T4-T3 conversion which meds?


Been taking nutri adrenal extra and nutri thyroid since late Feb. Genova test showed T4 ok but not converting to T3. Since starting glandular nutri thyroid I feel worse and it even gave me bad PMS. Dr P said I may have low progesterone but that I only need T3 as the nutri thyroid is adding to T4 that isn't being converted. I now have to import Cynomel? No idea where to get it. To further add to the confusion I decided to speak with Dr Bobd who deals with progesterone, she is aghast I have been told to take T3 and said I need progesterone and possibly armour. How can that be as Armour has T4 and the nutri thyroid already provided too much. Any suggestions welcome

47 Replies

  • AEK, Dr.P insists there is T4 in Nutri-Thyroid although the manufacturer claims it is hormone free. If it does contain hormone there's no way of telling how much and as it isn't a prescription med I doubt there is much.

    What are your recent thyroid results?

  • Hi

    I can't make head or tale of the results, Dr P wrote below them that there is sufficient T4 but not enough T3 hence a conversion issue. He said it's likely due to there being an adrenal issue but the nutri adrenal extra don't seem to have helped and if anything my hormones are worse

  • AEK, can you post the thyroid results with the lab ref ranges? I don't know much about adrenals so won't be able to interpret cortisol results.

  • Clutter, sorry I replied to Flower007 with test results and thought it replied to all, still getting used to using the forum.

  • AEK, I can't interpret urine ranges. If anyone can they are likely to need the lab ref ranges (figures in brackets after the results).

    I'll be happy to look at any thyroid blood tests you can post.

  • Hi Clutter

    Thanks, I've left my NHS printout for bloods with Dr P, I need to get those back but he said the bloods were within normal range.

  • Ok, Flower and Clutter, apologies, I am so confused and have found the blue horizon antibody test but as my husband has reminded me I paid for a full blood thyroid profile in Februrary this year. My memory isn't very good and I've been relying too much on the genova tests advised by Dr P which are helpful but obviously the forum is dealing with blood tests. The blood test for thyroid was also done by neurology and my Gp both showing as normal but I dont have these results and either contact the hospital and GP or ask Dr P to send the ones done by local GP.

    Can you see these results look nornal, is it not confusing.. I have also noticed that there is no T3 reading here only Free3?



    FREE THYROXINE 14.9 pmol/l 12.0 - 22.0

    FREE T3 4.7 pmol/L 3.1 - 6.8

    IMMUNOLOGY THYROID ANTIBODIES Thyroglobulin Antibody 77.7 IU/mL 0-115(Negative)

    Method used for Anti-Tg: Roche Modular

    Thyroid Peroxidase Antibodies 19.8 IU/mL 0 - 34

    Method used for Anti-TPO: Roche Modular

  • AEK,

    You have no thyroid antibodies so no Hashimotos which is great news as inflammation can be a problem in auto immune suffers.

    TSH looks ok.

    T3 & T4 both look a little low.

    I am confused as to what meds you are taking. Have you just tried the glandulars or are you medicated on thyroxine too?

    Hopefully Clutter will comment on results as I'm no use if you aren't medicated.


  • Hi Flower007

    Thank you for looking at these. I'm not on any meds apart from pyridosgimine for the MG. I have only been using the nutri glandulars since Feb but I feel worse. Been advised to use progesterone cream and order T3 but scared too. I don't think the bovine products agree with me really. So confusing. I've posted to Clutter too

  • AEK, TSH is low, FT4 is less than halfway through range and FT3 is less than half way through range. If there is any hormone in Nutri-Thyroid you aren't getting enough and need to take more but I think Levothyroxine, T3 or NDT are better options and you'll feel better with FT4 >17 and FT3 >5.5.

  • Hi Clutter, thank you and also to Flower007 earlier for your perseverance.

