T4 to T3 conversion troubles : Armor dose is... - Thyroid UK

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T4 to T3 conversion troubles

TrooperD profile image

Armor dose is 480mg for 2 years. Recent T4 test was double max range. Doc wants to decrease Armor 120mg. I have concerns about losing the T3 portion in that 120mg of Armor, as I still have mild hypo symptoms and was put on Armor because I don't convert T4 to T3 well. I requested a T3 only med to replace the T3 I'd be losing and would even like to bump up T3 further to see how I feel. Doc is being a PIA about it though. No T3 test done this time, as doc says she only test it initially (?)

Am I on the right track in my thinking?

Shouldn't T3 testing be a priority in cases like mine? Or, should I just go by the way I feel for correct dosage?

What does it take to just buy these meds on your own and order your own testing?

Not happy with dealing with Doctors!

50 Replies
SlowDragon profile image
SlowDragonAdministrator

Obviously it's essential to test FT3 and FT4 as well as TSH

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, or NDT make sure to take last dose 8-12 hours prior to test

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

TrooperD profile image
TrooperD in reply to SlowDragon

I'm in the states old boy. Thanks for the tips! My blood test orders always say 'no fasting' and it is generally taken in the afternoon, so your patient to patient tip is well taken!

So can't you just buy your own T3 from Mexico?

Are you serious?

Yes. Why not? If you are in the US, Mexico is the nearest place where you can get T3 easily. Of course, you could buy from anywhere that sells it.

Mexico is 1000 miles from where I live my friend. Canada would be a better option, but it's 500+ miles north. I'm still looking around.

Thanks

Not suggesting you actually go there - buy online - but only one border for goods to cross - I know you can get some things from Canada without a prescription but I don't think T3 is one of them. You can also buy from Turkey or Bulgaria.

I really would like more specific info from someone who is actually getting T3 from a specific source they can recommend from personal use experience. A specific company for instance.

Thanks for a list of countries, but that really isn't what I need.

Not allowed to mention companies on the forum only by PM

SlowDragon profile image
SlowDragonAdministrator in reply to TrooperD

You still need to organise FT3 and FT4 testing

Apparently it's more common in USA to test total T3

Better to get FT3 if you can

8 grains of Armour is a pretty high dose, so not surprising your FT4 was high. But, even so, that only gives you 72 mcg T3. And, if you're like me, you need a bit more than that. I'm taking 81.25 mcg at the moment. So, you're right, it would be a good idea to reduce the Armour and make up the difference with straight T3, plus a bit.

I would also add that it would be a mistake to reduce Armour by 2 grains in one go, without making up the difference with straight T3. Reductions in NDT should only be done at a rate of 1/4 grain every two weeks. And, if your doctor doesn't know that, she doesn't know much about thyroid!

So, if she agrees to you swopping two grains tow grains for some straight T3, the equivalent would be in the region of 40 mcg. But, difficult to know exactly because we don't know how much of that T4 you were actually converting. So, might be better to make it a bit less, and then work up from there. How does that sound? :)

TrooperD profile image
TrooperD in reply to greygoose

From what you wrote it looks like I was on the right track. Frustrating that

my doc doesn't get it! She did finally agree to prescribe additional T3 only and I'll push for 40mcg.

I pushed her for all the Armor I was getting, as the lower dosage wasn't working and it freaked her out giving me that much. My T4 test put her over the edge. She should have just prescribed additional T3 vs more Armor back then IMO. I just discovered you can get T3 separate, so I was a little upset she wasn't using it for me!

These hormones don't have much effect on me for some reason. I was over 300lbs, now at 275, so that may be part of it.

Thank for the help!

greygoose profile image
greygoose in reply to TrooperD

You probably have thyroid hormone resistance. Like me. I was taking 225 mcg at one point, when I first went T3 only. And I didn't feel a thing! Thought I was still hypo. Don't need as much now, but still more than the average.

I'm afraid it's very rare to find a doctor that knows anything about thyroid. They just don't learn much about it at med school. And, as they're taught that thyroid problems are easy to treat and not very serious, anyway, they don't take enough interest to find out more. And, they don't listen to their patients, because they are taught that all patients are idiots and liars, and exaggerate their symptoms. In fact, they don't even learn what the symptoms are! It's a sad state of affairs.

