Does anyone know if it is pssible to stimulate greater conversion by increasing muscle use eg by doing more walking? In other words, if you just sat around all day doing nothing, could this lead to less conversion of T4 to T3 and therefore feeling less well overall!
Maybe this is especially a question for diogenes???
Type-2 deiodinase is expressed in skeletal muscle but this does not seem to contribute much to circulating T3 levels ncbi.nlm.nih.gov/pmc/articl... . Although D2 contributes more to circulating T3 than D1 it is tissue dependant. For example, D2 activity can be upregulated by up to a factor of 50x in brown adipose tissue on cold exposure but this extra T3 does not find its way into the blood. If it did we would be very hyper when exposed to the cold! However, exercise raises mood and depression can lower TSH and reduce its bioactivity. So as exercise is good for you and may increase T3 just a touch so I would recommend moderate exercise.
That paper is interesting. I wonder if it only applies to people who have functioning thyroids, i.e. a more dynamic feedback process. If your thyroid isn't working and you only have a fixed amount of T4 and T3 - that which you took as a pill that morning - then maybe that muscular process doesn't work that way. I am particularly sensitive to my level of T3 and (as I mentioned above) I have to exercise to keep my blood pressure (BP) normal (since thyroid meds and statins interact) - and after riding my bike I do not feel exhilarated I feel wiped out. I used to take a T3 to boost my energy back up, which it did but it also knocked my BP back up - so now on exercise days I just watch TV in the evenings and often fall asleep lol.
I have a functioning thyroid but find I need to rest after exercise, although it gets a little better over time as fitness builds up. I think we lose the flexibility a fully functioning thyroid axis provides.
The interesting thing about my exercise is that long bike rides used to totally wipe me out, and I couldn't walk far without feeling exhausted. Since taking T3 (for 2.5 years), long cycle rides are easier, but I'm still a basket case in the evening.
However, the T3 has allowed me to build up my walking distances, and I can do about 6 miles now without feeling wiped out, in fact I now feel better if I fit a walk into my day. 8 miles recently was too much and the last 2 miles were a real drag.
Overall, though, since I've been building my walking distances - over the last 6 months - my resting heart rate has increased, and my first blood test since starting the walking was much higher than before, despite no increase in my T3 dose (and no thyroid gland).
It's a puzzle, and I'm just trying to work out how it works so that I can control it better. Taking the same amount of T4 every day never worked for me, but I was always under-medicated, so never went over-medicated. Now that I take T3, I'm closer to being optimally medicated, and therefore I can easily go a little over, or a little under.
Having now waded through the article, which is a tad complex for a non-scientist, I'm wondering if paragraph 7 gives us a clue to the fact that many of us are unable to convert enough T3 from T4 monotherapy.
In other words, if the D2 activity doesn't increase in hypothyroidism - at least in muscle tissue - then it is no wonder that the percentage of T4 that gets converted does not increase.
Also, for people like myself, with the Dio2 polymorphism, as well as no thyroid gland, aren't we always going to be well and truly "stuffed" on T4 monotherapy? It could certainly explain why I couldn't walk far before taking T3.
D2 activity didn't increase in muscle tissue, it does increase in other tissues because we know T3 levels are conserved in early stages of hypothyroidism when T4 is falling. The DIO2 polymorphism has minor psychological effects, the effect on T3 is so small you can't tell who has the polymorphism by looking at blood hormone levels. There has to be a different reason why you need T3.
Might it not explain at least why my biggest problem was walking more than a short distance?
I don't think it significantly changes conversion in the sense of changing your levels. But if you can do it, walking is very valuable in keeping your BMR good and general strength.
Thank you. It's all so complicated! I've been trying to build up the distance I can walk, over the last 6 months. I'm not back to pre-TT distances, but now that I've been on T3 for over two years, I seem able to do more. The puzzle is that my recent blood test showed a much higher FT3 level than I expected (given the amount I've been taking), so I'm trying to work out why.
Maybe my body is still recovering it's levels, and I could cut my dose of T3 again? I started on 25mcg, and after several months feeling that it was right, I became over-dosed, so I cut to 12.5mcg and that has been good for two years. I may now try 6.25mcg.
Do you leave 24 hours gap between last dose of T3 and the blood test? It is recommended that the test is as early as possible, fasting (you can drink water) and a gap of 24 hours between last dose etc. and take it after blood test.
Yes, I do all of that. The important point here is that without doing anything different, my level of FT3 has increased from about 4 to 7 (top of the range is 5.9). So I'm just trying to work out why, and the main difference in my lifestyle over the last 6 months is that I've been working hard to increase the distance that I can walk.
It's a puzzle, but the way I see it, the more I understand how everything works, the better able I shall be to mimic the way a thyroid gland would work.
One other thing is that about 3 years ago, I walked most of the way to the hospital for a blood test, since the roads were too snow-bound to drive. This resulted in the highest level of T3 I have ever seen while on T4 only (for at least 14 years). Instead of being bottom of the range or below range, it was about 5.8. Something seems to happen when I walk!!!!
Hi reallyfedup123. As I often read that people were improving on T3 alone, I switched from NDT to T3 and after taking some time to establish an optimum dose of 3 x 25mcg, feeling quite well.
Why is NDT a better option please?
NDT is more 'natural' than T3/T4 so therefore could be assimilated more successfully. You make a good point ie horses for courses 
Yes, I agree, I ride my bike for exercise (to keep blood pressure down) but on the days I do that I flake out completely about 4:00pm instead of my usual 9:00pm, the affect is very noticeable. I have no thyroid and I am on NDT, I never take my meds before 6:00am because I know my T3 will be used up too soon on a normal (non bike riding) day.
