Hi all, I don't have a thyroid due to thyroidectomy 1992. Should I be concerned about following thyroid results. I dose with 75mcg of levothyroxine for both of the following thyroid tests.
Recent (March 2021) TFT
TSH. 0.06. 0.27 - 4.2
FT3 6.64. 3.1 - 6.8
T4. 25. 12 - 22
Previous (Dec 2020) TFT
TSH 0.766. 0.27 - 4.20
FT3. 4.4. 3.1 - 6.8
FT4. 18.32. 12. - 22
Above tests done private. However, four days after March 2021 test I had annual blood tests at GP surgery which included thyroid blood test. GP called me with blood results. Surprisingly, my cholesterol level had gone to normal, from 7.6 to 2.9. My pre-diabetes level was also normal, gone from 45 to 4. GP did not have my thyroid blood test results. I am really baffled by these results and concerned about thyroid results with T4 being out of range; what will the effects of this be?
Had covid beginning of year 2020 think my body has changed in some really strange way. I have always been skinny no matter how hypothyroid I have been in the past now I have slammed on the weight good style. Sorry I am rambling.
Any feedback will be very much appreciated.
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DizzyD
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Well your T4 maybe slightly over the range but it has been able to push your T3 hugher in the range, and this generally means, less hypothyroid symptoms :
How are you feeling ?
I think your doctor may now be concerned as your TSH has dropped out of the bottom of the range and if this is the only blood test result run in primarty care it is not sufficienct evidence and on which and a reduction should be made.
Take your full private thyroid function tests with you to the doctor - they may not accept them and suggest they run the test again instructing full TFT's to the laboratory.
Your T3 is just in range, and there is no risk to running the low/ suppressed TSH : this is especially true since you do not even have a thyroid to stimulate anymore.
The accepted conversion ratio when on T4 - Levothyroxine only is said to be 1 / 3.50 - 4.50 T3 / T4 : with most people preferring to come in at around 4 or under :
So if we divide your T3 into your T4 result we get 3.70 on the March result whilst on the December result on the same dose your conversion ratio came in at 4.1 :
Quite why your conversion ratio has improved could be due to " better " levels of core strength vitamins and minerals, especially ferriin, folate, B12 and vitamin D ?
Your diabetes and cholestrial levels have both improved substantially - should these be factored in with these new results ?
Do you always leave 24 hours between last dose of T4 and the blood draw ?
P.S. There are several articles on the Thyroid uk website from Professor Toft - a leading endocrinologist - confirming that it is perfectly ok to run with a slughtly higher than range T4 if it gives the patient a higher T3 and a better health outlook.
( Sorry - my cut and paste involves scissors and glue ) !!
Hey pennyannie what an informative reply. Thank you so much. Praise the heavens, I don't really have any hypothyroid symptoms....I feel quite well really. Having said that I have gained weight and a good night's sleep is a thing of the past(pre-covid). Thing is, I never feel tired at end of day, or during the day....no afternoon slumps.
Yes, it is a mayor concern that when my GP gets, or finds the thyroid blood results that he initiated, he will want to reduce thyroxine because TSH level has dropped. As most of us know on this site low TSH is not the important number. ....FT3 and FT4 is what's counts. Just hope the thyroid blood test he initiated remains LOST. do not want thyroxine reduced, or go into battle with GP. Anyway, on the morning of that test, I took usual dose of thyroxine, drank decaf coffee (did not stick to usual protocol) because I do not take NHS thyroid tests seriously.
From past experience, and discussions with GP I know I will get no where if I presented my GP with my private thyroid results. He/they, are not interested or knowledgeable when it comes to FT3 and FT4 numbers. They are only concerned about TSH level.
So for March you divided T4 and T3 result to determine conversion ratio. Never heard of this before. Priceless info. Even better finding out conversion ratio is at 3.70...brilliant news.
Pennyannie prior to March thyroid test, I dosed with tiny amounts of NDT Efra 1/4 of 30mcg (split dose) twice daily to improve December FT3. Over a period of three weeks, maybe four, I ended up reaching 3/4 grain of 30mcg (split dose) daily. About four days before March blood test, I stopped taking the Efra. Even though i stopped dosing with Efra 4, days (could have been longer) before blood test I really do believe this helped improve my FT3 for March result. Took Efra alongwith 75mcg levo. Would good to hear your view on this.
Despite taking all the relevant vitiamins, and having good levels, plus having D102 gene test which was negative, I have always had conversion problem. Amazingly I now have good FT3 level but do think my FT4 should be a bit lower.
Yes I did follow advised protocol on day of March blood draw...😃 did not take thyroxine, drank only water, no B vitamins for a week, no food, no daily supplements either.
