Am I converting T4 to T3 adequately?

[msmono]

Do I need T3 now? I'm currently taking 100mcg Levo and have felt so normal for around 9 months (joy) but since October have been gradually feeling worse-more tired, brain fog and memory problems, itching is almost unbearable. Worsening tinnitus.

My last blood tests were October - blood taken as advised on here and I see my T3 is declining since the previous test.

Strictly GF diet/all Vitamin levels suggested on here when tested were optimal (I take supplements) I'm trying to remember if I've ever had selenium tested.

I'm worried that I'm not converting as my T4 is good but T3 only 25% through range.

Any advice gratefully received. Thank you

[fuchsia-pink]

I'd start looking into lio with these results ... have you had the list of T3-friendly endos from Dionne at Thyroid UK - [e-mail] - and it's worth a separate post asking if anyone can recommend someone near-ish to you. You don't need to see the nearest person to you - and they don't need to accept you as a patient - but if you can get lio on the NHS this is obv the cheapest way to get it x

[msmono in reply to fuchsia-pink]

Thank you so much for replying. I saw a private endo to get diagnosed but I don’t know how T3 friendly he is. I could try I suppose. I might also ask for someone to DM me where I can buy it online reasonably safely. Will check out the list again.

[fuchsia-pink in reply to msmono]

Got to be worth asking the private endo - I understand you can get lio with prescription for £1 per tablet ... and if he IS friendly, it's also worth asking if he will see you and prescribe lio on the NHS ...

Good luck x

[jrbarnes]

If these were my results I would do one more increase to 112 or you can alternate 100 on 4 days and 112 on three days. You're close to the top of the range so smaller increases would be better. For me, even a 6mcg daily increase is a big difference. Once you get to the amount of Levo your body needs it could mean a significant increase in FT3. If you increase your T4 up to 112mcg and you don't see an increase in T3 then you may want to consider adding T3.

[msmono in reply to jrbarnes]

Hi, thank you, have tried alternating 100 with 125 and that put my t4 up past normal but my 3 only moved a tiny bit. I also felt unwell. It might, as you say be worth trying a smaller daily increase. I don't particularly want to rush in to another medication battle with NHS at the moment. 😀

[jrbarnes in reply to msmono]

Since you were close to the top of the range on 100mcg yes I agree 125mcg would have been way too much! It's a very fine line between just right and over-medicated. It wouldn't increase T3 but only make you feel terrible. I've been there and it did not increase my T3 but it did increase the amounts of thyroxine in my body which made me feel fatigued, overworked and sweaty. It might be worth an increase three days a week and if you see some improvement perhaps add another day. You may want to hold that increase for about 4-6 weeks. I agree, if you rush to another medication it may always be on your mind if a small increase would have made you feel better. If you exhaust that avenue with Levo then it's not a bad idea to look into T3. Best wishes

[pennyannie]

Hello Msmono

The accepted conversion ratio when on Levothyroxine only is 1 / 3.50 - 4.50 : T3 to T4 : with most people preferring to come at around 4 or under :

So if we divide your T3 into your T4 your conversion ratio while on T4 only is at 4.92 :

The obvious solution is to add a little T3 and drop a little T4 if I read 20 as being the top of the T4 range :

Your conversion may well be improved with optimal levels of ferritin, folate, B12 and vitamin D but if these have already been actioned the next best step is as already suggested .

I'd approach the endo who is currently treating you, and mention that you are outside the accepted conversion ratio for patients on T4 only, watch for response, and if nothing comes back, ask for a trial of T3.