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[MotwCoop]

I’m looking to get a referral to an endocrinologist for ongoing symptoms despite TSH and T4 in normal reference ranges my T3 is at the bottom end. I want to discuss T3 with someone who has some understanding of the condition and issues. How do I find one that has an interest in hypothyroidism? I’m in East Yorkshire.

[Marz]

As you may know from following this Forum - seeing a consultant does not always mean you will receive the treatment you deserve.

In earlier posts of yours I read that Vitamin and Mineral Testing was mentioned - as the T4 you are taking will NOT convert in the body to the ACTIVE T3 unless the B12 - Folate - Ferritin - VitD are all optimal. Maybe that should be your first port of call

[MotwCoop in reply to Marz]

All my results are currently within normal ranges. Only T3 is at the bottom end. My GP is supportive so I’m certain I can get a referral, I’m interested whether there is a database of “good” consultants, who actually have an interest in thyroid disease?

[Marz in reply to MotwCoop]

Which results - the Thyroid ones or the Vitamins and Minerals ? Yes there is a list of Thyroid friendly Endos available from Louise Roberts - Admin.

Your normal results do not always mean OPTIMAL - sorry .... I noticed in another post you mentioned your Ferritin was 50 when SeasideSusie suggested 70 - so you also need results for B12 - VitD & Folate. Without being optimal you will have problems converting T4 into T3 ...

[MotwCoop in reply to Marz]

thanks Marz I’m happy that all my results, vitamins, minerals and TSH, T4 with the exception of T3 are now in range. I know they’re not optimal for me as I still feel terrible - that’s why I’m looking for recommendations for an endocrinologist. I don’t want to self medicate until I’ve seen one.

[Marz in reply to MotwCoop]

Are you still running - maybe that is using up your T3

[MotwCoop in reply to Marz]

Not so much, no mojo

[SlowDragon Administrator]

It's essential to have good levels of vitamin D, folate, ferritin and B12. Not just in range

Vitamin D around 100nmol

B12 towards top of range and folate at good level

Ferritin minimum of 70 or halfway in range.

What was latest TSH, FT4 and FT3 including ranges

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse 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 the articles from Thyroid UK email [e-mail]. print it and highlight question 6 to show your doctor.

Prof Toft - brilliant article just published

rcpe.ac.uk/sites/default/fi...

See Box 1. Some possible causes of persistent symptoms in euthyroid patients on L-T4

onlinelibrary.wiley.com/doi...

Email Thyroid UK for list of recommended thyroid specialists

[e-mail]

[MotwCoop in reply to SlowDragon]

Fab thanks

[silverfox7]

From one you had a conversion problem I found my vitamin levels had dropped! Levo was now failing in big time and I decided to go back to NDT but knew that wouldn't work if I had t got everything else in place. So increased my supplements andxitctook me 5 months to turn it around and get almost spot on so then went onto NDT with my Endo being happy to monitor me and I've been great. Very little problems and those because I've had other problems thrown at me like cancer treatment and very recently a plate in my arm following a nasty fall and operations tend to upset the apple cart a little. So I think you should get your Fab Four bits retested and post for comments. You may need to be increasing you doses of them a little. Trying different Thyroid meds won't work well without solving any deficiencies first. It can take time but well worth the effort.