Still plodding along on Levo, latest blood test results

[Jackiez]

Good morning lovely people. I haven't posted for a while as everything has been quite settled, however, I had my annual blood test last week and have been summoned by the GP! I know how the conversation will go, suppressed TSH, high FT4 dangerous! Etc etc.....My FT3 is low in range compared to FT4 which I'll need to explain to him, again! Can someone please help me out again with the maths around the conversion ratio please, as I can't work it out. I know I won't get T3 prescribed but I don't want him to reduce the Levothyroxine dose as I feel ok at the moment. Many thanks.

TSH 0.018 (0.27-4.13)

T4 117 (66-300)

FT4 21.9 (12-22)

FT3 4.31 (3.1-6.8)

The magic five are all good apart from Folate which I'll have to supplement again.

[greygoose]

Don't know what you mean by 'conversion ratio', but if you want to work out the percentages, then this will help:

chorobytarczycy.eu/kalkulator

With good conversion, the FT3 would be a slightly lower percentage than the FT4.

[Jackiez in reply to greygoose]

Thank you Greygoose

[greygoose in reply to Jackiez]

You're welcome.

[SeasideSusie Remembering]

Jackiez

It's said that for good conversion the FT4:FT3 ratio should be between 3:1 and 4:1. Yours is 21.9/4.31 = 5:1

You could also point out that your FT4 is 99% through range and your FT3 is 33% through range and they ideally should be in balance.

However, if you feel fine, know you wont get T3 prescribed and just want to stay as you are, then discussing conversion and ratios aren't really necessary. Refer to Dr Toft's article instead:

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):

"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).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

You can obtain a copy of the article by emailing Dionne at:

[e-mail]

print it and highlight question 6 to show your doctor.

[Jackiez in reply to SeasideSusie]

Thank you SeasideSusie