DIO2 AA- does this mean I don’t convert? If so reduce T4 & add more T3?

[Piggyoink]

Good morning lovely humans After threatening to sue my GP and taking a ton of great info from here plus the advice of doing a genetic test, I’ve finally been put in a trial of T3/T4. I was getting very sick on thyroxine so stopped it for many months and was until recently taking 3 capsules of metavive II daily which made me feel so much better but I was still not quite ‘there.’

I’ve now been taking 50mcg thyroxine and 10mcg T3 daily ( instead of the 25/5 dose I was asked to initially!) I’m struggling with tiredness and abit I’d brain fog and I was wondering what ( If anything) I should increase. Pulse and temperature are around 60 and 36.0 respectively which I think i could definitely increase, however I’m worried that the thyroxine may be pooling again ( if I can’t convert.) But also concerned that if I just increase T3 the ratio (and I know we are all different,) wont be better, so not sure what would be best?

I’m taking daily vit C, D, Zinc, B12, magnesium and liver supplements as guided by my nutritionist in order to support the synthetics.

Any help/ suggestions would be so welcomed. Thank you in advance again🙏🏾💜

[shaws Administrator]

This is an explanation:-

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

[Piggyoink in reply to shaws]

Ahhh... thank you... so if I also have conversion issues ( as per endo and nutritionist advice) is this a separate thing? And so my question still stands... should I reduce Levo and up T3 or just test with more T3 first? Sorry I’m clearly foggy today 😭🙏🏾

[SlowDragon Administrator]

Having DIO2 gene doesn't mean we don't convert, it just means our brains can't convert FT4 to FT3 so we seem to benefit from a SMALL dose of T3 added to Levothyroxine

Essential for vitamin levels to be optimal too

When were vitamin D, folate, ferritin and B12 last tested?

Add results and ranges if you have them

Do you have Hashimoto's? Diagnosed by high thyroid antibodies

If so are you on strictly gluten free diet?

Clearly 50mcg Levothyroxine and 2 x 5mcg T3 is small dose over all.

What time gap do you leave between first 5mcg dose and second? 8-12 hours?

You really need to wait 6-8 weeks before retesting TSH, FT4 and FT3

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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, make sure to take last dose 8-12 hours prior to test

Is this how you do your tests?

[Piggyoink in reply to SlowDragon]

Hi SlowDragon thank you so much for your time and advice. To answers your questions:

I’m totally gluten free and have been for over a year. I don’t have Hashis, I take all Levo and T3 together on an empty stomach when I wake up and don’t have anything to eat or drink for at least an hour after. I also follow the guidelines here for testing.

My last bloods were two months ago and were not ideal considering I take vitamins and supplements every day as directed by my nutritionist:

Vit D 84nmol ( 50-200) I’m taking a daily supplement and have done for over a year but clearly not working

Serum ferritin 71ug/L ( 12-300)

Serum folate 9.8ug/L (3.0- 17.0)

B12 “this service not currently available due to reagent shortage” ( ie costs! Ha)

I also take liver supplements, magnesium and curcumin every day.

I’m just so tired... more so that when I was on 3 capsules of Metavive II. Do you think I should add a later dose of 5mcg T3?

Thanks so much 💜🙏🏾

[SlowDragon Administrator in reply to Piggyoink]

Well many of us find taking T3 has to be in split dose, especially with DIO2 - the brain needs small steady supply

T3 is short acting. It's largely gone in 12 hours

If you are taking T3 as one 10mcg dose, suggest you try splitting it as 2 x 5mcg - one when waking. The second about 5pm

Personally I can only take it as 3 doses per day - 8 hour gap (7am, 3pm and 11pm)

You will have to wait to get bloods retested before considering adding another 5mcg dose of T3. Or You may well need increase in Levothyroxine first if FT4 is very low (likely)

Many of us need good levels of FT4 and FT3

Vitamin D - how much are you supplementing?

Is it a tablet?

Many of us find vitamin D mouth spray by Better You is more effective as avoids poor gut function

Common to need high dose to increase levels.

Which vitamin B complex do you take?

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect blood test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...