TrooperD profile image
TrooperD in reply to greygoose

In my research I also found that bodybuilders and weight loss people use T3 just to cut fat! Now the doctors get suspicious when you ask about it! Makes it harder on us that really need it to get it!

225mcg is a huge dose, isn't it? I think that would give a normal person a heart attack!

Don't know why doctors are afraid of T3. If you get too much it seems like you have to reduce because you would feel so bad! Somewhat self regulating in that regard. My girl couldn't even tolerate going from Synthroid to Armor because of the added T3! Her heart got all fluttery!

The last two days i cut out 120mg of Armor (as the doc asked) and I feel about the same. I do a pretty hard workout on an elliptical and did fine this morning. Maybe the very high T4 I had was converting to rT3 and blocking T3, so the blocking effect was greater than, or equal to, the T3 I lost by taking one less Armor.

Is that possible? I read somewhere too much T4 can turn into rT3 and block T3 to some degree.

Thanks again for the help!

greygoose profile image
greygoose in reply to TrooperD

Yes, that's true about the body-builders. They're spoiling it for everyone, and they're playing a dangerous game!

225 mcg is a huge dose, yes. But, I have heard of people that take even more than that, and are still hypo.

Doctors are terrified of T3 because they don't learn about it in med school, and they are totally out of their depth. It scares them.

Two days isn't really long enough for you to feel the effects of cutting the NDT. It will catch up with you later. T4 has a half-life of 7 days. T3 only 24 hours, but what gets into the cells stays there for about three days. So, you aren't feeling any lose, yet.

RT3 does not block T3 receptors. That was the old thinking, but present research has shown that it has its own receptors. So, no, that's not possible. :)

Too much T4 does convert to more rT3 than T3, so the level of FT3 drops. But, it's not the rT3 that causes it to drop. rT3 is the result, not the cause of anything. It is inert.

TrooperD profile image
TrooperD in reply to greygoose

So, I can expect to start feeling like crap in a few days, without adding T3 back in. Well, I have to get on my doc or find some myself. Probably some dude pedaling it to bodybuilders out of his van downtown! 🤣

greygoose profile image
greygoose in reply to TrooperD

Heavens! No need to go that far! You can get it from Mexico, I believe. You're in the US, right? Well, I have no idea what you can and can't get in the US, but we have plenty of US citizens on here, I believe, who buy their own T3 on-line. Post a new question asking the people who know to PM you links to their trusted sites. :)

TrooperD profile image
TrooperD in reply to greygoose

That was a joke about the van my friend... Mexico is 1000 miles from me, but I'm sure T3 is available around me somewhere. I'll post that question you suggested and see what comes up. My doc probably won't prescribe me all that i need so I need to get ready for that

You are a fountain of knowledge and I appreciate the help!

greygoose profile image
greygoose in reply to TrooperD

And you're very welcome. :)

in reply to greygoose

ah, just googled it: en.wikipedia.org/wiki/Thyro...

TrooperD profile image
TrooperD in reply to greygoose

I have to say my health problems are very minor compared to most folks that post on here.

Since I was put on Armor several years ago i feel pretty good, so the T3 seems to work for me. I just don't like my doc messing around with me because a number looks bad on my test and not thinking through how a change in my meds will effect how I'm going to feel as a result.

Hopefully, she'll get me the T3 I need. Cytomel is listed as being covered by my insurance. Four 5mcg tabs should be about right to replace the 18mcg I lost by reducing Armor 120mg, from my math. I sent her an email spelling it all out today.

Does my math look right to you?

Thanks

greygoose profile image
greygoose in reply to TrooperD

It will cover the direct T3 lost due to the reduction in Armour. But what about the amount of T3 you got from the conversion of T4 to T3? You cannot calculate that. You just have to make a guess.

