katbar You don't seem to be converting T4 to T3 very well. Assuming that you are taking Levo only, reducing your Levo dose slightly and adding in some T3 would help.
I am taking Levo only, I have been struggling for some time, I saw a nurse last time and she says she has trained in Thyroid and I dont need any T3 and they would be able to tell from other symptoms if I needed it, I have booked a Drs app today, as he has already declared it is normal I dont hold out much hope, but will ask to try some T3. Anyone on here getting T3 through their Drs. Thanks for help.
Well katbar , the nurse is talking rubbish. If this is a nurse at the surgery then she won't be a thyroid expert. Most endocrinologists aren't even thyroid experts, they specialise in diabetes and don't know very much about thyroid.
Does the nurse know more than Dr AnthonyToft, leading endocrinologist and past president of The British Thyroid Association, who wrote the following in Pulse Online Magazine:
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of this article by emailing louise.roberts@thyroiduk.org.uk and highlight question 6 to show your doctor (and the nurse!)
Your results give the correct information.
You can see that FT4 is at the top of the range and FT3 is 45% through it's range. Good conversion takes place when FT4: FT3 ratio is 4:1 or less (even 3:1) according to member Diogenes who is an advisor to ThyroidUK.
Your ratio is 21.7 : 4.8 = 4.52 : 1
So if you are still symptomatic then your FT3 needs to improve and adding T3 will do this.
It's possible that, like many of us hypo patients, your nutrients aren't at optimal levels (not just in range, but optimal), we need optimal levels for thyroid hormone to work properly. If you've not had the following tested then ask for them to be done or do them privately (we can point you in the right direction for private fingerprick tests). If you have had them tested please post the results with reference ranges for comment:
Vit D
B12
Folate
Ferritin
Getting a doctor to prescribe T3 is pretty much impossible at the moment, most CCGs are refusing because of the extortionate cost. A lot of us self source T3 to add to our Levo.
I am still being prescribed T3,I have been on it for 15 years,I had to trial Levo only for a few months to prove that I need it.
Your doctor is unlikely to prescribe it off their own back, you will probably need to ask to see an Endochrinologist as they seem to be the only ones allowed to prescribe it as far as I am aware.
You really need T3. My endocrinologist is a friend I’ve known since high school. He didn’t want to give it to me, but my baseline levels are:
FT4 1.6
FT3 1.2
TSH 0.3-0.6 (very low but my feedback mechanism is obviously not working well), and on Synthroid 150mcg, my T4 was through the roof, but my T3 had little improvement. Hence, conversion issue. I have to get T3 on my own, you can PM me if you want. Best of luck to you!
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