I have suffered with Thyroid problems for the past 35 years. Had a Hot nodule removed 35 years ago. Went from Hyperthyroidism to Hypothyroidism in the 5 years after. Was on medication until I was peri- menopause in my 40's. I have since had another nodule removed which turned out to ge Follicular Thyroid Cancer in Feb 2019. I had radioactive iodine and CT scans and ultrasound and finally I have been given the all clear. However now I am finding I am still suffering Hypothyroidism. I recently had my Levothyroxine reduced to 150mg daily. As my last results were:
TSH = 0.06
Free T4 = 24.6
Free T3 = 4.6
I feel no matter how my meds are adjusted up or down it affects my FT4 only and not FT3. I've got a spreadsheet if my meds and blood results before and since my thyroidectomy if needed.
My question is how can I increase my T3 when Levothyroxine is not working. Endocrinologist- probably because if COVID is not interested in discussing my options. Have asked my ENT specialist who says its up to Endocrinologist.
Alongside I have been put on Edoxaban as I've suffered clots in the past - which has had a marked improvement on my circulation and fitness levels. I used to take 3x weekly walks of 1 5 hours, now I go mountain biking 6x week for an hour. I have been told I have Mobile Atrial Septum - very possibly because of the clots - could well be why they put me on Edoxaban.
Dr. 's say I should loose weight but even though I've tried fasting by eating breakfast late so leaving 14-16 hours between supper and breakdast. Also tried Keto but , even with exercise, nothing is shifting. I feel it because my T3 is so low. Have asked to trial T3/T4 for 3-6 months but being told an Endocrine referral will only be after COVID.
My height is 171cm
Weight 103kg
So really need some advice.
Regards
Lesley
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LesleyLittle
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Were tests done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
Do you always get same brand of levothyroxine?
Which brand
What vitamin supplements are you currently taking
When were vitamin levels last tested?
For full Thyroid evaluation you need TSH, FT4 and FT3 tested.
Also EXTREMELY important to test vitamin D, folate, ferritin and B12 at least annually
Low vitamin levels are extremely common on levothyroxine
Ask GP to test vitamin levels
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Well it is obvious to see that you are not converting well the T4 into T3 :
The conversion ratio of T4 into T3 when on Levothyroxine only is : 1 / 3.50-4.50 - T3/T4 :
with most people preferring to be at around 4 or under:
So if we divide your T3 into your T4 we get 5.35 and this proves you are not converting the T4 well and the obvious solution is to drop some T4 medication and supplement a little T3 - synthetic Liothyronine.
Ideally both T3 and T4 need to balanced through the ranges, but we don't have those but guess estimate your T3 at around 30% whilst your T4 is around 120%.
No thyroid hormone replacement works well unless ferritin, folate , B12 and vitamin D are maintained at optimal levels so this will be another area that needs to be looked into.
These core strength vitamins and minerals maybe in range, thereby your doctor not suggesting supplementation, but for optimal health when hypothyroid, and without a fully functioning working thyroid, we need these built up to good high levels in the ranges
Some people can get by on T4 only, some people at some point in time, simply seem to stop converting the T4 into T3, and some people simply need both T3 and T4 dosed and monitored independently to bring both these essential, vital hormones into balance and at a high enough level in the ranges acceptable to the patients to restore well being and health.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2. and calcitonin plus a measure of T3 said to be at about 10 mcg plus a measure of T4 said to be at about 100 mcg.
The body runs on T3 not T4 - with T3 being said to be about 4 times more powerful than T4 with the average person using about 50 T3 daily just to function.
Personally speaking I just think when there has been a medical intervention and the thyroid surgically removed or ablated with RAI that both T3 and T4 be on the patients prescription for if, and probably when, both thyroid hormones will be needed to restore the patient's wellbeing.
As you will see from the above having lost your own production of T3 and not having it replaced you have been down regulated by around 20% of your overall well being and initially though the body will try and compensate, overtime, obviously, your QOL can be severely jeopardised.
The thyroid is a major gland responsible for full body synchronisation including your physical, mental, emotional, psychological and spiritual well being and this also includes your inner central heating system and your metabolism.
With optimum vitamins and minerals your conversion will improve but I believe your conversion ratio too wide to be closed without the introduction of Liothyronine and probably a dose reduction in Levothyroxine.
Thyroid Uk who are the charity who support this forum hold a list of endocrinologist, both NHS and private, who support T3 prescriptions, and I think you will be better placed getting a referral to an endocrinologist who knows his profession and is able to prescribe what he considers suitable, rather than" folding " if the local CCG have instructed all and sundry not to initiate new prescriptions of Liothyronine.
I'm with Graves Disease post RAI thyroid ablation in 2005 and now self medicate having been refused both Natural Desiccated Thyroid and a trial of T3 by my doctor and local hospital.
I trialled both NDT and Liothyronine myself, but prefer NDT which is pig thyroid, dried and ground down into tablets referred to as grains.
Each grain contains all the same known hormones as that of a human gland and NDT was successfully used to treat hypothyroidism for over 100 years prior to the mid 1960/70's when Big Pharma launched T4 - Levothyroxine - along with the blood tests, guidelines and ranges that most doctors seem wedded to.
Sorry, I seem to have gone on a bit, and hope this makes some sense, you're started by writing this first post and this forum is amazing and you will be supported .
Go onto the Thyroid uk website, contact the charity for the endo list and start reading up on their website on all things thyroid so to equip yourself with a little bit of knowledge and be better prepared for the medical professionals and have some input into your treatment options.
P.S. you will also find on the Thyroid UK website details of private companies who will run the appropriate full thyroid and vitamin and mineral blood tests for you if our doctor is not able to do these for you.
Many of us have to go privately to get these full blood tests, and it's very necessary as it will be the foundation and cornerstone on which forum members rely on seeing before they offer considered opinion and advise on the next step forward for your well being.
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