Conversion improved massively - adding more T4 and removing some T3

[liaratsoni]

Hi everyone,

I have recently seen a tremendous improvement in conversion - when I first started on levo I had a levo at top of range on 75mcg and a t3 just in range and I was struggling to eat and very underweight. The last few months I have been supplementing b12, vit d, having some b vitamins every day and eating liver weekly and for 6 months now have been eating a full diet and have put most of my weight back on! My conversion has now changed dramatically - just 4 weeks ago on 75mcg t4 and 6.5mcg t3 I had a t4 of 16.1 (10-20) and a t3 of 4.8 (3.5-6.5) when previously even on 10mcg t3 my t4 was still 17.5. Yesterday I had another blood test and had been of 7.5mcg of t3 and 75mcg t4 so only a 1mcg increase but was feeling bad on it (high heartrate, bad internal shaking, wired, anxiety, insomnia) and today got my results as t4 of 13.7 and t3 of 5.2. My T3 is likely higher than this as it was done 15 hours after my last dose. As only a 1mcg increase took me up from 4.8 to 5.2 and I felt very wired and bad with a high heartrate and anxiety I went back to 6.5mcg t3 a couple of days ago and thats calmed but I feel hypo so think I need to add some t4 as I am feeling very cold, constipated and tired which I assume is because my T4 has dropped.

How much T4 should I add do you think 12.5mcg would be a good amount? I reduced t3 a couple of days ago so when do you think would be ok to add the T4? I try to go gently on my body as its quite sensitive. Thank you!

[greygoose]

It's impossible to tell how well you convert when taking T3. You have to be on T4 only to see that.

[liaratsoni in reply to greygoose]

Ah that is a good point! My need for t3 has definitely deceased and my need for t4 has increased so I assume I am doing something right!

[Hidden in reply to liaratsoni]

Just out of curiosity: how do you know that once on T3 + T4, and without tests to confirm out-of-range FT3? As Greygoose points out, there is no way of knowing how well you convert once on T3...how do you know you are not feeling better because of the T3?

The only way of finding out would be to go off T3, take levo only for several weeks, and then retest.

[liaratsoni in reply to Hidden]

The T3 definitely helps and I have no plan to stop it altogether but I definitely don't need as much as I did - previously I was on 10mcg and the same amouunt of levo I am now and didn't feel well even thought at one point I had a higher FT3 and FT4. Now my FT4 has dropped hugely on the same T4 dose and less T3. I assume this means more of my T4 is going into T3? I think I need to up my levo though because 13.7 (10-20) is too low for me I think I feel better around 16!

[greygoose in reply to liaratsoni]

FT4 has dropped hugely on the same T4 dose and less T3. I assume this means more of my T4 is going into T3?

Ah, that's a mistake that lots of people make. But, apparently, according to those that know, that is not proof that more T4 is being converted to T3.

It is simply a fact of life that when you add T3 to your T4, the FT4 level will drop. But, nobody knows why. We've had that discussion on here many times.

[liaratsoni in reply to greygoose]

Ah thats interesting! I guess I will just have to wait and see what happens to my bloods when I add some more T4! This is useful to know 😊

[Hidden in reply to greygoose]

I´ve made that mistake in the past...that is, adding T4 to T3 in an attempt to raise FT4 levels. Didn´t help...after feeling better for a couple of weeks, I started feeling worse, with a return of hypo symptoms.

I have read several times that, when you add T3, T4 levels drop. I cannot remember any sources so, if anyone has any, please provide links!!!

But it would seem that, once you take any form of T3, your T4 levels will be lower and that is no cause for concern as long as your T3 levels are well in range.

I think the "you need a high in range FT4" dictum refers to people on levo only, who need to make sure they have enough T4 for optimal conversion...and not to people on a T3 + T4 combo.