    I don't no why I didn't respond to the glandulars, Dr P was adamant the NT wasn't being tolerated as I felt worse, my ears are still ringing. Clutter, can you explain why the results were interpreted as normal, they are more or less the same as the ones done on the NHS and I've been told my thyroid function is normal and its chronic fatigue or depression. I've spent most of today crying with despair. Do you think I should order the T3 as Dr P suggested or try Armour as suggested by Dr Bond who thinks T3 is wrong, she's advised progesterone like Dr P for night sweats and PMS. She advised me to take progesterone and then start Armour later. Mean while I just feel awful and life is passing me by. I hope you are having a better day. AEK2015

  • Hi

    Sorry to sound stupid. Did the last post come from the administrator or clutter? I'm still not sure I am using the forum correctly

  • AEK2015,

    We all cry with despair sometimes as a thyroid condition is so misunderstood and can make us feel so ill.

    Clutter has advised that she thinks you will feel better when your levels of T4 are more than 17 and T3 more than 5.5 and this could be achieved by taking Levothyroxine, T3 or NDT.

    Once you are properly medicated you will not only feel better but more in control of your illness. Remember thyroid issues can affect us physically and psychologically.

    Sometimes it is better to let go of the "why things have happened" and "what they mean". Hormones are so complicated that doctors often have different interpretations of results.


    clutter is admin.

    Chin up,


  • I know "we all cry with despair". I am owning how I feel personally .Thanks for the advice however


  • AEK, I'm sorry you feel so poorly you're in such despair. I'd go with Dr.P's suggestion and try some T3 which is the active hormone. It is absorbed faster than Levothyroxine although it still takes several weeks to metabolise and probably some months before symptoms resolve. Some patients can't tolerate thyroxine in Levothyroxine or NDT and have to take T3 only.

    Your results are interpreted as normal because they fall within range. They're low-normal, not optimal however. You won't get treatment on the NHS with those results but you may feel considerably better if you take T3 to get your FT3 higher. Don't be alarmed if your TSH and FT4 drop when taking T3, it's quite common.

    If T3 doesn't suit you can change to NDT as sometimes it is necessary to try different types of thyroid replacement to see which suits best.

  • Good morning clutter. Thank you for this! I find it very helpful and I'm going to take your advice. I will order the T3 today and try it and see. Thank you for your thoughtful message. AEK2015

  • Sorry, I forgot to ask before I signed off. I don't think bovine adrenals agree with me. I need to continue treating adrenals. In your experience do the herbal products work as well or would switching to Dr Wilsons as recommended be a better option? I think they do a herbal tonic without liquorice? I've no idea if these are too strong or can interfere with thyroid medication. Thanks

  • AEK, start with a quarter tablet (6.25mcg) to see how you tolerate it. You can raise to 12.5mcg after two weeks split into 2 doses 6-12 hours apart. Stick with 12.5mcg for 4 weeks before raising to 18.75 mcg and hold that dose for 6 weeks and have a blood test before increasing further.

    It may be good to continue adrenal support while you introduce T3. I've no experience of any adrenal support so post a question asking for advice.

  • AEK,

    Just taking glandulars may not be your answer to getting better.

    You haven't advised whether you are already on thyroid medication or not.

    Are your symptoms related to classic hypothyroidism or hyper through intolerance of glandulars?

    If you are seriously hypothyroid, NAX and NA would not be enough as are only intended to supplement or alone treat minor thyroid/adrenal issues.

    If you post your thyroid hormone test results complete with ranges (numbers in brackets), members can advise as results can give a very clear picture of what is going on.

    Regarding your saliva stress test in previous post, cortisol is meant to be high in the morning, gradually reducing throughout the day and reaching a low at night time.

    A healthy result would show a big spike on waking, followed by an 80% decrease throughout the day reaching an all time low at night time, where sleep & rest would encourage regeneration and the process would start again.

    Adrenal fatigue is determined by irregular and abnormal spikes and lows, in other words, anything outside of range.

    High cortisol levels generally present before low when adrenals have become exhausted.

    It can be confusing consulting with many different doctors as thyroid issues are so complicated and far reaching, each have their own protocols.

    I too have seen Dr P and couldn't tolerate the glandulars.

    Have you had your vits, iron and calcium checked?


  • Hi Flower

    Thank you for your message. Here goes with the Genova throid test results.

