How to improve low conversion of T3

[Molly139]

Hi, is there anything I can do/take to improve T3. I’m currently taking 2000 vit D, 200 vit k2-MK7 and 4g of mag365. I’ve just read zinc and selenium can improve conversion, can anyone offer any advice please? My results from July are below missing results are on the second report. Thank you

[jimh111]

I’ve never seen anything that improves conversion. Low selenium can impair conversion but it would also push your TSH up as the pituitary relies on conversion to respond to T4.

[Molly139 in reply to jimh111]

Apologies if my choice of words is incorrect I’m trying to get my head around all this

[jimh111 in reply to Molly139]

I think your conversion is normal ,if you are taking levothyroxine I would reduce the dose a little. You may need a little liothyronine to feel well but it’s very difficult to get it prescribed.

[SeasideSusie Remembering]

Molly

Did you leave 24 hours between your last dose of Levo and your blood test?

[Molly139 in reply to SeasideSusie]

Yes I did and fasted too

[SeasideSusie Remembering in reply to Molly139]

Molly

👍

So it would seem that you need a high (over range) FT4 to produce a mid-range FT3, even lower in range with the second test as it's only 35% through range.

As you have Hashi's, and this tends to often cause low nutrient levels, it might help to improve your Vit D and folate levels.

With your Vit D at just 43nmol/L, it would be better if you took more than 2000iu D3. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L and to reach that level from your current level, based on the Vit D Council's suggestions you could supplement with 5,000iu D3 daily.

Retest after 3 months.

You don't need 200mcg K2-MK7, 90-100mcg is enough for up to 10,000iu D3.

For your folate you could include folate rich foods in your diet and consider taking a good quality, bioavailable B Complex such as Thorne Basic B or Igennus Super B, both of which contain 400mcg methylfolate at the suggested dose on the pack.

Selenium is often recommended when there is Hashi's as it is said it may reduce antibodies and it may also help conversion. Consider supplementing with selenium l-selenomethionine 200mcg daily or maybe a yeast-bound selenium, but avoid selenite and selenate forms as these are poorly absorbed.

[SlowDragon Administrator]

Vitamin D obviously needs improving

Retesting in another 2-3 months

GP should prescribe 1600iu everyday for 6 months, but easier to self supplement

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Folate is rather low too. You might benefit from improving

[McPammy]

I found improving my ferritin helped a little. Do you know if you are a poor converter T4 to T3. You could try the DIO2 gene test through Regenerus Laboratories to check this. This may be your issue and not just low vitamins. I’d never heard of this DIO2 gene test before being a member on here. I took the test and I’m positive, which means I’m a poor converter, only converting 8% to T3 from Levothyroxine. I’m now prescribed T3 medication and boy what a difference it has made.

[Hafa]

Others have posted more knowledgeably on the vitamin D and folate, so I won’t add to that. I noticed the ferritin level is a bit high. My doctor cautioned me not to take iron supplements as I’m post-menopause and don’t have periods. Too much iron makes me feel kind of restless and irritable (hard to explain) and I donate blood and feel better.

[fuchsia-pink]

Is your GP any good? It's possible, but tricky to get lio on the NHS - that will improve your free T3 result and allow you to reduce your free T4. It can only be endo-prescribed, and not many do, because it's expensive, difficult to measure and lots of them simply don't think it helps [I'm guessing none of this last group has ever had a conversion problem]. If your GP is helpful, they can give you the referral you need to see an endo. It doesn't have to be at the nearest hospital to you, but must obv be reasonably convenient.

If this is of interest, I'd suggest dong some research into likely endos. Get the list of T3-friendly endos from Dionne at Thyroid UK - [e-mail] - and do a separate post asking for recommendations for endos near-ish to you. You'll need to show you are a "poor converter" - which these results do. Good luck x

[Molly139 in reply to fuchsia-pink]

Thanks fuchsia-pink I’ve just emailed Dionne for a list of T3 friendly endos. My GP has referred me to an endocrinologist and I’ve requested an appointment. I’m guessing that it’s NHS and will probably take months for an appointment. So will be looking into private ones, I hope they’re not too expensive!

[fuchsia-pink in reply to Molly139]

You may be lucky with a quick-ish NHS appointment - MUCH cheaper - as you then get your lio free too with a private prescription form a private endo, getting German lio is currently reasonably cheap but who knows what will happen after the Brexit transition period ends ... Crossing fingers for you x