Please can someone explain the things that can cause conversion problems.
Would a deficiency of vitamin D cause a problem with the conversion?
My mum has changed the time she takes her thyroxine now to an hour before food and we thought this would have made a difference to her levels.
She used to take 75mg, her levels were not right so she was moved to a dose of 50mg & then to 25mg. She had more symptoms and GP was moving dose up & down & nothing would level it. We are now under an endocrinologist who has put her back on 75mg & she feels much better in herself. The consultant has taken full bloods & stool sample. TSH & T4 are still high even after adjusting the time it is taken.
Mum was on this dose for over 30 years with no problem until a statin was introduced. She takes thyroxine in the morning & statin at night now. She is also taken probiotics and a tablet called t4 convert by Nutri advanced.
She had full bloods done including T3 & was told selenium & magnesium was low. Also a parasite wad found in her stool sample so an antibiotic prescribed hence the probiotics.
Levels are a little better after changing the time taken & introducing T4 convert but still high T4 & TSH.
There was a mention of taking T3 but he has decided to keep her on 75mg for another 5 weeks and check full bloods again in 3 weeks. Mum has atrial fibrillation so mentioned speaking to a cardiologist before introducing T3. She also takes warfarin, sotalol & an antacid for an oesophogus problem.
What can we do to improve conversion of t4 to t3 without introducing a t3 tablet? Odd it has been fine for the last 30 odd years and now doesn't seem to be happening.
Thank you.
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Lynny66
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Do you have the actual numbers: ranges and results? Because just saying 'high' and 'low' tells us nothing.
Is she still taking the statin? If her cholesterol is high, it's more than likely because her T3 is low. And she shouldn't be taking a statin. High cholesterol is not a problem in itself, it's a symptom of low thyroid.
Low nutrients can affect conversion, it's true, so they should be optimised. But there can be so many possible reasons for poor conversion. Low calorie diets, high/low cortisol, long-term beta blocker use, infections/injuries, etc. etc. etc. Sometimes you can never find the cause, so T3 is necessary.
You say her FT4 is high, so how long a gap does she leave between her last dose of levo and the blood draw?
As mentioned she should ask for a copy of her blood test results along with the reference intervals.
As her problems coincided with the introduction of statins it might be an idea to ask if she can stop the statin for a few weeks and measure her TSH, fT3, fT4 to see if they have substantially changed. I don't know of any study showing statins affect T4 to T3 conversion but I suspect nobody has ever looked.
Low selenium definitely can affect deiodinase (T4 -> T3 conversion) so it makes sense to get her levels up. This presents with high T4, high TSH and low T3 levels. It's probably not the problem but an easy, cheap and safe fix to try. There's some studies that suggest low vitamin D might cause problems especially if there is diabetes also. Many patients have low vitamin D levels but when they get them up I don't see their fT3 changing. I would just use cheap supplements, I doubt the Nutri stuff is any better - it hasn't done the trick so far.
I would get her vitamin D and selenium levels up. If that doesn't do the trick I would ask if they can try stopping the statin for a while or least trying a different one.
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
I would suggest getting a DIO2 gene test. This will let you know if she has a gene conversion issue. You can get in done via Regenerus Laboratories. Just google them.
I agree with Greygoose. My cholesterol was high but it was due to low T3 I also had low cortisol. Once I started on T3 my cholesterol lowered and my cortisol improved significantly.
The gene test is a good place to find out why your T3 is low. It’s all private and if it’s not positive you do not have the mention it. But if it’s positive then that is your answer. My positive report is now scanned on my NHS file so Drs can see I need T3 for sure and there is no ambiguity or questions anymore.
Agree...my Dio2 test (positive/homozygous result) started my journey towards recovery.
The result is in my NHS file, and endo agrees that I need T3.
So far so good, but....
It has turned out - through trial and error - that I need a supraphysiological dose of T3 (100mcg to date) which same endo is not happy about!
So thyroid hormone resistance is my conclusion.....thanks to help here but rejected by this endo!