Sincere thanks...this has really been a learning curve for me. Really appreciate your help and support.
Hey pennyannie you have been of tremendous help now and in the past (March last year) re: my NDT journey. I have tried many times with NDT to no avail. I even have a private endocrinologist now who prescribed me NDT (Efra) September last year. Surprisingly, I did not ask him for NDT he just asked if I would like to trial it. Not seen him since he prescribed Efra trial which did not go that well at all.Now I can make an appointment with him and discuss "combo dosing" with small doses of NDT and levo.
Efra is just one brand of Natural Desiccated Thyroid and all NDT brands are made from pig thyroids and contain all the same known hormones that our thyroids once gave us :
Namely trace elements of T1. T2, and calcitonin plus a measure of T3 and a measure of T4 : in roughly a 1 / 4 ratio :
I take NDT which states on the bottle that each grain contains 38mcg T4 + 9 mcg T3:
Just looked and it seems that Efra is slightly different at 35 mcg T4 + 8 mcg T3 :
A fully functioning working thyroid is said to support you daily with trace elements of T1. T2 and calcitonin plus a measure of T3 said to be at around 10 mcg plus a measure of T4 said to be at around 100 mcg :
So, the reality is you haven't a thyroid and lost your own production and we do have a guessestimate that this equates to about 100 T4 + 10 T3 : so if you don't replace both thyroid hormones you have lost around 10 mcg T3 - and T3 is said to be about 4 times more powerful than T4 - and equates to around 20% of your overall wellbeing.
So on just T4 you have been down regulated and given time, your body will not work as effectively as it once did, and pull you down even further.
All I know is that when I introduced T3 alongside my T4 it was like a light bulb being turned back on, as though my pilot light had been repaired and reignited and my metabolism kicked in.
So, ideally replacing like with like seems to me the most sensible solution and having been very unwell on T4 only and without a thyroid, I've plumped for taking NDT :
It's generally accepted that we need a balance of T3 and T4 and if the 1 /4 ratio in Natural Desiccated Thyroid suits you well, you may have no need to add in any synthetic T3 or T4 to find your own optimum level of T3.
Hi pennyannie I totally understand where you are coming from re: NDT rather than synthetic treatment such as levo. Ideally, I would rather dose with NDT but I am apprehensive of doing that due to the T3 content in NDT. (I have been diagnosed with AFib) Also, i have unresolved adrenal problems which cannot be rectified, (long story)so this hinders any progression I could have with NDT.October last year, I was diagnosed with AFib after being admitted to hospital. At time of AFib attack I had been on NDT trial for five weeks. I am not saying T3 content in NDT actually caused the AFib but I do believe the T3 pooled in my body, due to the unresolved adrenal problem, hence my first AFib attack.
Second AFib attack occurred when I caught covid in December.
My mind would not give up on NDT. There had to be a solution. Basically, I knew by my December thyroid test, that my body, and cells needed some more T3 in order to function just a little bit better. I have some synthetic T3 but I did not want use them for obvious reasons.
So playing it safe, I opted to do "combi dose" of levo and very small amounts of NDT strictly for the T3 content. As the March thyroid results show my FT3 has greatly improved so all is well. Slow Dragon commented that these results are Just about perfect. Bloody marvellous!!
Just got to restart combi dose otherwise cholesterol an pre-diabetes level will rise again and I don't want that to happen.
Thank you most kindly pennyannie for all your help and support. It's priceless
Hey greygoose when GP phoned me about my blood results (not thyroid results he did not have them) he was amazed about drop in cholesterol and pre-diabetic level. He repeatedly, said "I don't know how you did it" . I didn't know how I did it either until you just told me. Prior to March thyroid results, I dosed with tiny amounts of Efra (1/4 grain of 30mcg twice daily for about 4, maybe 5 weeks. I aimed to improve December result re: Ft3. During this time still taking 75 levothyroxine. Roughly about week before March thyroid blood test I stopped taking the EFra. Was not expecting the results I got, with added bonus of normal cholesterol and normal diabetes reading, who could ask for more? Well I will ask for more!!!! I WANT MORE EFRA (T3)Looks like I need to start taking small amounts of efra again.
Ohh greygoose, with my private thyroid results and knowledge gained from you and this site, cannot wait to get a face to face consult with my GP and tell him how I actually got my cholesterol/diabetes level down to normal. He claimed it was because my thyroxine had been reduced a year ago from 100mcg to 75mcg. No way...T3 it's all about the T3. My persistent conversion problem has now been sorted.
So appreciate your short but poignant reply to my post.
