Thyroid UK
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Test results - not converting well to T3?

Hi Everyone,

Just got my results back. Tsh 1.47 (0.27-4.20) free T4 21.58 ( 12-22) and freeT3 4.20 (3.1-

6.8) so T3 a bit low. What do you think about upping my dose a little ( currently on 150 mcg of levo) say to 150 and 175 on alternate days? Will my T4 go above range and does that matter? Ive been feeling v lethargic and full of inertia. Dont want to exercise and keep eating gluten when normally i avoid all together. Bit down in the dumps:(!

7 Replies

Conversion appears poor. I think increase in levo would push t4 above range. Would you consider t3? I get liothyronine from nhs, but you'd have to see an endo, and they are becoming reluctant to prescribe due to cost. Many who can't get it from NHS buy online.


Thanks for your reply, beh1. I have wondered about t3 and what it might do for me but hoped i wouldnt have to go down that route, especially with how difficult it is to get now. Also, it seems much more tricky to get the dose and timings right?


janiebell Good conversion takes place when FT4:FT3 ratio is 4:1 or less (according to member Diogenes who is an advisor to ThyroidUK). Your ratio is 5.13 : 1

My results would have looked like yours years ago, but with a GP who didn't know much about thyroid and me complaining more and more of symptoms, my Levo was increased and increased but I never got any better. The only thing I did get was a very suppressed TSH and a FT4 that reached 30 (11.8-24.6) at one point.

Now, years later and adrenals having been stressed, I learned what the problem was, took things into my own hands and added some T3 to a reduced amount of Levo. With some tweaking, my FT4 has come down and FT3 increased.

I think you should be considering adding some T3 at this point and, if necessary, reducing Levo a little.


Well your ft3 is only 30% through range whereas ft4 at top. A small amount of t3 meds could make a difference; I started on 5mcg and am now on 10. Many people take all t3 with the t4 dose, but yes you would have to try out to see what works for you. I understand that it's scary self dosing, so could you see an endo and ask him to monitor you?


Have you had your Vitamin D, B12, folate and ferritin tested? They all help in the conversion and help General health as well.


so long as ferritin,folate,b12 vit d3 are all at least halfway in their ranges then yes T3 is your best bet to sort matters

you might also need to consider NDT

are you taking any other medications inc oral contraceptives or are you using aluminium or non stick cookware or foil as all can mess up the thyroid


Thanks everyone for your replies. Really useful to remeber that in the past i have been really vigilant about vit d, folate, ferritin, etc and ive been very hit and miss over the last few months. I also had an extremely stressful two weeks before bloods were drawn and i see that stress can impair conversion. Ive decided to be strict about my diet, strict about my vit regime and i've also started taken an organic siberian ginseng tonic for stress. I will see where i end up but am certainly not ruling out trying to see if i can trial t3. I would love to give naturethroid a go but just cant afford it at the moment. Does anyone know if you can have t3 where mine is and be well? Does it always follow that if t3 isnt in top of range that you will be unwell?

Many thanks, jx


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