Hi there, I have my latest blood results and was wondering if I am maybe not converting T4 to T3 very well. The reason I am asking is because I still have days where I am really tired and I find it very hard to lose weight. I have always been a fan of the gym and like to go 4 or 5 times a week but I think the workouts make me more tired and bigger! I have been going to the gym for over 20 years and was diagnosed hypothyroid 2 years ago. I haven't managed to get anywhere near my previous fit self yet.
TSH <0.1 (0.27 - 4.2)
T4 20.8 (10 - 22) 90% through range
T3 4.7 (3.1 - 6.8) 43% through range
I'm not sure what levels I am trying to achieve for the best chance of good health. I take 150mcg levothyroxine daily.
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Poloneck
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These need to be optimal for thyroid hormone to work properly. Ferritin needs to be 70 for good conversion. So nutrients are the first thing to check if not already done.
Thanks SeasideSusie, I did ask for all those nutrients to be tested but unfortunately I have been given a full blood count instead of ferritin and no vit D result yet.
Folate 12.8 (3.9 - 26.8)
B12 504 (197 - 771)
From the fbc I can see I have low neutrophils. I will make another appointment for ferritin and vit D. I did explain what I needed tested and why so I don't know why I got something else but I can't complain too much as I got T3 tested!
Folate isn't too bad, it's recommended to be at least half way through range which is 15.5+ with that range.
What is the unit of measurement for B12? If it's pg/ml or ng/L then it would be better over 550 and around 900 is better.
Ferritin is very important so you need that testing, along with Vit D so if you can come back with those results when you have them we can comment.
Supplementing with selenium can help conversion. Some people like to test first but if you can do that then 100mcg selenium l-selenomethionine daily (definitely not more than 200mcg) may help.
Have you ever had thyroid antibodies tested? Just wondering if you have autoimmune thyroid disease aka Hashimoto's.
SeasideSusie, B12 is ng/L so I will get a vit B complex to cover that and folate.
I'll post again when I get the other results.
I have been diagnosed with chronic autoimmune thyroiditis which I think is Hashimoto's although I wasn't over range with TPO antibodies, just right on the upper end of range. Didn't get tgb antibodies tested.
I have been given a full blood count (FBC) instead of ferritin
Your FBC can tell you if you are anaemic.
Low haemoglobin is commonly used by doctors to indicate anaemia.
MCV - Mean Cell Volume - If this is high in range or over the range it indicates that your B12 and/or folate are probably too low. If MCV is low in range or under the range it indicates that your iron and/or ferritin are probably too low. However, if your B12 and/or folate and iron and/or ferritin are all low then your MCV may look normal.
Please note when doing any research that a US equivalent to the FBC is the Complete Blood Count (CBC). Also, be wary of units of measurement. They aren't always the same in the US and other countries around the world. And finally, reference ranges differ from lab to lab, not just country to country. Always use the reference ranges supplied with any test results you get.
Do these look OK to you? I did have low ferritin when I was diagnosed 2 years ago. I have not been tested since. I include red meats and liver in my diet and take spatone as the ferrous sulphate didn't agree with my stomach.
Your haemoglobin is only 9% of the way through the range, which might suggest your iron and/or ferritin could be improved. I don't know what might be considered optimal for haemoglobin, but personally I would want mine to be a bit higher than that.
Just for reference, you might find these links of use :
If you take iron supplements then leave them off for a week before testing and do the test first thing in the morning under the same circumstances you would do a thyroid function test, including the fasting.
Oh, just noticed...
I include red meats and liver in my diet and take spatone as the ferrous sulphate didn't agree with my stomach.
Can I just point out that ferrous sulfate tablets (the prescription-strength ones) have 65mg iron in per tablet. Spatone sachets contain 5mg iron.
If your iron and ferritin stay too low then you could consider trying an iron supplement with more iron in. The usual ones would be ferrous gluconate (35mg iron per pill, from pharmacies or internet only) and ferrous bisglycinate (iron content varies up to a maximum of about 25mg iron per pill, from pharmacies or internet).
You are right: you're not converting well. Assuming nutrients are all good, next step may well be to try and get lio ...
I assume you're in the UK. It's possible, but tricky to get lio prescribed on the NHS - this is by far the cheapest option if you can get it. Otherwise, a private prescription can - currently - be obtained reasonably cheaply from Germany [details on the main Thyroid UK site] - but who knows after Brexit transition. With no prescription of any kind, you need to ask for suppliers via a Private Message.
For NHS lio, you must get a prescription from an endo - your GP cannot prescribe it - and not many will, because it's very expensive, it has a short half-life so is difficult to measure, and lots simply do not believe it does any good [I'm guessing none of these are actually poor converters: for me, adding some lio to my levo has been transformative]
You can ask your GP to be referred to anyone - it doesn't have to be the nearest person but obv needs to be reasonably convenient. I'd recommend (a) getting the list of T3-friendly endos from Dionne at Thyroid UK - tukadmin@thyroiduk.org (b) a separate post on here asking if anyone can recommend anyone near-ish to you and (c) as a last resort looking at local hospitals and the thumbnail biogs of endos to see in anyone mentions thyroid or if they're all diabetes specialists.
You will need to show you don't convert well - which you do. Good luck x
Because you say you are tired and it is hard for you to lose weight I wonder if it might be worth it for you to do an adrenal stress saliva test and also test your blood sugar. An abnormal result from either test could account for those symptoms.
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Blood test results opinion please!
Strange blood results . Clues please 
Blood results looking like subclinical hyperthyroidism
