I have had some results through and a letter from the NHS consultant to say that as my TSH is now 0.2 I am to stay on the same amount of T4 that I have been taking. However I am not allowed to have T3 anymore. The tests for Free T4 were 17.21 (12.00 - 22.00) T4 89.8 (59.00 - 154.00) Free T3 3.74 (3.10 - 6.80) Reverse T3 22 (10.00 - 24.00) and Reverse T3 ratio ll.07 (15.01 - 75.00). The TPAntibodies were 62.9 (0.00 - 34.00)
Do you think I should re start taking T3 , self medicating to bring myself back to being well as I was before it was withdrawn, and if so, should I drop the T4 down to say 100mcgs daily Am I right in thinking my problem is conversion which I think is called Hashmitos and also the Reverse T3 ratio, and would it have been the T3 that helped both these problems. I have felt so unwell since stopping the T3, and have so many of the classic symptoms. I would just like some advice before I start self medicating.
thank you for all your help and advice over this difficult time. Ann Simpson
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Ann-Simpson
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Ann - poor conversion doesn't cause Hashimoto's. Hashi's is an autoimmune thyroid disease caused by antibodies attacking the thyroid. Your Hashi's is confirmed by your over range TPO antibodies.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Also, supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed can help reduce antibodies.
Information about the gluten connection and Hashi's:
Thank you for your reply. I was on levo only the T3 was withdrawn last November. I was on 150 mcg levo and that has been reduced to 125mcgs . I understand about the antibodies but is the conversion a problem?and was the T3 helping that? I am intending to self medicate T3 but was wanting to check on this site that is the right thing to do. Thank you very much. Ann Simpson
Are the following tests private or done by consultant? I can't imagine NHS doing reverse T3. If private, what's the TSH?
FT4 17.21 (12.00 - 22.00)
TT4 89.8 (59.00 - 154.00)
FT3 3.74 (3.10 - 6.80)
Conversion ratio is 17.21 : 3.84 = 4.48 : 1
Good conversion takes place when FT4: FT3 ratio is 4:1 or less. Adding T3 doesn't help conversion, it gives you the T3 that your body is not managing to convert from T4. Once you add T3 to Levo, you can't work out how well you convert, there's no way of knowing if you add T3.
However, referring back to one of your earlier threads here
All your vitamins and minerals are low. Thyroid hormone can't work properly and conversion can't take place until they are optimal, particularly ferritin must be at least 70 and yours is 45.16. You need to address them all and suggestions were made for supplements and doses.
You should put the building blocks in place, have a firm foundation, see where your levels lie then and see how you are converting. Then you will know if you need to add T3.
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Reverse T3 22 (10.00 - 24.00)
Reverse T3 ratio ll.07 (15.01 - 75.00)
rT3 is in range albeit at the top end, ratio is low, some articles say it should be over 20.
Thank you. I was told by the nhs consultant that all the vital and
Minerals were within range. However on reading your previous post have been eating liver every week and going to get a B12supplement. I have a pretty gluten free diet as feel better like that. Are you thinking I should wait and try to improve by supplement? Thank you Ann Simpson
Yes, my opinion is that you should optimise all your vitamins and minerals first. No thyroid hormone can work properly unless they're optimal.
Even though your vitamins and minerals were within range, it's where in range that matters, and more importantly it's optimal levels that are needed for us hypos. I gave you the recommended levels in the other thread.
Doctors aren't taught nutrition so as far as they are concerned even if something is just one point above the bottom of range then everything is hunky dory. And what most GPs and many endos know about Hypothyroidism would leave room on a postage stamp! This is why so many people come here with a very similar tale - doctor tells them their results are fine and any symptoms they are experiencing are psychological or self inflicted. Even though nobody here is medically trained, their experience and research means that their collective knowledge far outweighs what most doctors know.
If you were symptom free before the letter from the 'consultant' - hawks into nearby spittoon - why would you take their advice? If you were well, and are able to self-medicate, why wouldn't you?
Have just sent you a text and then saw your reply to me. I was on 150mcgs levo and 20mcgs T3and was great. Then T3 removed and very unwell since but they will not let me have T3 since last November. Now on 125 mcgs Levo and am intending to self medicate with T3 but just wanted advice that it is the right thing to do. My confidence with all of this has gone. Thank you Ann Simpson
But if you can't face the battle and have access to self medicate, but there are currently supply issues as so many have had T3 withdrawn like you solely on grounds of cost, not clinical need.
But you probably now have low vitamins and will need to improve them first.
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further advice on blood results 
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Edited to show results in text: Blood results advice please
