really sick. I personally have found that for many (myself included), keeping the TSH @ 1 or below quiets the antibody activity.

And yes; most patients w/ Thyroid Disease do seem to have low ferritin and a lot of other minerals as well. Have you ever tried Floradix? It is liquid, fast acting and easily asorbed. Ideally, your ferritin should be between 50 to 100 and the closer to 100, the better.

As per Vit. D deficiency........................I personally have quite differing opinions about that one.

Vitamin D may exacerbate autoimmune disease...............
http://www.physorg.com/news158425579.html

So, maybe the body is trying to protect it's self at this time?? I wonder?

If you wish a recommendation, I would say, "Hey, take a walk on th wild side and get a little "real" sunshine each and every day and eat some foods that have vitamin D in them but not to excess!"

And it's not all about dairy either..................here are some suggestions for foods high in Vitamin D. 
http://dietary-supplements.info.nih.gov/factsheets/vitamind.asp

But do get some sun. You don't have to stay out long. Also, being out in the daylight helps to keep that "3rd. eye" healthy and sets your circadian cycle so you sleep well.

Andros


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## Melnwest (Aug 31, 2009)

Andros,

Thanks for your response! Yes, my last thyroid levels on Aug 13th I listed, I had been off my levothyroxine for almost 2 weeks, because I had run out, I know bad....but was relocated to AZ from WA..anyways, so I imagine that is possibly why my TSH was up since in July it was 0.54 and that was when I had been on my levothyroxine consistently; I was just curious if I needed to be on additional Cytomel type med or switch to Armour for help with my T3 being a little low? I didn't know anything about the whole T3/T4 thing really until I went on this board and another thyroid website..all very interesting. That is interesting also about the ferritin being tied to hypothyroidism; so I have that against me and my iron deficiency anemia (I have the low serum iron); think I am going to ask about iron shots or IV iron because of all my symptoms and been on tablets for 3 months now and labs slowly coming up...idk...
So, do you mean that if the TSH is closer to 1.0 then the antibodies are more stable and not as high?

The vitamin D article and autoimmune disease thing is interesting, though now I am a little lost on what to do...will have to ponder that one a little more, and weigh the evidence. Yeah, I live in Arizona so lots of sun here, I just need to get out more and not be inside so much; though getting Vit D decreases with sunscreen use which I try to do here with skin cancer in my family.

I have just had so many symptoms and my body has been a wreck, so thanks for your help and any additional help is greatly appreciated. I am on Ferrous Sulfate 325 mg tablets: 1 tablet twice a day right now since 5/28 (so 3 months now) and vit D 4,000 I.U. every day, and Magnesium 400 mg cap everyday, and levothyroxyine 175 mcg tablet every day along with my other meds I take. I of course don't take the iron and thyroid and vitamin D together (they all interact)...

Thanks!


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## Melnwest (Aug 31, 2009)

Andros,

And yes, I had looked into Floradix, just not sure if I could handle the taste and if the herbs in it would interact with all my other meds
I am on Zonisamide and Neurontin for migraine prevention and fibromylagia, and I am on Hydroxyzine and Fluoxetine also for anxiety disoder/depression, and calcium

Just have been having the restless leg feelings at night and towards the end of the day and my toe nails have been looking bluish/pale for about a month and sometimes short of breath/heartbeat is fast, so thought I might need the IM/IV iron for that...not sure though

thanks,
Melody


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## Andros (Aug 26, 2009)

Melnwest said:


> Andros,
> 
> Thanks for your response! Yes, my last thyroid levels on Aug 13th I listed, I had been off my levothyroxine for almost 2 weeks, because I had run out, I know bad....but was relocated to AZ from WA..anyways, so I imagine that is possibly why my TSH was up since in July it was 0.54 and that was when I had been on my levothyroxine consistently; I was just curious if I needed to be on additional Cytomel type med or switch to Armour for help with my T3 being a little low? I didn't know anything about the whole T3/T4 thing really until I went on this board and another thyroid website..all very interesting. That is interesting also about the ferritin being tied to hypothyroidism; so I have that against me and my iron deficiency anemia (I have the low serum iron); think I am going to ask about iron shots or IV iron because of all my symptoms and been on tablets for 3 months now and labs slowly coming up...idk...
> So, do you mean that if the TSH is closer to 1.0 then the antibodies are more stable and not as high?
> ...


This is very tricky and you seem to know a lot about this. FT3 can be low simply because you are undermedicated on T4 only. Also, it can be low for the same reason if you are on T3/T4 combo and finally if you are a non-converter. So, timely labs for FT3 are important no matter which route you take until you are stabilized and in the euthyroid state. For most, that is w/ TSH @ 1 or below and FT3 and FT4 mid-range or even higher so long as it is in range and the patient does not present w/ clinical hyperthyroid symptoms.

Conversely, when taking any T3; it is normal to find the FT4 rather suppressed meaning below mid-range and as I say, this is normal and not cause for concern provided the patient feels well.

The best rule of thumb to follow with everything is, "At first do no harm!" And if you do too many things all at one time, it is very difficult if not impossible to tell which one is helping you. Being a good scientist is very importantl

I read your siggie and you sure have multitudinous medical issues but I do suspect that the majority of them are co-morbid to thyroid disease and if we can get you on track, you are going to feel a lot better.

Andros


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## Andros (Aug 26, 2009)

Melnwest said:


> Andros,
> 
> And yes, I had looked into Floradix, just not sure if I could handle the taste and if the herbs in it would interact with all my other meds
> I am on Zonisamide and Neurontin for migraine prevention and fibromylagia, and I am on Hydroxyzine and Fluoxetine also for anxiety disoder/depression, and calcium
> ...


Melody..........how are you doing? I was going through the posts and I thought I would give you a shout!


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