    24 Hour Urine sample: T3= 883. T4 = 1,480. T3:T4 ratio= 0.60

    Adrenal Stress profile ( saliva). Cortisol. Sample one post awakening= 33.00, sample two 4 hours later= 3.90, sample three 4 hours later = 2.20, Sample four 4 hours later = 1.50. Sum of cortisol= 40.6

    DHEA Mean= 0.37

    DHEA cortisol ratio= 0.91

    DHEA sample 2 ( am)= 0.39

    DEA sample 3 (pm) 0.35

    To be honest, Icannot understand these results and Dr P was particularly unhelpful in explaining them. I got fed up being charged £45 for a brief and unhelpful telephone conversation and as a result I am no better off and feel worse.

    I found the tinnnitus kicked in once I introduced the nutrithyroid . The thing is I have an auto immune condition called Myasthenia Gravis and was diagnosed with it a year after having my daughter ( 2012). I have had a ling battle with PMS and chronic fatigue syndrome. I have been experiencing worse PMS since taking the glandulars and having night sweats again. I dont take thyroxine as my thyroid was always found to be functioning according to standrad blood tests. the Myasthenia was easily diagnosed and the antibodies showed in my blood stream. These thyroid and adrenal issues are so hard to pin poinf or many of us how frustrating. I often wonder is it all in my head, does anyone else>

    I am open to your advice. Do you think T3 could help, I dont know if Armour will if it has T4, I dont think I need that according to DRP who says T4 is ok just not converting

  • Flower I meant to say that I had B12 test and was low on it , Dr P advised B12 and folic acid and I take this along with calcium

  • Flower, if you can make any sense of my results it would be great. I wondered if you could share what has helped you as I saw on a previous message that you have seen improvements over the past 14 months?

  • Hello AEK2015,

    Sorry to hear about your Myasthenia Gravis and

    feeling so unwell.

    Your symptoms are real and definitely not just in your head as thyroid issues can effect us physically and mentally.

    I can't read these results as this is Dr P's forte but will compare them with mine tomorrow. I discussed my adrenal saliva test at length with Dr P so may be able to decipher through comparison.

    I think you are absolutely right in considering your adrenals but thyroid med is equally important. Without blood test results it is difficult for members to comment regarding your conversion issues.

    You will need to post your thyoid hormone blood test results from your GP, complete with ranges (numbers in brackets) as these give a very clear picture of what is going on and members will understand them more easily.

    Remember a doctors "normal" will not necessarily be what we determine to be vital for good health.

    Do you manage the Myasthenia Gravis antibodies?


  • Hi Flower

    Thank you, I was just saying there to Clutter that Dr P has my NHS printout but I can ask go surgery to do it again as Dr P takes forever to send things out. Finally I feel supported and able to speak with people who understand and are walking this path, thank you. I take pyridostigmine or brand name mestinon. For the myasthenia. It's an acetylcholine inhibitor and my eyes don't drop when I use it. I will get the results as soon as I can.

  • Eyes don't droop not "drop" 😄

  • My big improvement has only been since March after suffering a massively terrible reaction to NAX and NT after just 10 days. As crazy as it sounds, the reaction blew my debilitating brain fog away and kick started my adrenals, evidenced by a later saliva test showing cortisol sum as 24.2 from 15.4.

    I have since suffered adrenaline problems which are decreasing and believe that adding T3 to my T4 would address the remaining issues. I see my endo next Tuesday.


  • AEK2015

    Remember I have no experience or medical training and have only really discussed adrenals at length with Dr P so don't understand the saliva thyroid tests.

    My latest adrenal Genova saliva test was taken in April so assuming your ranges are the same, I will interpret your results using my own as a guide.

    Sample 1 - 33.0 is way above range. Post awakening shows peak adrenal gland function & normal circadian activity.

    Sample 2 - 3.9 just inside of lower range. Determines adrenals adaptive response to the demands of the first few hours of the day.

    Sample 3 - 2.2 just in lower range. I always get an energy slump late afternoon & you probably do too. It is important to eat a healthy snack to prevent adrenaline from trying to control blood sugar levels & avoid the shakes. This sample shows adrenal function in relation to glycemic control.

    Sample 4 - 1.50 in range. Shows prior to sleep the baseline adrenal gland function which should be at its lowest of the day.