However he has reluctantly conceded that high dose T3 works for me and that the status quo should remain...while emphasising it would not be his advice (as per guidelines issued, I guess, and concerned about those on high looking over his shoulder.)
Yet....he cannot explain why I can otherwise tolerate 100mcg T3. There is plenty of evidence to explain why, but he refutes this.
On his advice I would eventually drop back to being
barely able to function - my cellular level T3 would begin to drop again!
Madness ....
If poor conversion is suspected and nutrients have been optimised then the genetic test can turn things around.
Having said that I self medicate and buy my T3 which takes responsibility away from any "nervous" medic!!
It should not be so but it leaves me in control.
Good luck Lynny66 and Mum. Conversion problems can exist for a long time before serious symptoms appear often, in my experience, misdiagnosed as other health issues. I'm 74 with a symptom-time scale similar to your Mum.
I guess many of us here can relate to your Mum's experience
Best...
DD
Definitely recommend she starts taking a selenium supplement of 200mcg per day. Especially as she was found to be low on blood tests. Multi vitamins don’t contain the best amount so it’s worth taking separate supplements to increase the levels. She also could take magnesium too as that was low. T3 does apparently affect the heart so the Doctor is wise wanting to discuss with colleagues before initiating this.
Magnesium, Taurine, vite B comp.ex, selenium , vite C, and L - carnitine ,vite D, Zinc, for Heart and A fib , i would say (COq 10 also but she is on WARFARIN ) look them all up. I also devide up MY dose of Thyroid hormone into 3 lots over the day as if I take full dose all at once my heart goes off it's head too fast and misses beats. Have you tried Slippery Elm for oesophogus problem ,I would not be without it myself.
Have you had your oesophagus checked? My father took slippery elm for some years as he followed an ayurvedic lifestyle, and had digestive problems which slippery elm helped. Sadly, when he eventually went to the doctor he had advanced oesophagal cancer and we lost him soon afterwards.
I am not suggesting that you have this problem, but I wish he had checked sooner, rather than treating the symptoms.
Unfortunately, the NHS treatment for oesophagal cancer killed a friend of mine in a mater of weeks, so I suspect you get more time by not undergoing it.
I am so sorry about you friend. I am sorry for your loss. The outlook these days, if caught early enough, is usually good. My father in laws brother had early oesophageal cancer at the same time, but was given the all clear after treatment.
Nutrients are *Extremely* Important with our thyroid vitamins as greygoose so very well says . They help our thyroid meds work better for us . Vitamin "D" helps with T4 to convert to T3 Selenium , Iron , Zinc . It would be very useful prior to starting any of these nutrients to have your vitamin "D" /K2 Selenium Iron (ferritin) Zinc B-12/folate , magnesium values .
Fish oil , CoQ10 , magnesium , Taurine vitamin "C" are Very helpful for the heart .
You might need for this an NP rather than a conventional Dr .
We are awaiting blood results from Cambridge to exclude assay interference, I'm not sure what this means?
If the thyroxine is reduced to 50 my mum has symptoms of palpitations so we asked to stay on 75.
Depending on the result of the assay test we may be referred to a cardiologist to see if it is safe to stay on 75mg as mum has atrial fibrillation and takes sotalol and warfarin.
She also takes a statin and an antacid- Lansoprazol.
Mum has been advise to stay on 75mg thyroxine, continue with T convert and also 2 tablets of Vitamin D3 2000 a day and repeat these tests in 3 weeks to see if there is a change.
Can someone explain to me what TSH, T4 , T3 and reverse T3, magnesium & Vit D should be please and also how the genetic test tells us if she is converting properly. So confused! Thanks
*Sigh* It seems to me that if her FT3 had been optimal (in the upper quadrant of the range) years ago, many of her current health problems would never have developed. Her Reverse T3 is elevated because they attempted to solve her health problems by raising her T4 too high, which gets converted to Reverse T3 if FT3 is too low. See: zrtlab.com/blog/archive/cle...
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