Hi I am new, I am planning to order the DI02 test since I have trouble converting T4 to T3. Is this a good test to do? Diagnosed hypothyroid in 2012. Thanks!
TSH 4.66 (0.2 - 4.2)
FT4 14.7 (12 - 22)
FT3 3.4 (3.1 - 6.8)
Taking 25mcg levo
Trouble converting T4 to T3: Hi I am new, I am... - Thyroid UK
Trouble converting T4 to T3
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Rosa18
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Rosa18,
You are undermedicated to have TSH 4.66. Ask your GP for a dose increase.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
You don't need to buy a DIO2 test. Poor conversion is demonstrated when TSH is low in range, FT4 high in range, and FT3 low in range.
That's happened before on 175mcg levo. Thanks
Rosa18,
Do you have the results and ranges for when you were on 175mcg?
When was dose reduced from 175mcg?
Was it GP or endo who reduced dose?
TSH 1.20 (0.2 - 4.2)
Free T4 19.3 (12 - 22)
Free T3 4.0 (3.1 - 6.8)
Reduced to 25mcg from 175mcg, endo reduced. Thanks
Rosa18,
Did endo say why?
I can see no reason whatsoever for reducing dose. TSH is in range, FT4 is in the upper range which is desirable but it's not even top of range, and FT3 is lowish in range.
Sorry that was before T3 was added. When T3 was taken away are below
TSH 4.01 (0.2 - 4.2)
Free T4 12.9 (12 - 22)
Free T3 4.1 (3.1 - 6.8)
Endo said it was of no benefit to me whatsoever.
Rosa18,
It would help if you would say what doses of Levothyroxine and T3 you were taking.
Before T3 added I was taking 175mcg levo When it was taken away 25mcg Levo
Rosa18,
How much T3 you were taking in addition to 25mcg Levothyroxine?
None
Rosa18,
You said: "Before T3 added I was taking 175mcg levo When it was taken away 25mcg Levo".
What dose T3 was added to what?
You aren't making any sense. You said you were taking 175 levo, then you said you were taking T3, but now you say you weren't taking T3.
Thank you when taking 175mcg levo I was shown to have poor conversion so endo recommended T3 would be ideal. I then had dose reduced to 75mcg levo when T3 was started. My current dose is 25mcg
Your dose of thyroid hormones of 25mcg is insufficient, 50mcg is a starting dose and every six weeks a 25mcg incremental dose is added until TSH is 1 or lower. Both FT4 and FT3 are low too no doubt due to your very low dose of 25mcg.
I'd get an increases before you think of a DIO2 test. You don't have sufficient hormones to relieve you of clinical symptoms.
I suggest getting your dose to 1 and your Frees may also increase. If you are taking a reasonable dose of levo and your Frees are still too low, then you can look at other factors.
(I am not medically qualified and had undiagnosed hypo.
thyroiduk.org.uk/tuk/about_...
That's happened before on 175mcg levo so was given T3. Thanks
I hope they reinstate your T3 again if they removed it from you prescription. but your TSH is too high.
No they don't intend to. They have discharged me with general anxiety. Thanks
I would not be surprised if everyone who had T3 withdrawn has 'general anxiety' and it has been caused by the medical profession's incapacity to understand how thyroid hormones work in the body.
You are far better to be discharged but I would see a professional person (lawyer) to remove the general anxiety from your records.
You can start off by sending to the person (I cannot call him/her Endocrinologst as they don't deserve the name) the following:
rcpe.ac.uk/sites/default/fi...
thyroiduk.org.uk/tuk/newspa...
thyroiduk.org.uk/tuk/newspa...
You can also advise them you are making an appointment to see your local MP as T3 was to be only removed on the patient's agreement.
The first link is by Dr Toft, who is an eminent Physician/endocrinologist and he is also Physician to the Queen when in Scotland.
Extract:
The unforeseen consequence is that guidelines have assumed a
clinical and legal importance far beyond that which was ever
intended by their protagonists. Although their consensus
recommendations are rightly qualified by the acknowledged
variability of the quality of evidence, it is the key statements
which are seized upon by the non-expert, and not the
reservations.
It is as if guidelines, like the tablets given to
Moses on Mount Sinai, have been carved in stone for a new
generation of doctors that seems duty-bound to follow each
edict slavishly. The impression is that young physicians have
ceased to think, ceased to challenge received wisdom and
ceased to recognise that patients come to the consultation
as individuals, expecting to benefit from the opinion of an
open-minded and experienced professional.