    Your cortisol sum is 40.6, my first sum was 15.4 but would definitely say yours would benefit from support. Nutri glandulars don't suit everyone but there are others you could look at. I have just started taking Dr Wilsons but can't comment as its too early days.

    There are adaptogens available that help with cortisol issues and I know that Holy Basil helps with both high and low levels. I haven't taken any as they can be very powerful and wouldn't advise doing so without professional advice.

    With regard to your menstrual problems, I suffered for years until medicating on Levothyroxine. The following link although aimed at Hashimoti sufferers, shows the relationship between the thyroid and our monthly cycles.


    Post thyroid blood test results when you have them for members to comment. You so sound like you could use some thyroid hormone med.


  • Hi Flower

    Excuse the late response and doh as I have asked some things in the last post before reading your latest one which answers some of it! Do you think Armour would work for you or T3 only for thyroid meds? The same question for me do you think Armour would help my conversion issue if I'm not responding to glandulars? I know I've not posted my bloods so it's hard to answer.God I'm thinking my results are ok in comparison to yours yet I really experience awful symptoms, I then think is it all in my head but no it can't be as I'm a sane person. I thought the adrenal results looked ok but Dr P said in his comments that I need full adrenal support. I will try the other product you've recommended, it looks more expensive though. I'm using progesterone cream as from two days ago and I know it can help with the thyroid and adrenal hormones. Do you have a conversion issue too and is that why you need T3?

  • Hi

    Sorry delay as away for weekend. I'm sorry to hear this and also glad you are seeing your endo. That must have been really hard having the reaction you did!!Does that mean you wouldn't take Armour for T3 & 4 as its animal thyroid and you reacted to NaX & NT? I have decided to stop the NAX as I still have this tinnitus and feel worse. I've just come through a rough few days of feeling low with worse apathy. I honestly feel worn out fighting this and I know so many of us do but we keep going!What do you take now and will the endo prescribe T3?

  • I take Levothyroxine and hope endo will prescibe T3. If he doesn't agree, I will be self medicating T3 with guidence from this wonderful forum as after four years, I have had enough of weird symptoms and know I will never get any better.

    What are you going to do?


  • Dr Wilsons supplements are more expensive. I am taking the adrenal stress formula, Vit C and adrenal rebuilder which is a glandular. The recommended dose is 4 tablets a day but I am starting on a quarter of a tablet so as not to induce any unwanted side effects.


  • Does that mean you can tolerate glandulars but just not the nutri products. I hope I'm understanding you and not confusing matters. I've just had a eureka moment, the NAX and NT are Bovine sourced and I have an intolerance to cows milk. Do you have a cows milk intolerance explaining your reaction? Tell me if I am barking up the wrong tree or dare I say mooing up the wrong tree!

  • Lol. Yes NT is bovine sourced. No I dont have a milk intolerence.

    I have adrenal fatigue, so my body uses adrenaline instead of the unavailable cortisol. Very bad news.

    Nutri Adrenal contains adrenaline and so was too much for me.

    Dr Wilsons glandulars only contain the adrenal cortex which does not contain adrenaline.

    I only started them yesterday as have been too scared. So far so good although I am only on a quarter of a tablet. Lol.


  • Oh, that's interesting but not good to hear as it's causing you trouble. I do hope the Dr Wilsons will work for you? Have you used any natural adrenal products like borage or ginseng or liquorice? I'm wondering how effective these are. I need to find a substitute now for the NaX and you've given me a possible option. I would like my ears to stop ringing with tinnitus, I think it will stop when NaX out of system. I should get some shut eye. Good night from AEK2015

  • I get tinnitus too. Yes, good night.


  • Hi

    I don't know what to take. Dr P said order cynomel T3 online because the adrenals didn't help the T4-3 conversion. He suggested the Nutri Thyroid was making me toxic and also said it contained T4 which confused me as I believed it is hormone free. He says I will have to take T3 on its own with adrenal support. The progesterone expert Dr Bond disagrees with women taking just t3 and advises armour and progesterone. I don't know what to do. Do you get the terrible apathy and mental fatigue, I wish I could have my life back, I don't know if I should just order t3 on its own and just try it

  • No don't AEK2015. You need to wait until your blood test results come back.

