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Thyroid UK
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long time no post but wanted a bit of advice, after last time I got back to my usual 125ug T4 and a lot of my anxiety symptoms went, but still have a few left and I get very nervous when travelling more than a few hundred metres from the house and have a feeling of urgency, but a lot better than it was.

I'm currently working with my nutritionist on a methylation protocol and finally titrated up to dose and having my healing reactions (SAMe, ALCAR / ALA, B vits, Choline, AGPC). Before I started reducing my cortisol with PS and this protocol last year I was feeling quite good and my numbers were around: TSH 0.1, FT4 22, FT3 5.0. but my latest results (and the last set two months ago) show lower conversion and my FT3 is in the lower 4's. My ferritin has always been high, going to work on that next. I'm hoping conversion will bounce back after I've finished with everything I'm on right now.

So I'm thinking about going up to 137.5ug T4 and see if that can push my FT3 up to help with the last bit of anxiety does that sound a good thing to do?

Thanks, Steve

Latest Results 1/8/17

Vitamin B12 574 pg/ml 197 - 771

Folate (serum) 10.3 ug/L > 2.9

FERRITIN * 545 ug/L 30 - 400

C Reactive protein 0.8 mg/L <5.0

TOTAL THYROXINE(T4) 93 nmol/L 59 - 154


FREE THYROXINE * 22.9 pmol/l 12.0 - 22.0

FREE T3 4.2 pmol/L 3.1 - 6.8

Thyroglobulin Antibody * 243.4 IU/mL 0-115

Thyroid Peroxidase Antibodies * 115.3 IU/mL 0 - 34

14 Replies

No, probably not. Your FT4 is already just over range. If you increased T4 it might lead to increased RT3.

You have high antibodies, so Hashimoto's. Are you gluten free?

What about vitamin D levels?


I'm with you on that one SlowDragon

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Do you know why your ferritin is high? Are you supplementing? If not, have you had iron serum tests and liver function tests to rule out haemochromatosis and liver disease?



You can try the increase to see whether it helps as FT4 is only mildly raised. Some people do need higher FT4 to convert sufficient T3. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.



B12, folate and CRP are good.

Has an iron panel been done to rule out haemochromotosis (iron overload) raising ferritin? Ferritin can be raised when there is infection or inflammation but CRP rules out inflammation.

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Consider adding selenium to your lineup of permanent supplements as it helps to reduce the antibodies that inhibit conversion. And do seriously consider GF as already suggested.

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I agree with the others. Your ferritin is high due to inflammation. Gluten is probably causing the inflammation unless you can find another reason. Try cutting gluten for a week or two and if you see how much better you feel, it will give you the incentive to continue. Also, supplementing selenium is helpful for conversion. B12 is pretty low as well. You probably have high reverse T3 which has been mentioned. Dr. Eric Berg has informative videos on You Tube describing adrenal issues that are clear and understandable. Best wishes Steve!

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Thank you all for the replies - wasn't expecting such a quick response!

Diet - Yes I'm currently Gluten, Diary, most carb and nightshade free - just meat and veg for me most of the time, have been since December but hasn't really made much difference.

Vit D - My last Vit D test was 101 and I take 3000IU a day

Selenium - I have tried and gone through two bottles of liquid selenium (can then use it as a spray in my old vit D spray bottles) but it didn't seem to make any difference. I have a graph and both have been going down slowly by themselves over the last three years but still there I think the TPO was actually normal last test randomly. I am having quite a lot of mixed nuts including a few brazil nuts a day too.

B12 - I'm taking B complex that has cyanoB12, 125ug (2500% RDA!) and in the upper range so should be OK, am going to ask about activated version.

Ferritin - no supplementation and don't eat huge amounts of red meat been pretty much the same since my first measurement 3 years ago, had several regular iron panels and TBIC etc are normal just ferritin high - still haven't tried giving blood to see if it comes down. Last liver tests were all mid range (not been drinking much).

I have been told that the raised ferritin and antibodies could be underlying inflammation and biotoxins from my nutritionalist which we are going to look at in more detail after finishing with methylation, my last stool test said I had some Blastocytis so could be that.

