Hi - TSH down but am I converting to T3? THANKS!!!

Hi - I wonder if you kind people would please help me figure out my latest test result? A bit of background: TSH was 6.34 (range 0.35-4.50) & T4 12.4 (range 11.00 - 23.00) two months ago. I started on 50mcg of levothyroxine for four weeks and then upped to 75mcg for the last four weeks. Feeling a bit better but nothing dramatic.... Oh, and HASHIMOTOS confirmed!

Results: 

Free T4 21.6 (range 197-771), TSH 0.90 (range 0.35 - 4.50), Free T3 4.8 (range 3.1 - 6.8)

Vitamin B12 580 (range 197-771), Serum Folate 13.9 (range >3.0)

25 OH Vitamin D 57.03 (range 50 - >200) borderline insufficient

Coeliac Screen - Tiss. Transglutaminase >2 (range Neg >29 Y.mL)

Endomysial Ab's (IgA) negative  

Thyroglobulin Antibody 684.1 (range Negative = 0-115) PRINTED IN RED

Thy. Peroxidase abs. >500.0 (range Negative = <50) PRINTED IN RED

Iron 20 (range 10.0 - 30.0)

Iron Binding Capacity 41 (range 45-72) PRINTED IN RED

Transferrin saturation 49 (range 20-50)

IGA 1.47 (range 0.70-4.00)

Cortisol (serum) 249 (range 172-497)

Any help is most gratefully received!!

14 Replies

oldestnewest
  • Sorry just noticed a typo - Free T4 results should read: 21.6 (range 11.0 - 26.00)

  • Hi Blue, the TGB antibodies basically due to blood sugar issues.  I hope this video will play but can you go to you tube and locate it if not?

    The excerpt below is from Stop the Thyroid Madness.  stopthethyroidmadness.com/l...

    FERRITIN: Measures your levels of storage iron, which can be chronically low in hypothyroid patients. If your Ferritin result is less than 50, your levels are too low and can be causing problems…as well as leading you into anemia as you fall lower, which will give you symptoms similar to hypo, such as depression, achiness, fatigue. If you are lower than the 50’s, you are scooting by. Optimally, females shoot for 70-90 at the minimum (Janie’s is 80 when her iron is good); men tend to be slightly above 100. If your ferritin is much higher, you have INFLAMMATION–the latter causes iron to be thrust into storage and inflammation is common with thyroid patients for a variety of reasons. In less common cases, higher ferritin can be from liver disease, alcoholism, diabetes, asthma, or some types of cancer. If ferritin is high along with a high % Sat and Serum iron, you may have hemachromatosis or a MTHFR defect. Having heavy metals can push your ferritin low, by the way, while your other iron labs are good or higher. We learned that we should be off all iron for at least 12 hours before testing to see what supplementation is doing for us, but 5 days to see your true iron levels.

    SERUM IRON (also called just Iron or Total iron): Measures the small amount of your circulating iron which is bound by the transferrin. You are looking for ‘close to’ 110 for women, upper 130’s for men, based on what we’ve seen on hundreds of lab results. European or Australian lab ranges are something like this 7-27, and optimal is in the lower 20s at the least for women and higher for men. If you are considerably higher than optimal, you could have the MTHFR mutation which will need testing and treatment. The MTHFR mutation also drives the ferritin low with normal or high iron.  If all four iron labs are high (serum iron, % saturation, TIBC and ferritin, you may have the genetic hemochromatosis and you can ask your doctor for testing for that.

    PERCENT % SATURATION of IRON: Measures your serum iron divided by your TIBC. Women want to be close to 35% (or .35 for Canadian ranges), we have discovered, and men closer to 40-45%. Like all iron labs, you should be off all iron for at least 12 hours before testing to see how your supplementation is doing, or up to 5 days to see what your natural levels are. The latter may be best. NOTE: % Saturation can look falsely good or high if your TIBC is too low!!

    TIBC (Total iron binding capacity): measures whether a protein called transferrin, produced by the liver, is enough to carry iron in the blood. Used to determine anemia or low body iron. If your result is high in the range and in the absence of chronic disease, you may be anemic. With healthy amounts of iron, this test will be low in the range—about 1/4th above the bottom number in the range provided.

  • (Sorry I posted this twice as I'm not sure if you got my other message as it was a general post not to you specifically)

    Dear Heloise, Many thanks for your reply.

    I think I understand the excerpt (please make allowances for brain fog!) but I seem to be low in the TIBC (Iron Binding Capacity) - do you know what this means? In general do you think my iron looks o.k.? I am completely taking on board what you said about the blood sugar levels as I went to see the Functional Medicine company in London recommended by Thyroid UK and one of the things he mentioned was that I might be hypo or hyper glycemic (sorry can't remember which DUH!!!) so I am going to be tested for that.

    I really appreciate your advice!

    Best wishes

  • Hi Blue, your serum iron at 20 is good.  You always wonder if they are meaningful though as serum only means what is traveling around in the blood but getting into the cells is far more important. 

    If you divide the serum by the TIBC your saturation is 48% but I think that is a false high because your TIBC is low so you may be ok there.  Were you taking iron before the test?

    Your TIBC is low which they say is good but should be 1/4 above the lowest number which would be 52 I think, and you are 41. 

    Why is there no ferritin test?  This is your iron storage and as stated should be around 80.  It's very important for converting Levo into the active FT3. 

    There is another video by Dr. Clark at you tube for high TPO antibodies.  I think it is #7. 