But, from what I understand, if you have high FT4 levels along with high FT3 levels on a T3+T4 combo, your body will convert more of the T4 to reverse T3 (inactive, since less T4 is needed for conversion once on T3), so a drop in T4 levels does not necessarily mean more T4 is being converted to FREE T3...which is what you´d need.

[greygoose in reply to Hidden]

But, from what I understand, if you have high FT4 levels along with high FT3 levels on a T3+T4 combo, your body will convert more of the T4 to reverse T3

Depends how high is high. And, that is different for everyone, from what I've read. So, one can't give a definitive answer to that.

[Hidden in reply to greygoose]

GG, can you please tell me how to link to someone´s name when referring to them in your reply?

[helvella in reply to Hidden]

Type an @ symbol. Then continue with the member's name.

For example (and I have added spaces between the characters):

@ P u r p l e C a t 7 1

At some point, a list of member's names appears at the bottom of the comment. You have to click on their name in that list. When you click on the name, in your post, the name turns blue and loses the leading "@" symbol.

Hidden

[Hidden in reply to helvella]

Thanks, Helvella...I sometimes miss the good old days when we used typewriters and Tippex...!

[greygoose in reply to Hidden]

I don't! lol Give me a computer any day.

[asidist]

sometimes the inability to tolerate higher doses of t3 (resulting in fast heart rate etc) is due to insufficient ferritin and resolved by getting more iron through diet or supplements. i know you’re already eating liver weekly so may not be the case for you but may be worth testing your levels just in case to make sure you don’t need more still? the ideal level is typically considered 80s or 90s (US range at least). best of luck

[liaratsoni in reply to asidist]

Hi! I think I am realising low iron is the main problem right now. My FT3 level being 5.2 at 15 hours after the dose means it would be higher and makes me think it would be around where I need it within the proper 8-12 hours after but I still feel rotten mainly exhausted and weirdly lightheaded so I can't stand up for long periods, problems with anxiety and with some other lingering digestion issues and my body and especially heartrate and anxiety goes haywire if I try to up anything even minutely so I think iron is the main thing to work on right now. It was 22 a few months ago and I have got it up to around 43 with the constant liver eating but the range at my doctors is up to 250 so I am nowhere near optimal which I am told would be mid range so about 125!

[asidist in reply to liaratsoni]

I was also getting a lot of anxiety and dealing with an increased heart rate trying to raise my T3 initially, and happened to read on this board that symptoms like that can be caused by low iron. Looked it up and found great research supporting that - I wish doctors knew these things! I actually noticed a big difference the next day after taking an iron supplement. I've continued trying to keep my Ferritin levels up with foods and supplements and it's not quite where it needs to be for me (65 with range 15-150) but if I start to notice my heart racing, supplementing helps me immediately, it's kind of crazy. I hope you're having success with it as well!

[liaratsoni in reply to asidist]

Wow I’m glad that works so well for you! Iron definitely has a huge impact - I had really bad dizziness and weakness and that’s got way better as my ferritin has increased. I don't need as much now but when I needed more t3 and I had good ferritin I was fine could do any increase a-ok but when my ferritin dropped I just couldn’t tolerate it barely at all! It’s wild how much of an effect it has!

It’s difficult to tell as I had supplemented other stuff too but I think it made a huge difference to my conversion too!

[asidist in reply to liaratsoni]

It is! I just can't get over the fact that doctors don't know about something so significant.

That's awesome that it's helped with your conversion too. That is one thing it didn't do for me - unfortunately! That was one of the first nutrients I worked on increasing because of my hair loss and even as it approached 90 my Ft4 levels did not budge (and neither did my hair loss), but maybe if I had been taking other nutrients it would have had a synergistic effect like you mention. This is one of the articles I read that talks about the importance of iron for hypothyroid patients and it does mention that iron helps improve conversion: alliedacademies.org/article...

I'm planning to talk about this more in depth with my endocrinologist too, so that he can help other hypo patients with this knowledge. I shudder to think how many people give up on T3 because of the symptoms we've been talking about, when in reality they just need more iron!