TrooperD profile image
TrooperD in reply to greygoose

I don't convert very well, so I was guessing the 25% reduction in T4 wouldn't matter very much. I didn't see the result, but she said my T4 was double what it should be. I'll just have to see how I feel on 20mcg of T3 plus, 360mg of Armor.

greygoose profile image
greygoose in reply to TrooperD

Yes, that's all you can do. But, in future, you really ought to get the numbers: results and ranges. Doctors tend to exaggerate, or play down, results to suit their purpose, knowing that you can't contradict them because you don't know the actual numbers.

TrooperD profile image
TrooperD in reply to greygoose

I was just reading that hypothyroid increases your chance of acquiring a frozen shoulder. And what do you know, my right shoulder has been frozen for 3 or 4 years.

Muscle weakness was another symptom. Well, before I got put on Armor I had severe muscle spasms in my low back. They were severe enough to put me in the ER twice, as I couldn't really move. Fireman and ambulance guys had to lift me off the floor onto the gurnee.

Dealing with my low back no doctor could figure it out. Some would just poke me in the belly and tell me to lose weight. I've always been pretty athletic, so that never set well with me. I'm sure that isn't pleasant for anyone though. One doc got pretty upset I wasn't losing weight. I also got an MRI and went to a neurosurgeon and he told me there was nothing wrong with my back.

Physical therapy helped somewhat, but spasms continued until I switched from Synthroid to Armor.

My theory on why T3 made my lower back better.

Lower back muscle problems are often caused by weak glutes. My lack of T3 caused further weakening of my already weak gluteus medius. This additional weakness caused my severe lower back problems.

Doctors just gave me muscle relaxers and pain pills, without much effort in finding the root cause.

That's my story

greygoose profile image
greygoose in reply to TrooperD

Doctors very rarely look for the root cause. They just want to prescribe drugs - that's what they're trained to do!

I've never had a frozen shoulder, but my terrible back spasms did lead, indirectly, to me getting diagnosed, as did my excess pounds! Long and painful story! So, yes, I know all about this stupid idea that if you'd only be a good boy/girl and lose weight, all would be well! Idiots.

TrooperD profile image
TrooperD in reply to greygoose

So you had back spasms too! Wow! Little things like losing all the hair on my legs and under my arms would seem to be indicators to the doctors my thyroid was screwy, but they never look or ask.

My back is starting to twinge again because my doctor reduced my dose. Embarrased to say I'm constipated too. I think I'll just keep taking that additional pill until the doc gets me some T3 to replace what I'm losing.

TrooperD profile image
TrooperD in reply to TrooperD

So, I just took 2 more Armor in order to help get back some of the T3 I lost over the last 5 days.

We'll see if I get heart palpitations from that. I seriously doubt it!

greygoose profile image
greygoose in reply to TrooperD

Oh, yes. And, I saw a lot of doctors about those back twinges! But none of them made the connection with thyroid - I wasn't diagnosed at that point. But, even if I had been, I bet they wouldn't have made the connection!

Yes, lost all body hair, too, and half my eyebrows, and a lot more than half of what was on my head! Long before I knew what a thyroid was, I went to a GP and said: I'm very tired for no reason; I've put on a lot of weight although I haven't changed my diet, don't eat much; I'm losing my hair. He told me to leave my car in the garage and get on my bike! Yes, sure, riding a bike is sure to make my hair grow! They just don't have a clue!

TrooperD profile image
TrooperD in reply to greygoose

It's a pisser for sure. I took the extra two Armor this morning out of spite!

While waiting to eat after taking the Armor I did my elliptical workout and got 5 extra minutes in easy! I don't know if it the extra T3, or if I was just pissed off about my doctor!

No ill effects from that 36mcg of additional T3 yet! 👍

greygoose profile image
greygoose in reply to TrooperD

I doubt it was the extra T3. It has hardly had time to be taken up by the cells, and was probably still in your stomach! :)

TrooperD profile image
TrooperD in reply to greygoose

It would sure be nice to grow some hair on my head back! Kinda nice not to have leg or under arm hair.

Although with all the skin tags I have maybe hair would be better. I've been asked if I shave my legs, which as embarrassing, since I'm a dude!