Well, your conversion problem hasn't exactly been sorted, has it. It's just the T3 in Erfa that has raised your FT3.
Please do explain to your doctor that cholesterol is made in the liver, and the liver strives to always make the same amount and keep it stable. But, when T3 is low, the body cannot process and excrete cholesterol correctly, and it tends to build up in the blood. Raising T3 levels reduces cholesterol levels in the blood.
Ohh I have no idea what you mean greyhound re: my conversion problem has not been sorted. Please explain further. How does one actually sort a conversion problem other than dosing with T3? Is there an alternative?
The way I see it the T3 has raised my FT3 hence the job is done.
In the past I have consistently harped on at any medical person I see, who mentions my high cholesterol, pre-diabetes, or hypertension, (they so intent on blaming lifestyle) that I have low T3 which is contributing to these conditions. They take no notice of course.
Will explain to my GP what you suggested. Also going to suggest to him that he adds to my medical history that I do not have high cholesterol, pre-diabetes, or hypertension (monitoring blood pressure to see how it goes hopefully get off the meds).
GPs words still ring in my head "I don't know how you did it". It was not me it was Efra.
The way I see it the T3 has raised my FT3 hence the job is done.
Depends which job you are referring to. The job that is done is raising your FT3. But, you haven't improved your conversion for all that.
Conversion is when one atom of iodine is removed from 1 molecule of T4 and turns it into T3. Your body doesn't do that very well. And taking Erfa won't change that.
There are many, many reasons for poor conversion, such as low nutrients - especially selenium - or low calorie diets, infection or injury, or high cortisol. One can sometimes be lucky and remove the cause - usually more by luck than judgement - but for most people, conversion is not that easily rectified. And, that is why they have to take T3.
Yes taking T3 is simply treating a problem (low FT3) rather than the actual cause of the problem namely a conversion issue in my case. Similar to GPs, they treat symptoms and don't delve into searching for actual cause of a health problem. My cholesterol issue is a classic example.I have sorted most of the reasons for poor conversion apart from cortisol problem. Tried to sort cortisol problem, low morning, below range noon, high evening and night. Was taking adrenal supplements and dhea, ended up being carted off to a+e by ambulance....diagnosed with AFib. AFib got more problematic when I caught covid so there is no option left for me to get adrenal issue sorted. Hence I resorted to taking very small doses of Efra along with thyroxine and to help improve my FT3 level which worked. Hopefully, a knock on effect of improved FT3 might help my adfenals. Only time will tell.
Your cortisol results sound like typical adrenal fatigue. I doubt that the AFib was caused by the adrenal supplements (what were they, by the way?) or DHEA. What you need to do is raise the morning levels, and the evening levels will take care of themselves. And, you can very often do that just with a little TLC. Start your day, as soon as you rise, with a high protein breakfast. Always go to bed and get up at the same time every day. Adrenals need lots and lots of vit C, lots of B vits and plenty of salt - try the adrenal cocktail. I hate saying 'avoid stress as much as possible' because I know how difficult that is. But it really is essentail to avoid it as much as you can to help your adrenals recuperate.
Totally aware that you were not criticizing me for using Efra....but you did manage to get me to see, that my conversion issue was not sorted. On the other hand my, FT3 was raised so job done. Big difference greygoose having to be Efra dependant as opposed to actually having my conversion issue "SORTED" is daunting, to say the least.
Thing is I need to choose more appropriate words in the future. Whoops spellchecker changed you user name to greyhound, I failed to notice this!!
Another example of me hastily using the wrong word is when I said that my AFib attack was caused by adrenal supplements (AS) which you say you doubt. As a matter of fact the AS I took (just one dose) "triggered"the AFib attack (first AFib ever). I took just one dose of AS on the day but I had also been taking DHEA (prescribed by private endo along with trial NDT) for five weeks. What do these two supplements have in common? They are both glucocorticoids that are proven to trigger AFib in some people, pre-diagnosed or not. The risk of AFib emergence, is 4 times higher among new users.
On said day, I was fine. Earlier had taken usual trial dose of NDT and DHEA which I had been taking for five weeks. However, in the back of my mind I was worried about T3 " pooling", basically going no where, due to my messed up, untreated adrenals. Hence, I took my first ever adrenal cortex. What a mistake! About an hour later fast, erratic, irregular heart rate. Phoned BHF who suggested I call an ambulance right away which I did. While I waited for them to turn up heart symptoms began to calm down. At this point I knew what had happened? A surge of adrenal cortex (glucocorticoid) hit "pool" of T3 then hey presto, AFib attack and diagnosis. So I stopped trial of NDT, DHEA and adrenal cortex. Second AFib attack was when I had covid January this year so my adrenals must be in a right state.
