T4 conversion query when medicating: Hi Sorry in... - Thyroid UK

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T4 conversion query when medicating



Sorry in advance if this is a daft question, I've taken on board quite a lot I feel


Can you tell me please if I will still be converting my own t4 to t3 whilst I'm medicating low dose of levo anf t3? Appreciate it depends on my thyroid state

The reason I plumbed to take t3 is that my t3 was in the lower third and my tsh was over 4 and mostly I felt lousy - but my t4 was relatively high in range before supplementing , so it would appear my conversion wasn't good even though I addressed gut. acid and vitamins , And to supplement more t4 was questionable as it was high in range

Why I ask is, if there is still some ok natural thyroid function, I understandably would like to keep this, and I feel not bad just topping up low with low t4 and t3, I even wondered if could just take tiny t3,?

the difference is remarkable as the horrid heavy eyes and tiredness no more, the panic and phobic side much better, no more muscle aches and fatigue and this is with this small supplementation

It seems to be good to be true that this tiny supplement (t3 at 18 and levo at 25) mg

Has made so much difference to me, has anyone else experienced this and as certain stresses are no longer in my life, I even wonder if there is chance of recovery

I'm confused re hashi, I've been told by endo and every blood test Barr one, that I don't have antibodies, I've done a few private ones too, on just one test the antibodies were just over range,

I feel this strange to see it just the once and so low in number, but there again I'm told I definitely have hashi if have had this result even once,

when I've seen others results I find it hard to think I've got much problem understandably

Thanks in advance

J 🦋

6 Replies

What were your results for TSH, FT4 and FT3 before you added T3 (include reference ranges).

What are your results now after being on T3 for ?? weeks?

The answer to your question about if you will still be converting T4 to T3 probably depends on your conversion before. In my experience, having some conversion but not good enough, when I was tweaking my meds and lowered Levo, then increased it again, but left T3 dose the same, I found that I did still have some natural conversion.

on just one test the antibodies were just over range

Then you have Hashi's, over range antibodies confirm this. The below range antibody results were just because antibodies were low at the time of the test. Antibodies fluctuate, sometimes they will be over range, sometimes not.

Jeppy in reply to SeasideSusie

...thank you , did you just know when you bit the right spot SS. and how many weeks on same dose to make the decision? Have you stayed good or had to vary doses again? Sorry for interview. Deep thinker.

SeasideSusieAdministrator in reply to Jeppy

I have other conditions to contend with so never actually feel well, so sometimes it's hard to know which is causing what symptoms.

I took it slowly with adding T3 and tweaking doses. I reached a pretty good place with good test results, but thought I might need a little less Levo. That was a mistake because I went downhill and my FT4 plummeted to almost bottom of range and my FT3 decreased as well although I kept T3 dose the same. I had to increase Levo back to what it was and it's been a long haul back. As my FT4 rose, so did my FT3 again not changing dose of T3, so I knew I still had some natural conversion. My thyroid results are now pretty much perfect for me, they are almost back to where I felt best when tweaking, and nutrient levels have been maintained at optimal levels for a long time apart from a hiccup with Ferritin level and that's almost back to optimal now.

I now know from experience that when my results are at a certain level then my thyroid is as good as it gets for me, and any symptoms I am experiencing are down to something unconnected.

It sounds like you have a milder version of hashi if your antibodies are not going much above range when they flare. Hopefully this means that it will be easier to find your sweet spot and maintain that level. As SS says you need to note the test results at which you feel your best. If your hashi does progress so that you get flares which alter your results markedly at least you will have a good idea of where you need to aim for. Those that have big swings find that they may need to dual back their medication slightly during the hyper part of the swing but only as long as it lasts which may only be a few weeks/couple of months.

Most Endo’s are diabetes specialists and have no understanding that antibodies fluctuate and tests along with them as a result. When a flare is occuring and dying cells dump their hormone they dont grasp that this is a temporary change that may just need a temporary adjustment to your meds with a retest in 2 months to see if things have settled again. If your antibodies do start to climb it is worth considering going gluten free ( has to be 100%). Gluten contains a protein called gliadin which is similar enough to proteins in the thyroid that it can stimulate antibodies, so many find that going 100% gluten free can lower antibodies and even out flares.

Thankyou so much for replies iv read mixed messages and i was hoping for what you explain naturally yes im back to gf as dif this ladt year but slipped back

You are all of you so kind and helpful xx

.....really frustrating at times and to know what to think vs what you may hope to happen even if beyond ecoectation as even the experts vary iv noticed eg Dr P and Skinner

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