BTW, I was reading that excessive skin tags can be a sign of early insulin resistance and other things. Have you heard of excessive skin tags being related to thyroid?

greygoose profile image
greygoose in reply to TrooperD

Lots of athletic dudes shave their legs! It reduces wind resistance. All the top cyclists in France shave their legs - and some of them shave everywhere!

For the skin tags, try apple cider vinegar. Dab it on frequently throughout the day, when you can. If they are large enough, try tying a piece of cotton round them, and pulling it tight. Leave until they drop off. I had one that was so resistant that I had you use both the cotton and the ACV! I think they are related to thyroid, yes, but can't remember where I read that.

Oh, and you could try high doses of vit C and magnesium for the constipation! Works wonders. :)

TrooperD profile image
TrooperD in reply to greygoose

Thank for the tips! I'll use them.

Got my added T3 Rx today @ 20mcg/ day. Puts me at 74mcg/day with what's in the 360mg of Armor I'm taking now.

greygoose profile image
greygoose in reply to TrooperD

Good. Let us know how it goes. :)

OzoneGirl profile image
OzoneGirl in reply to TrooperD

Magnesium will help with muscle spasm, most people with thyroid problems are low, & in fact most people everywhere are usually low!

Fascinated to hear that hypothyroidism causes frozen shoulder - I have just developed that ! Can you tell me where you read that please?

in reply to greygoose

greygoose, what is thyroid hormone resistance? How does one know if that is an issue?

greygoose profile image
greygoose in reply to

It means that the thyroid hormone is not getting into the cells. One can't know with any certainty because there are no tests to tell you how much gets into the cells. But, if you have good levels of FT3 in your blood, but still have hypo symptoms, then you can assume that you do have it.

in reply to greygoose

So quite different to the wiki article? Which I put in the wrong part of this thread...

greygoose profile image
greygoose in reply to

No, that's not the condition I was talking about. :) It's a question of vocabulary. There are some things people just can't seem to make their minds up what to call! But, I was talking about the condition where the thyroid hormone can't get into the cells, for some reason.

in reply to greygoose

The reason that I'm asking, is that "resistance" or "intolerance" is a reason for prescribing T3 (where I live) at a discounted rate. If one does not have documented resistance or intolerance, then one has to pay the full amount. Which is still a lot less than in the UK, it must be said. (I'm going from memory here, but I think those are the two terms used.)

I suspect that the wiki definition is the one used here.

greygoose profile image
greygoose in reply to

I've just reread the wiki definition, I didn't read it very thoroughly this morning as I was in a hurry. And, I have to say, I don't really understand what they're talking about! They appear to be confusing two different syndromes. I honestly can't make it out. If anyone can enlighten me, I'd be eternally grateful! lol helvella?

in reply to greygoose

Short version - rare, elevated thyroid hormones without suppressed/low TSH.

Wiki isn't always perfect, but interestingly a study found it to be just as accurate as Encyclopedia Britannica!

Oops, edited to also also tag helvella.

greygoose profile image
greygoose in reply to

Yes, I got that bit. But, then they went on to say that although people appeared to be euthyroid according to their blood tests, they still had hypo symptoms because the hormone wasn't getting into the cells. Which appears to me, in my innocence, to be a totally different problem. The pituitary only goes by what is in the blood, so I don't see how the two problems fit together.

in reply to greygoose

I also know that there is some thought that just because the pituitary thinks it has enough, that the cells might not be getting enough.

greygoose profile image
greygoose in reply to

Oh, most definitely. The pituitary only reacts to what's in the blood.

wellness1 profile image
wellness1 in reply to greygoose

If one sees an improvement in hypo systems on thyroid hormone replacement, even if symptoms eventually return and FT3 serum levels are good, would that rule out thyroid hormone resistance?

greygoose profile image
greygoose in reply to wellness1

Possibly, yes. If the symptoms return, it probably just means that you need an increase in dose. But, if you have to keep increasing until the FT3 goes over-range, then possibly there is some degree of hormone resistance.

wellness1 profile image
wellness1 in reply to greygoose

Thank you, greygoose. :)

greygoose profile image
greygoose in reply to wellness1

You're welcome. :)

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