Being in the Hashi situ leads to lots of trying to research, as you know. Along the way your understanding changes...and back and forth and confusion...well....
I am a few years down the line, still fighting... and I suddenly get lost on some things. Maybe some of you can clarify - IF you are pretty convinced which is right:
1) I first thought we need as much T4, as high in range as possible, that is converted to T3, which also needs to be as high in range as possible.
So when that T4 is converted to T3, you need to keep the T4 maintained at said higher level and that is the straight forward crux of it all.
2) I then started to read that whilst T4 needs to be as high as possible, the importance was as much as possible converted to T3 as that is the usable form.
OK SO WHERE IS THE CONFUSION.....
Whilst thinking to self that if the body isn't making enough T4, that if you somehow converted that lesser T4 to T3, that you are in doo doo... as the body cant replace that (used - converted) T4 as fast as it is struggling.
BUT THEN.... crept in the thought that some of the converted T3 goes back round to be converted back to some T4 - OMG!!!
So then (and this may sound daft) I started understanding that because the T3 may be a little low, the T4 making slows... HUH?!! (All technical processes, depending on cause)...
I've thought the TSH raises to tell the T4 (layman's version NOT correct version) to make some more.....and then later read the TSH raises because it is the T3 that isn't high enough.... oh 'eck!!
(we wont go into RT3 lol)...
These are the ways a lot of info on the web is read - and contradicts other info etc, so there I am - unable to take T4 but also not wanting to take anything really (ok, I know....mega risk) and as I said it's been a rocky old road BUT I AM SO SENSITIVE TO MEDS, body often rejects, so NO I AM NOT BEING SILLY - I am DUBIOUS that if certain meds make ill.... why would I think others wouldn't cause bad reactions? I'm one in a million...LOL... anyway I am going down the whole route here of what to try and what I have tried and what I can't have (or GP wont prescribe) or I wont take... etc... I assure you I am not daft!!
So all the time I have to think deep to self... such as "If I use up the small amount of T4, convert to T3 and that is used fast...then BOOM... I've had it..
I had a private test for Iodine and it showed as deficient - which MIGHT have been the reason T4 was lower....
EXCEPT there is that controversy about don't take Iodine if Hashi - aaarghhhh....but anyway I was using iodised salt and not masses, but also trying to eat some foods with iodine in.. well may be had it in.. aside modern farming or processing or GM etc
FED UP by now, of course as NO GP would help with any of this...
MY LATEST OWN OPINION... is of course.. the body has needs and if you don't put in what it needs, it cant magic it out of thin air - this leads to me realising for years, we have been conditioned or brainwashed by GPs - as everyone knows they DONT have the cure - OR they do and are keeping quiet - or otherwise there are various causes - but anyway ...
If any of you have read the same that if you get T3 in line, the T4 may start to rise, because it was lowered due to lack of T3 - I would be interested in this.
Otherwise yes of course we need both...and YES I KNOW some people are only on T3 or may have had thyroid removed etc etc... that isn't what I am getting at... I am getting at the specific process......
Also - re Genova own testing - I didn't do the loading Iodine test, I did the urine iodine, T3 T4 test - which was mighty crazy as said T4 and T3 (cellular) in range (not high but mid) and I was way out with TSH and T4 when GPs last tested (Ft3 was low in range but never out bar maybe once)....
I am trying to help self - but it is no good me going along with the theory I am lacking in iodine - IF say... the test might vary due to output - OR SAY the thyroid was holding on to some iodine, hence why it didn't all show in the water... LOL
Then why would the thyroid hold on to iodine you say - maybe as I read it cant process it OR it holds it back, due to other malfunctions.. obviously!
You can see my view was to take what the body needed to make T4, then as long as conversion was ok, enough T3 would be made and so on........
Now I have to decide if I need to work on better conversion in order to shift the T4 manufacturing onward and upward IF it is the T3 level that determines....?
Does this make sense to you? (I know it is complete everything that needs to work) but is it the straight forward version OR is it the recycling?