I think Dr Berg is brilliant, he has some really easy to understand stuff especially on keto and intermittent fasting (I lost over 12Kg on IF)

My recent obsession has been Energy Metabolism masterclasses by Chris Masterjohn (who needs game of thrones!), lots of it doesn't sink in but really interesting knowing how cells work! youtube.com/channel/UCSJJM-...

I'll go up to 137 over the next few weeks and see how it goes, could add selenium back in too to see if that helps.

I monitor my waking temperature as well and normally around 36.15 which is a bit low.


Have you checked your selenium level? I would give you an idea how much selenium you need (and if you need additional supplements at all).

Also, you mention you are taking cyan B12- this is the cheap, synthetic form. The cyanide group is a poisonous and needs to be removed by the body by methylation. MethylB12 is the preferred form which exists in the nature.

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You may not be having enough carbs. This is bad for two reasons. Firstly we actually need a reasonable amount of carbs to achieve proper conversion. Two if the body perceives signs of starvation it stimulates the production of rT3 instead if T3 to reduce metabolism and save energy, you may be eating fewer calories than you realise. This is the complete opposite of what most of us want/need to achieve.

It is totally counterintuitive to me as I have been very low carb for years due to weight issues. I have found since diagnosis that having the equivalent carbs to a couple of slices if bread a day actually helps to stop weight gain and I feel better. I have found that for me at least, starchy foods work as well. I think it was GreyGoose that suggested this and after experimentation, to be fair, they were right.

I too need slightly over range FT4 but you need to be a little bit wary as too high again can encourage rT3 if the body perceives what it thinks is over production of hormone.

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Thanks for that - doing gluten free and low carb would tie in with when the conversion went down, I also lost around 6kg when I started but could be due to lowering of my sky high cortisol too as it's stabilised and going up very slowly now.

I do have some white rice, sweet pots, corn snacks & dark chocolate a few times a week think I measured around 100g carbs a day on average. I have been upping my calories and forcing myself to eat more as I wasn't even near 2000 calories and taking berry/coconut milk shakes every day to add a few hundred kcals. Sometimes I just don't feel that hungry though! I haven't measured my rT3 lately, it was 0.24 when I started 2 years ago.


I completely know where you are coming from with eating. I dont get hungry. I did an experiment which shows I dont get physically hungry until 20 hours after my last meal, even a small one. I now have to remind myself to eat as if I get busy or preoccupied I simply forget, this from someone who had issues finding the off switch.

As a lifelong sufferer with weight issues I hate having to eat when I am not hungry as for me that has always been a very dangerous habit to get into especially if we get me optimal (good GP) but needs must.

I try to go with smaller more calorie dense meals now and have a sandwich for lunch with a good seeded bread. A small handful of nuts is good for extra calories, good oils and if you buy the right ones, trace elements. Bear in mind the 2 slice level suits me but Im a 5Ft3 female so need less plus I dont have Hashi so can get away with some gluten 🎉

Ps depression, anxiety, paranoia and desire to be alone are all primary hypo symptoms for me and the first signs my thyroid levels need adjusting. It helps that I didnt have the first three at all prior knackered thyroid so a bit more obvious as symptoms for GP, especially as they disappear after a raise.

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Maybe try cognitive therapy for the anxiety symptoms..


Interesting reading on Magnesium. Helpful for anxiety and sleep, but also read up on taking the correct type as there are a few different ones:




Hello all, after increasing my dose a little it has bumped up the FT3 a bit but still feel really tired all the time, so going to try a bit higher to get it up further.

TOTAL THYROXINE(T4) 106 nmol/L 59 - 154


FREE THYROXINE * 24.4 pmol/l 12.0 - 22.0

FREE T3 4.3 pmol/L 3.1 - 6.8

Still really worried what is causing the decrease in conversion since lowering my cortisol as this should have had the opposite effect, I was converting about 25% T4 (looking at other people's test results this looks around average) but currently at about 18%. NT is suggesting spirulina to reduce inflammation, Glutathion 2.5ml to help detox and adding a new multivitamin with more active forms of vitamins and minerals. but he is not an MD and can't comment on the thyroid results.

Wonder if I should get at rT3 test as well? maybe it is one of those paradoxical things that I actually need to reduce T4 as a lot of it is going to rT3?

I do feel warm and clammy occasionally with noticeable heartbeat sometimes, heart rate is not particularly raised though. Exercise seems to help for a few hours.

Any other ideas?


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