Blood test results

[Sunnydevon]

Hi everyone, can anyone help with these results please. I am currently being treated for an eating disorder as I have lost a lot of weight in the last few months. I am now on an eating plan so having 3 meals again and snacks. Would my weight have an effect on my thyroid? Any help appreciated. TSH 0.208 0.27-4.20 mlU/L

Free T4 18.35 (1) 12-22 pmol/L

FreeT3 2.6 (2) 3.1-6.8 pmol/L

[MaisieGray]

Chronic calorie restriction can have the effect of lowering conversion of T4 to T3 and increasing conversion to Reverse T3, which has the effect of putting a brake on your metabolism. You won't know definitively if this has happened to you unless you blood test your levels of course, and the NHS generally doesn't test FT3 never mind RT3, but in practical terms you may have felt fatigue, tiredness, a general slowing down perhaps. It depends on how badly, and for how long, you were experiencing the effects of your eating disorder.

ps You haven't posted any results

[MaisieGray in reply to MaisieGray]

Thanks for adding your results. So as you can see, your FT3 is severely depleted, as I said it could be as a result of severely restricting calories.

Has your GP commented on your FT3 result? I don't know how long it can take for the FT3 : RT3 conversion ratio to rebalance after initiating healthier eating, but you could ask for an Endo referral with a view to requesting Liothyronine to be added to your Levo (am assuming that you are diagnosed hypothyroid pre-this particular problem).

[Sunnydevon in reply to MaisieGray]

I had Graves’ disease treated with RAI 12 years ago. Should I ask for an increase in Levothyroxine? I did mention this to hospital doctor but she said she wasn’t concerned about results. I am taking 125mcg of Levothyroxine at the moment but have taken higher doses in the past. It was decreased about 18 months ago as I was feeling anxious and my T4 was a little over range. I’m now wishing I’d kept it the same as doctors not keen on increasing.Thank you for your reply.

[MaisieGray in reply to Sunnydevon]

There is a little wriggle room to increase your Levo a little, but the problem currently isn't an inadequacy of T4, but poor conversion to T3 in favour of RT3. Hence my suggesting the addition of T3 if possible. As I mentioned, I don't know the rate at which this prioritisation re-orders itself once the body is no longer under threat of what it perceives as starvation because you are eating healthily again. So it might be a short term problem that will gradually sort itself out, or will it take a longer time to readjust and meanwhile you could benefit from a short term ingestion of T3 to address your very low level - perhaps someone else may have a view on that.

[SlowDragon Administrator in reply to Sunnydevon]

Recommend getting folate, B12, ferritin and vitamin D tested by GP

Or test privately via Medichecks or Blue Horizon

These frequently need supplementing to maintain optimal vitamin levels

Good vitamin levels help conversion of FT4 to FT3

Once vitamin levels are optimal and you are on stable diet, if FT3 remains low then you may need increase in Levothyroxine or addition of small dose of T3

[Sunnydevon in reply to SlowDragon]

Thank you for your reply.x

[Lalatoot]

We need carbs to convert levothyroxine ie t4 into the t3 that your body uses. I am not medically qualified but I think that you are on the right track to improve that conversion. You may also be low on vitamins so it would be worth getting ferritin, foliate, B12 and vit d levels checked and supplementing if necessary. Again we need to have vitamin levels up near the top of the range to make good t4 to t3 conversion.

[Sunnydevon in reply to Lalatoot]

Thank you for your reply.x