I recall someone sharing a post explaining the different possible reasons for poor conversion from T4 to T3. Unfortunately I can’t find it. Could you remind me plse.
Also is it normal for T3 to fluctuate ? Mine is 3.8 pmol/L (3.2-6.8) with T4 19.4 (12-22) and TSH 1.02 mU/L (0.27-4.2)
Previously it has been 4.7 in January and 5.3 in November. Earlier last year it was around 4.
Any ideas why this is happening. My Levothyroxine dose is 75/100mcg alternate days (was previously 100mcg 5days & 75mcg 2days)
My vit D was 115 mmol/L but other than that my folate (19.6 ug/L 4.6-18.7) ferritin (86 ug/L 15-300) & B12 936 (180-700 ng/L) were all good
I don’t have recent TPO results (205 in January)
I’m feeling weakness in legs & generally not very motivated or sprightly but I’m better overall than I was 4 months ago. So I’m totally confused.
Thanks for any advice
Polly
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Polly91
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Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working. Your vitamin levels are good.
Presumably you supplement some or all of these?
What supplements do you currently take?
Your FT3 is very low. You may well need the addition of small dose of T3
Email Dionne at Thyroid Uk for list of recommended thyroid specialists.
tukadmin@thyroiduk.org
But FIRST you might wish to try strictly gluten free diet
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
I’ve been following all the good advice on here eg gluten free for 7 months and dairy free for 5 months.
I’ve been trying to heal the gut and I supplement with B complex, Magnesium, vitamin C, fish liver oil , vitamin D, Co enzyme Q10 & occasionally selenium.
So I was thinking things would improve but lowering the dose of Levo just slightly seems to have made such a big difference.
Could it be that I’ve switched from 100mcg 5days/75mcg 2 days to alternate 75/100mcg.
Would suspect, that like many of us with Hashimoto's you will need the addition of small dose of T3
Otherwise you will need high FT4 and suppressed TSH in order to have high enough FT3
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
But many of us try this high FT4, without success. Instead finding slightly lower Levothyroxine dose plus T3 is best option
But you might want to try this FIRST
Looking to get FT3 over 5 as a minimum
Obviously due to current outrageous price of T3 charged by pharmaceutical companies to NHS, it's extremely difficult, but not impossible, to get NHS T3
Roughly where in the UK are you? There are some very pro T3 endocrinologist around
Private prescription enables access to cheap T3 from the EU
Shaws just posted a research paper from Dr. Lowe explaining the conversion process and the effect that enzymes had on the conversion from T4 to T3. Super research! He named the specific enzyme that helps with the conversion process. Don’t have that link but if you can find Shaws (administrator) then she just posted that within the last two or three days.
There’s a lot of controversy and push back on enzymes and their role that they play in the conversion process but Dr. Lowe has it spot on. I know it works from personal experience having great success with it for the last year or more. have been able to reduce the NDT dose by 2/3. Also believe selenium plays some role in this conversion process. Personally take both proteolytic enzyme‘s and digestive enzymes and selenium. Recently began taking a methylated selenium that is even better. (L-Se-methylselenocysteine) or SeMSC ( 200 mcg).
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