I get aching muscles most days but if I have a gentle walk they disappear for a while . I have not managed more than a mile since TT but I try a couple of times a day and that seems to help .
8or9 pm find me sleeping through TV progs though 🙃😙
Keep going Gcart, I had a TT, I went down to the depths of ill health on Levo having to lean on a supermarket cart to do my shopping, then recovered as far as bike riding (almost) every day. See if you can get some T3 from anywhere in the world (even maybe a prescription from your doc - or a different doc!). I flake out at 9pm too - but that's not too bad to put up with.
What about trying some qigong on youtube it is a good way to become more flexable and easier on the body than walking or the gym.
You could try this and build up your muscle gently also why not do some simple legs exercises at home just not too many it depletes the T3
I already do Qi Gong twice a week, and table tennis twice a week. Also, when the weather is ok I do long cycle rides on a sunday. It's walking that has been a problem since my thyroidectomy. I went from being able to do 10-15 miles with no problem, to struggling to do 2 or 3 miles.
Since taking T3 for two years, I decided it was time to build up my walking again. I'm up to 6 miles, and still working on it.
It's just my blood test result that is puzzling me, and I want to work out what has made the difference, as it's the first time in about 16 years that my result has been hard to explain as my T3 was over-range instead of low in the range.
I think that you are right regards high T3 when mine was high I was a lot better especially regarding keeping fit. Before my TT two years ago I had never been ill and took no medication I swam one mile every week did yoga and did lots of walking I was 69 years old and had been running until I was 66 years of age.
I now just sit about all day waiting I can't be bothered only do 20mins walk and go gong most morning . I am just a shadow now of my old self not vibrant just old. I really hope that you do well and don't forget to keep walking .
It's a frustrating business. Like you, I wasn't ill before my thyroid gland was removed, and I was very active. I consider it highly unethical of the NHS to remove thyroid glands, and then not replace what they have taken away ie T4 and T3.
I'm working up to writing a very strong letter to the CCG in my area highlighting this unethical behaviour, and the fact that doctors are forced to deliver medically negligent treatment because they are not allowed to prescribe T3. I shall then copy it to all and sundry!!!!
Good luck, and do try to exercise. One thing that I have found is that I feel much better when I do regular exercise. Sitting around makes me feel worse, so it's worth the effort. Cycling is good - you get to rest intermittently when you free-wheel, so it's easier than walking.
Thanks for your views of course I know about getting up and doing something but it's very hard. I have never like bikes even on the gym rather swim but here in France there are no pools around. Our house is for sale and I hope to return to swimming and my Yoga once again thanks for your encouragement good luck with your letter
It's related so I hope useful...but potentially irrelevant, so I apologise in advance if so. I suffered for many years with what I later understood to be exercise intolerance. It all began in the very early years of what I now know to be hashimotos. Fast forward 15 years when, still undiagnosed, I would sleep - crash out - after yoga, or 20 mins on the exercise bike or a spot of weights. This was extreme exercise intolerance and seemed to occur no matter what kind of exercise I did. Walking - which I do a lot of - included. T3 changed all of that. Not immediately and not always ( in the sense that I have days/ periods when I crash a lot) but I am virtually free of exercise intolerance and feel stronger than I have in years. I have an app on my phone and aim for 6km on a normal day and, in fact, routinely walk 8-10km.
For what it's worth, I have just, after nearly 2 years on T3, increased my dose by about 6mcg to around 93-95mcg. I have not reverted to a size 10 ( or 8 as I was at the onset of hashimotos) but remain a 14.
Anecdotal I know, but lack of T3 ( and T4) appeared to be linked to my inability to exercise, anaerobically and aerobically.
Yes, lack of T3 has always been my problem as well, where exercise is concerned. My current challenge, though, is working out why my level of FT3 has gone up so much higher than normal. I'm just trying to be better at controlling my levels, and keeping them at levels which don't have any negative effects.
Well, anaerobic viz aerobic does different things to the body, and there are a fair number of papers out there looking at hypo/hyper -thyroidism, treated or otherwise, and exercise (in)tolerance. You may need to accept that you cannot achieve physically what you used to. It is hard, very hard I think, for previously very active people to do less than they would like to do. I have just cancelled a trip back to the UK ( should be on my way to Wales right now) because I know very well that carrying a heavy laptop and trailing a suitcase plus the travelling (and walking!) will leave me shattered and recovery could be a week or more. I'm learning...
6 miles is around 10km I think, which equates to one of my ''quite a bit of walking'' days. And I feel the difference between 6km and 10km. But you also do Qi Gong and try to cycle, so are already achieving lots. I don't know how hard you bat that ball, but both this and table tennis might be anaerobic exercises? You might, on the other hand, be walking very quickly and trying to make it more of a run? I used to do this but realised I felt better slowing a little ( though still a reasonable pace.)
I would, personally, want to see a good number of over-range T3 results before I reduced my T3 dose. One ( ?)over-range result is interesting but should be seen again ( and even again) to warrant any changes to your regime?
Sorry rfup123 I only just saw your reply. I found it hard to split my dose because of the empty stomach then the hour before you eat. I can only do that once a day! Especially when the "empty stomach" part happens when you are asleep.
"Not everyone has to wait an hour before eating after taking their meds"
I do not understand what would allow one person to not wait whereas another person has to wait?
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