  • Thanks Heloise for taking the time to reply. I was wondering about the ferritin also. I don't know why it wasn't checked. I am due to have another blood test in four weeks so I will make sure they check it. I am not taking iron supplements at the moment. Do you think I should be and, if so, which are best? Many, many thanks & all the best!

  • I'll be honest Bluemaxx. I'm torn between trying to replace all the shortcomings of the body or looking to find out WHY it has shortcomings.  Some of the shortfalls like iron may be due to the fact your stomach acid may be low.....too low to extract minerals from food.   This is a natural side effect of low metabolism.  So perhaps increasing stomach acid is the way to go.  The more I learn, I think I lean toward a more holistic view and healing from the inside out.  That's why I post the videos from functional medicine perspectives like this.

  • Hi Heloise,

    I'm new to all this but I think you are so right. I just bought Izabella Wentz's book "The Root Cause" to try and sort out my health. Re: the stomach acid, my doctors (an ENT specialist, then a Gastroenterologist) put me on Omeprezole before I figured out MYSELF that I had a thyroid problem and asked for the test. I have been to see the Functional Medical Team recommended by Thyroid UK in London and he couldn't believe it as my problem was LOW not high acid. Thank god I took myself off the Omeprezole last October. It is so frightening when you realise that you can't trust all doctors.

    Hope you're sorting out all your health problems. Thank God for this website!!!!

  • Good for you, Blue!!!  It is a jolt to discover that many bureaucratic systems have it wrong and are slow to change especially when profit is involved.   It's so rotten that the ultimate sacrifice is the health of innocent patients. 

    There is hope, though, that people like Ms. Wentz and Mr. Bergman generously offer their wisdom to the world.  I'm certain they will all recommend abolishing most "drugs" prescribed by doctors.   Keep educating yourself. 

    ps  I have to declare that lately I'm reading more about biofilms and how they are interfering with immunity and may be the root cause of chronic problems.  Let me know if Ms. Wentz mentions that.  fearlessparent.org/suppleme...

  • No, you're not converting terribly well. As a general rule, if you are converting correctly, your FT3 should be higher than your FT4 in their respective ranges. Your FT3 is a little lower than your FT4.

    Your B12 is a bit low - optimal is 1000. And you already know your vit D is insufficient. And you are positive for Hashi's. Low nutrients can affect conversion, and people with Hashi's often Don't convert terribly well.

    You're only on a starter dose of Levo, though. So, things might improve if your dose is increased and you optimise your B12 and your D. :) 

  • > "As a general rule, if you are converting correctly, your FT3 should be higher than your FT4 in their respective ranges."

    Is that right gg? That is the first time I have heard that. I find it very interesting as I have DIO2 polymorphism and believe I am therefore a poor converter and yet still struggling to have this recognised.

    In Jan this year my TSH was 0.08, my T4 was 21.5 (12 - 22) and yet my T3 was only 4.9. For me that is proof enough. Getting closer to self-medicating by the day!

  • Well, that's what I've always been told. But, I wouldn't expect an average GP to know that!

  • (Sorry I posted this twice as I'm not sure if you got my other message as it was a general post not to you specifically)

    Dear Greygoose, thank you so much for answering my question. I just wondered if I could ask you for further clarification. 

    My endo is very nice and he said that he could trial me on T3 if I like. I said that I would wait a month and see how I get on. Do you think I should just start straight away or wait to see how I feel once I have supplemented the B12 & D3? I told him that I had a real crash everyday after lunch. The man I went to see at the Functional Medicine company in London (sorry not sure what his professional title is) suggested that I could be hypo or hyper (sorry still learning!) glycemic but the doc said that I should try taking the levothyroxine in the morning instead of at night to see if that helped. I started that this morning. Funny thing about that Vitamin D3 though. Last night I took 3000 ugs and I feel a lot better today!

    I really appreciate your advice!

    Best wishes

  • If he's willing to give you T3, take it! Don't look a gift horse in the mouth! But you still need to get the D3 and B12 up to be able to use the T3, and for your general health.

    Typical grasping at straws from your GP, I'm afraid. But, whenever you take it, do make sure you leave 4 hours between your thyroid hormone and your vit D3. :)

  • Thank you Heloise & Greygoose for taking the trouble to answer my question! And, sorry to pester you both, but may I ask two more questions please?

    Heloise: I think I understand the excerpt (please make allowances for brain fog!) but I seem to be low in the TIBC (Iron Binding Capacity) - do you know what this means? In general do you think my iron looks o.k.? I am completely taking on board what you said about the blood sugar levels as I went to see the Functional Medicine company in London recommended by Thyroid UK and one of the things he mentioned was that I might be hypo or hyper glycemic (sorry can't remember which DUH!!!) so I am going to be tested for that.

    Greygoose: My endo is very nice and he said that he could trial me on T3 if I like. I said that I would wait a month and see how I get on. Do you think I should just start straight away or wait to see how I feel once I have supplemented the B12 & D3? I told him that I had a real crash everyday after lunch. The man I went to see at the Functional Medicine company in London (sorry not sure what his professional title is) suggested that I could be hypo or hyper (sorry still learning!) glycemic but the doc said that I should try taking the levothyroxine in the morning instead of at night to see if that helped. I started that this morning. Funny thing about that Vitamin D3 though. Last night I took 3000 ugs and I feel a lot better today!

    Once again - thank you both!!! I feel that I am finally getting somewhere with my health with the help of this website and getting good professional help.

You may also like...