Simply because no two patients present in the same
manner, guidelines, by their very nature, are the antithesis
of the art of medicine. We cannot afford to underestimate
the level of frustration among patients, exasperated by the
‘one solution fi ts all’ philosophy. It was put to me recently
by a patient that, if governments wished to save money
from their healthcare budgets, they should invest in fl ocks
of African grey parrots, as these repetitive mimics could
easily replace the current breed of doctor in the consulting
room. She had a point
No such thing as general anxiety. Ask for a blood test that proves you have it. You have a blood test that proves you are undermedicated, so if they want to say you are not, they need to prove it scientifically.
Also had dose reduced from 175mcg levo to 25mcg based on
TSH 6.5 (0.2 - 4.2)
Free T4 13.1 (12 - 22)
Free T3 3.1 (3.1 - 6.8)
I think whoever decided to do so is in the wrong profession and should certainly not be treating/advising patients who end up very ill with lots of symptoms.
I think it's time you changed this doctor as your results for someone on 25mcg is awful.
You would be better looking after your own health as many have been forced to do on this forum and have succeeded.
A doctor who has a patient on 25mcg levo who has a TSH of 6.5 I doubt he has passed any exams.
You need to see a different GP. Those results mean you needed an increase. Make a complaint against the doctor who reduced your meds based on these results as s/he is a menace who needs retraining.
What were you taking when you had T3 and what were your results then?
Thank you, I was taking 10mcg T3 and 75mcg Levo.
TSH <0.02 (0.2 - 4.2)
FT4 20.5 (12 - 22)
FT3 5.2 (3.1 - 6.8)
Those result look quite decent. Both Free T4 and free T3 fairly high in range, although some people might want a slightly higher free T3 to feel well. it looks as though that dose suited you quite well. How did you feel? Looks like your doctor doesn't understand that TSH falls when a) we take t3 and b) when the pituitary senses thyroid hormones, whether produced by us or from tablets. You should be dosed on your free T3 and free T4 results not your TSH.
Do you think adding t3 helps with conversion.
T3 (liothyronine) is the ActiveThyroid Hormone and it doesn't need to convert. T4 (levothyroxine) is inactive and has to convert to T3 and it does seem to work for many people and I doubt they'd be on this forum looking for help/advice.
Our body needs T3 and we have millions of T3 receptor cells in our body, brain and heart have the most.
Quite a number of researchers have proven that some people who're hypothyroid need a T3/T4 combination.
If you are in the UK, doctors have been told they cannot prescribe T3 unless an Endocrinologist does and many wont due to the cost and the majority of the medical professionals also seem to believe that levothyroxine suits everyone - it certainly didn't suit me.
Do you realise you've put your post onto one that is three years old! Therefore you wont get responses/suggestions from other members.
So I suggest, you put up a brand new post for yourself and you will also get more advice from members and also regarding vitamins/minerals that you may require.
SlowDragonAmbassador
You need a new endocrinologist
This one is a sadist
You are now extremely under medicated
When T3 is stopped our vitamin levels crash right out
Ask your GP to test vitamin D, folate, ferritin and B12
Post results and ranges if you have then already
T3 removed, advice on how to get it back
healthunlocked.com/thyroidu...
Why T3 should not be stopped
healthunlocked.com/thyroidu...
Typical posts after T3 stopped
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Essential to get vitamins optimal before adding T3 back in
Presumably you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ask GP for coeliac blood test first
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
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 print it and highlight question 6 to show your doctor please email Dionne: tukadmin@thyroiduk.org
Prof Toft - article just published now saying T3 is likely essential for many
rcpe.ac.uk/sites/default/fi...
Thyroid UK are collecting evidence of malpractice due to removing clinically needed T3
Please consider sending a brief outline of this. How T3 improved you and the subsequent disaster since it was stopped. I would include the dire vitamin levels
thyroiduk.org.uk/tuk/get_in...
Scottish parliament debate on T3
Those results don't show conversion problems, they just show general undermedication - you don't have enough free T4 to convert to T3. It would be easier to tell when your TSH is under 1 and your free t4 is in the top quarter of the range. I wouldn't waste money on a DIO2 test until you are properly medicated on levo and your results actually show poor conversion.
Thanks, my results when on 175mcg levo showed poor conversion. That was what my endo said but have I been told wrong?
TSH 1.50 (0.2 - 4.2)
FT4 19.2 (12 - 22)
FT3 4.1 (3.1 - 6.8)
Have you looked at all the supplements that help t3 conversion - once this has kickstarted perhaps you can stabilise on a dose - upping the levo dose only works if you can use the extra efficiently - those who can’t get there on levo alone are left with sorting it out for themselves
You need to get away from this doctor. And get yourself some T3 somehow.
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