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Thyroid UK
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Blood test results advice please!! Unable to convert T4 to T3!!

THYROID STIMULATING HORMONE *6.10 MIU/L (0.2 - 4.2)

FREE THYROXINE 14.3 PMOL/L (12 - 22)

TOTAL THYROXINE 93.5 NMOL/L (59 - 154)

FREE T3 4.2 PMOL/L (3.1 - 6.8)

THYROGLOBULIN ANTIBODY *>5000 IU/ML (0 - 115)

THYROID PEROXIDASE ANTIBODY *98.4 IU/ML (0 - 34)

VITAMIN B12 225 PG/L (190 - 900)

FOLATE *2.3 NG/L (2.5 - 19.5)

25 OH VITAMIN D *38.6 NMOL/L (50 - 200)

FERRITIN *12 NG/L (15 - 150)

I am just wondering why I have below symptoms on 150mcg Levothyroxine? I have T4 to T3 conversion problem. Diagnosed 2011 with hypothyroid:

Dry skin

Fatigue

Muscle cramps and pain

Losing hair

Rashes on face

Dry eyes

Hard stool

Flaky nails

Pins and needles

Heavy periods

Headaches

Brain fog

Memory loss

Tinnitus

Thanks

34 Replies
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Looks to me your converting t4 to t3 correctly but your totally undermedicated with a TSH at 6.10 still

No wonder you still have classic hypothyroid symptoms

Also ferritin , b12, folate and vit D3 all are way way too low ...they must all be at least halfway in their ranges

Are you gluten free ? Because maybe something is blocking absorption of vitamins ...or are you taking other meds or PPIs

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Thanks was on 175mcg levo previously which showed poor conversion

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No PPIs, not gluten free or taking other meds

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Suggest you try going gluten free for 3 months to see if that improves matters with absorption ...its so strange that your conversion is good on lower doses but bad on 175mcg

Was it a different make of levothyroxine when you were on 175mcg that could account for the problem too

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Same brand

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I agree with above, and you have hashis

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Agree with reallyfedup, your conversion is good, you're just under-medicated. :)

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Thanks was on 175mcg levo previously which showed poor conversion

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Well, you seem to have got over it. Now, you're just under-medicated. But, you do have Hashi's, which accounts for a lot.

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These aren't my current results

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Then why did you post them?

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I was confused about the antibodies, I didn't know what they meant

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Well, had you asked what they meant, people would have explained. It means that you have Hashimoto's Thyroiditis - aka Autoimmune thyroiditis. It's an autoimmune disease, where the immune system attacks the thyroid and slowly destroys it. Which means that your levels will jump up and down because the dying cells deposit their stock of hormone in the blood.

As you only mentioned conversion, people got stuck talking about that. :)

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Sorry brain is all muddled. Can I put recent results up please?

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Might be best to start a new thread, so that more people see them. :)

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And for my two penny worth....

looks to me like you’re not absorbing all that levothyroxine at anywhere near the 80% max! Maybe!?.....

You could try splitting the levo dose late pm early am ensure well away from food if not already

You could try taking some T3 either in desiccated thyroid or pure synthetic, that would quieten down your TSH without overloading you with t4. But remember tsh doesn’t just signal the thyroid to produce t4 it also signals intra cellular conversion of t4 to T3 so don’t suppress it?... TSH ranging from 1-4 over the 24 hr circadian rythyms is probably ok and normal.

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There’s a way to go before Kaytee1’s TSH is suppressed!

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Thanks was previously on 175mcg levo which showed poor conversion

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Thanks was previously on 175mcg levo which showed poor conversion

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T3 was taken away and my brain feels so messed up about what to do right now

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People with Hashi's sort of need their TSH suppressed. :)

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Why?

It could be just as likely that over medicating with t4 is a factor in the ‘I’m a poor converter issue’ ... ... aside from the possible benefit for a euthyroid amount of free t3 as a supplement for a primary hypothyroid patient, allowing TSH to go low is a logical culprit for reduced t4 - t3 conversion, along with overly high free T4, both factors Can have a negative feedback influence.....

The balance is super fine tuning in management of hashimotoes

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But she’s not over medicated

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The less stimulation there is to the gland, the less there is to the immune system to attack the gland.

Obviously over medicating with T4 is a factor in poor conversion, but just one factor out of many possible factors, as is low TSH - although her TSH isn't low in those results above, but they're not even her latest results, so I don't really know why we're discussing them.

We have to make a choice, do we want to keep the TSH in range so badly for the sake of a slightly improved conversion - because it's unlikely to be the TSH the sole factor in the poor conversion - or do we want to even out the misery of swinging between hypo and hyper by suppressing the TSH, and at the same time, slow down the destruction of our gland? Seems like an obvious choice to me. I'm all for adding in T3 and to hell with the TSH.

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You need to be properly optimised where the TSH is under 1 (0.25-0.5 ideally) and free T 4 and free T3 in the upper third of their range - your symptoms should abait and you should get better absorption of minerals vitamins etc although you may still need to supplement.

I felt dreadful with a TSH of 6 with Pretty much all of the symptoms you list except I was post menopausal.

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Nobody can know, especially from a distance, what someones balanced TSH ‘should’ be.... its a totally unique to the individual dynamic equilibrium with t3 and t4....

Where’s the solid evidence that a particular individual should have a tsh of way less than 1?.....

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Thats what the physician to the Queen when she is is Scotland says - he is well respected and called Anthony Toft you should read his statements they are very enlightening. We may not know what a persons optimal TSH is but as the median is between 1 and 2 and if you have hypothyrodism you loose the T3 you used to make then under 1 is recommended by Toft. It was exactly what my endocrinologist aimed for in my case and Guys & St Thomas’ is a well rgespected hospital

Are you suggesting 6 is normal? Where is your evidence to supporters rt - that you could try that joke Pearce who thinks a thyroid hormones is actually a narcotic drug

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I was on 175mcg levo previously which showed poor conversion

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So I need T3 back? On 175mcg levo

Aug 2015

TSH 1.23 (0.2 - 4.2)

FT4 19.3 (12 - 22)

FT3 3.6 (3.1 - 6.8)

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T3 taken away what do I do please thanks, my brain feels all messed up

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Either buy T3 from a safe supplier or order NDT

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Hi kaytee... I would say you definitely need all the vitamin supplementation ASAP to bring those up to scratch first as they are heavily involved for converting t4 to t3... it’s no wonder you’re not converting well?

Also removal of t3 so quickly can sometimes make ur body crash and vitamins too.

Get ur doctor to give u b12 injections, loading doses of vitamin D and start supplementing with folic acid also. You’ll never feel well whilst those vitamins are that low (I can personally attest to that too!) most of your symptoms could be linked to almost all of those

In the meantime they could hopefully up your thyroxine again as your 175mcg results showed normal free t4 range at least. May need to source t3 separately but def sort those vitamins out ASAP I would say

Good luck x

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Kaytee your ferritin, B12, vitamin D and folate are way too low which I feel would be causing a lot of your symptoms you listed. I would not be able to function if mine was as low as that. Low B12 gives me such a muddled brain I have to be over a 1000.

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On a side note, if constipation is still an issue, as a major issue for thyroid problems, try increasing the fat content of your diet. Decrease or cut out the bread, potatoes, sugar, rice, milk and yoghurt.

Oil such as good mayonnaise (no sugar), olive oil, butter, and especially coconut oil and coconut milk. Works well in coffee. Will have you trotting off to bathroom alright - enough fat in our diets helps reduce constipation

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