Regardless of the above February this year I dosed with very small amounts of NDT and levo (combo dose) for a period of 4/5 weeks then stopped. We both know the health rewards I got from that so I plan to start dosing with NDT again. (small doses)
Brand: Thorne Adrenal Cortex
Adrenal supplements did not cause AFib attack but they did trigger my attack.
I off to have an adrenal cocktail now. 😁
Thanks a million greygoose for all your help and support.
At this point I knew what had happened? A surge of adrenal cortex (glucocorticoid) hit "pool" of T3 then hey presto, AFib attack and diagnosis.
I'm sorry, but none of that sounds likely. For a start, T3 does not pool. You make it sound like grease floating on top of water, in little round globules. It doesn't do that. T3 is transported round the body, in the blood, attached to carrier proteins. There aren't isolated little floating islands of T3 that anything can 'hit'. The half-life of T3 is only about 24 hours, so it doesn't have time to pool. What doesn't get into the cells is excreted/converted to T2 - half of it within the 24 hours. Pooling is an invention of STTM and the theory doesn't stand up to scrutiny.
Adrenal supplements did not cause AFib attack but they did trigger my attack.
So, you had previously been diagnosed with AFib? If not, then 'cause' and 'trigger' add up to the same thing.
The adrenals pick uo the slack when the thyroid can't cope, and so they work together and both need supporting.
You might like to read a book written by a doctor who has hypothyroidism Barry Durrant - Peatfield - entitled Your Thyroid and How To keep it Healthy - I know it sounds counter intuative as we two don't now have this amazing little gland but we do need yo know what it does so we can try and compensate accordingly.
I started taking drenal glandular over 1 yearbefore I switched from T4 only medication due to reading the above book and the fact I had had RAI treatment which burns out the thyroid in situ and is also known to be taken up, to a lesser extent, by other glands and organs in the body.
Having lost your thyroid you have lost your own natural production of around 10 mcg T3 daily - so it's logical to replace this measure at least.
NDT also contains all the same known trace elements of T1 and T2 and calcitonin all of which you have never had replaced since your thyroidectomy, and I believe they were there for a reason, and it's sensible to replace like with like.
Now you are on levothyroxine it’s normal that cholesterol has dropped
Your thyroid results look about perfect
As long as Ft3 is not over range you’re not over medicated
For full Thyroid evaluation you need TSH, FT4 and FT3 tested. EXTREMELY important to test vitamin D, folate, ferritin and B12 at least annually
Ask GP to test vitamin levels once year
When were vitamin levels last tested
What vitamin supplements are you currently taking
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
The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is under 2
When adequately treated, TSH will often be well under one. Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)
Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
Slow Dragon, I have been on levothyroxine for over 32 years. Realised in the course of receiving and replying to posts that my cholesterol dropped because I took efra for a short while (4/5weeks) prior to getting March thyroid test. Suspect the Efra contributed to my thyroid results looking just about perfect which you so kindly stated.
Just got to start taking tiny doses of Efra again along with the 75mcg levo (combo dose).
Hey Scrumbler greetings and welcome to the party. Late arrivals are always welcome.
Yes I was undermedicated on just the 75mcg of levo since February last year, that is until I added small amount of NDT, March this year , surprised at great outcome: rise of FT3. which became evident when I got my thyroid results. Was not aware of any benefits at all (symptom wise) while taking combi dose. I am no longer undermedicated. but will become so if I don't restart NDT
You are confused as to why I stopped taking the NDT. Honestly I could not recall why I stopped. Then I had a light bulb moment,the room lit up. Here goes. I decided to use NDT as an experiment because I was so confused and unwell with many symptoms post-covid. (Caugth covid Dec) Long covid symptoms is very similar to hypothyroid symptoms and I did not know which was what. However, I do know that insomnia I have had since covid is so very much worse than insomnia that is related to hypothyroidism. With hypothyroidism insomnia, I would get a full nights sleep by taking an occasional sleeping pill. Not so with long covid insomnia...nothing works and believe me I have tried many drugs ( one off dose) even though I loath taking pharmaceuticals... I needed some sleep. Then one day I decided to try some NDT to see if it would help with insomnia. Took it for four or five weeks. It did not help insomnia, so I stopped taking it.
Somewhere along the line since I stopping NDT I started to feel quite well, less hypo. No suspected long covid symptoms apart from proven long covid insomnia that is persistent.
Been on this device since 1 am. Had one hour light sleep earlier. Woke at 12.30 so took 2 sleep tabs as prescribed by GP. They done nothing.
Scrumbler no point in addressing the other points you mentioned re: "I'm confused" you will end up with book.
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