  • I think a healthy person would get terrible apathy and mental fatigue if they had to sort all these health issues out, let alone poor people like us with big hormone inbalances.

    AEK, believe it will get better when you are correctly medicated.

  • Ok, thanks for that, hey it's only taken 27 years, I can wait a few weeks/ months to find the right meds. 😄😄

  • Ok, do you mean wait until I get them back from Peatfield and post them on the forum?

  • Yes. You told clutter you would be getting another set from your surgery.

    It would be really dangerous to take thyoid meds without knowing your test results. I know Dr P has told you to take T3 and he us a wonderful person but as you said before, elusive.

    You have asked many people and other doctors their opinions and are now confused.

    It's better to start again with results and then a plan to get better.


  • Ok, I will take advice. I think I would be quicker asking the surgery. I will post when I get them, I will be interested to hear what others can tell me about my results as it's very confusing.

  • Heck, one last thing as I'm confused over blood results. As NHS said in normal range and I showed to Dr P who said the same. The 24 hour urine test was the one that showed the conversion problem. I am still confused as to how the bloods will inform anyone. Is it not reflecting total volume in the blood and not what's being used by cells? What can you tell me that is different? Do many people on the forum experience this discrepancy between blood and urine tests? Is it common, I'm still learning and confused

  • Yes it is possible to tell a conversion problem from blood tests and don't usually analyse urine thyroid hormone tests as members only seem to have bloods taken so are more experienced in bloods.

    Remember some conversion problems can be due to nutrient or mineral deficiencies, liver issues, adrenal problems, certain meds and inconsistent blood sugar levels as explained above.


  • AEK,

    In view of your Myastebia Gravis, have you been tested for thyroid antibodies? Hashimotos auto immune disease is prevalent in people with thyroid problems.

    There is a big school of thought that having one auto immune condition, generally leads to others. that is why I was previously asking how you manage your antibodies. pyridostigmine medicates the disease but controlling the antibodies is important to prevent progression. Many find a gluten free diet helps reduce body inflamation.

    The links below explain how one auto immune condition may lead to another. Myastebia Graves is mentioned in the first one.




  • Hi

    With regards to the Myasthenia Gravis ( MG) the neurologist took bloods for antibodies again last year, confirmed they were indicative of the condition and high but wouldn't test again saying it's not necessary. I had a thyroid screening through the hospital ( didn't get those results) and again from Go which were normal,but not for Hashimotos instead I did a private blood test from blue horizon for it and antibodies and it came back within normal range. Dr P has that print out also so I need to get this back and can post it. ah, I may have a copy as results from blue horizon were emailed, I will look today. It's all a blur really, they can see I have MG but as the symptoms are managed by the pyridostigmine I'm basically seen as ok, if I complain then the option is to have my thymus removed and I am not doing it! The chronic fatigue and low mood are seen as depression sadly. Dr P said on examining me that I was very hypothyroid, my basal temps still 36.3/4. Is it common for the people on the forum to have normal blood tests and hypo symptoms?I had glandular fever age 12 and Dr P attributes issues to that as I never fully recovered. I do eat a gluten and dairy free diet most of the time with the odd slip up.

  • Ok, Flower and Clutter, apologies, I am so confused and have found the blue horizon antibody test but as my husband has reminded me I paid for a full blood thyroid profile in Februrary this year. My memory isn't very good and I've been relying too much on the genova tests advised by Dr P which are helpful but obviously the forum is dealing with blood tests. The blood test for thyroid was also done by neurology and my Gp both showing as normal but I dont have these results and either contact the hospital and GP or ask Dr P to send the ones done by local GP.

    Can you see these results look nornal, is it not confusing.. I have also noticed that there is no T3 reading here only Free3?



    FREE THYROXINE 14.9 pmol/l 12.0 - 22.0

    FREE T3 4.7 pmol/L 3.1 - 6.8

    IMMUNOLOGY THYROID ANTIBODIES Thyroglobulin Antibody 77.7 IU/mL 0-115(Negative)

    Method used for Anti-Tg: Roche Modular

    Thyroid Peroxidase Antibodies 19.8 IU/mL 0 - 34

    Method used for Anti-TPO: Roche Modular

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