Looking for advice. After 9 years of feeling unwell and repeatedly visiting the doctor i was diagnosed April 2017 with hypothyroidism with bloods of TSH 4.38 range 0.3-3.94 Free T4 11.0 range 12.3-20.2 and was put on 75g thyroxin. I saw an endocrinologist in December as all symptoms remain and more blood tests showed THS 0.54 range 0.3-3.94 Free T4 19.8 range 12.3-20.2 and Free T3 4.3 range 3.7-6.7 with still very little improvement to my health. The endo suggested that it was a conversion problem but that T3 was not available on the nhs. I have spent the last year since diagnosis optimising my vitamin and mineral intake, have given up gluten and have a plant based diet. My blood tests have just come back TSH 1.05 so on the increase again, Free T3 4.8 so a slight rise, T4 21.2 so over optimum range. Am i correct in assuming that i am not converting? I plan to try and work further on the route cause of possible non conversion but i have a friend who is currently in Greece and has offered to buy me T3 which i feel i should take advantage of. Please could someone advice on brand names and dose for her to buy? I meant to say that despite my bloods looking good i am still suffering with all associated symptoms.
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sarah7o
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You are correct, you are not converting well. Good conversion takes place when FT4:FT3 ratio is between 3:1 and 4:1 and yours is 21.2/4.8 = 4.41 : 1
However, before considering taking T3 you need optimal vitamins and minerals so that thyroid hormone can work properly. Have you had the following tested
Vit D
B12
Folate
Ferritin
If so please post the results, if not you need them tested and optimal levels are
Vit D - 100-150nmol
B12 (serum) - minimum 500, best at top of range
Folate - at least half way through range
Ferritin - half way through the range
Your friend in Greece may find it difficult to buy T3 over the counter, Greek residents are now having to show their prescription and generally are only allowed one box at a time.
Thank you for your reply. It's very helpful to have a ratio guide and not something I'd heard of before. I do suppliment but don't have any up to date vitamin/mineral tests so I will get them done and post the results. Thank you for reference ranges - very helpful. I am trying to work on my conversion rather than take T3. I'm feeling particularly bad at the moment and a bit desperate. I think I'm being over medicated which is making me feel worse- would you agree based on my results?
I think I'm being over medicated which is making me feel worse- would you agree based on my results?
Yes and no.
TSH 1.05 (0.3-3.94)
Free T3 4.8 (3.7-6.7)
FT4 21.2 (12.3-20.2)
If you were overmedicated your TSH would be suppressed along with FT3 being over range. FT3 is the important result, if FT3 is in range you're not "overmedicated". However, with your results showing poor conversion, FT4 slightly over range and FT3 low in range, they suggest you need a little less Levo plus the addition of T3. But you need the vitamin and mineral tests so we can see where your levels are and if anything needs addressing there.
Thank you for your reply this is interesting. I am vegan. I suppliment all B vitamins, plus zinc, which I am low in, and magnesium but haven't had any up to date tests. I will get an up to date blood review and post.
Medichecks Thyroid or Blue Horizon Thyroid are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
I had the time and brain power today to read through all the links - thank you again. I am going to the doctors tomorrow with a list of bloods i would like done, and to ask for a trial on T3, it looks like it could be prescribed under our local CCG but i doubt they will say yes. I have also made an appointment to speak to my local MP - if i'm turned down by my GP any guidance on what to ask for/ specifically say? In one of the links you sent. Clear legal outline it states that any medication that appears on the drug tariff can be prescribed, How can i find out if T3 is on there - i tried the link posted in the letter but with no results. I would like to go in armed
Before starting any at3 your vitamin levels must be optimal. So essential to test these before even considering T3
Post results and ranges on new post when you have them
T3 is on the national drug tarrif. There was talk of removing it last November (entirely on grounds of cost) but they know we need it and it is to remain available, but only under secondary care (endocrinologist)
You need your endocrinologist to prescribe, he says you have clinical need. The initial 3 month trial must be initiated by endocrinologist. GP is not allowed to initiate
Assuming this goes well, then ongoing care and prescribing is then passed to GP
Obviously you might not test positive for having it, but if you do it can help in the argument for being prescribed.
I got my NHS trial without it, but then did DIO2 test during that 3 month trial. I tested positive- heterozygous (from one parent) it helped when I had to argue for continued NHS funding.
Research suggests 16% of patients on Levothyroxine have DIO variation
But currently in some CCG areas there is blanket ban regardless - eg Brighton
However Lord O'Shaughnessy did mention in recent House of Lords debate that DNA issues need taking into consideration and they are going to have to make T3 available to all areas of UK .....once they have dealt with getting price down. The current postcode lottery is unacceptable
In Kent one CCG area is offering DIO2 test on NHS and guarantee to prescribe T3 if test positive
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