Help please with my Thyroid b/t result

[Oakwood4321]

Hello,

Please could I have help to understand the private thyroid results?

Thanks

[SlowDragon Administrator]

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Results show poor conversion of Ft4 to Ft3

Ft4 above top of range

Ft3 only 27% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Can see on previous post you are going to be working on improving low vitamin levels

Do you always get same brand levothyroxine?

Which brand

[Oakwood4321 in reply to SlowDragon]

Thanks for replying SlowDragon. I did test at 4.45am which was 24 hours since last dose of Levo. Had nothing but water beforehand.

I have Mercury brand of Levo , pharmacy only give that one after I requested they stick to same brand a coupon months ago.

My last private thyroid test (early February, posted on here) was the 1st I had done.

Results were:-

TSH 1.23 (0.27 - 4.2)

FT4 22.5 (12-22)

FT3. 4.29 (3.1 - 6.8)

Not sure if there’s any improvement or worsening between those and today’s.

I seem to have a complete mental block understanding/absorbing thyroid info.

I’ve started again on supplements.

🙏🏽

[SlowDragon Administrator]

Previous antibodies test confirms autoimmune thyroid disease

Are you on strictly gluten free diet?

If not get coeliac blood test done BEFORE trialing strictly gluten free diet for 3-6 months

Likely to need addition of T3 prescribed alongside levothyroxine

Roughly where in the U.K. are you

Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3

...NHS and Private

[e-mail]

The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is ALWAYS under 2

When adequately treated, TSH will often be well below 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

[Oakwood4321 in reply to SlowDragon]

🙏🏽This helps to understand the thyroid tests a bit more.

I had a blood test for coeliac about 2 years ago. It was negative. I’ll dig the gp letter out & reread. I decided I was gluten intolerant as it does upset my system. I’m avoiding gluten but in last few months I’ve slipped periodically with this. No gluten for last month.

I have gp phone call booked tomorrow pm, to discuss cholesterol. I’m not taking statins. I’ll email him my Thyroid private results and ask for Endo referral.

If no joy I will look on the list I’ve received from Admin.

I live near Basingstoke, Hampshire.

Thank you SlowDragon 😊

[SlowDragon Administrator in reply to Oakwood4321]

Private endo’s are doing consultations on zoom

Will pm you

[Oakwood4321 in reply to SlowDragon]

Thanks SlowDragon. 😊

[pennyannie]

Hello Oakwood :

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

So to find your conversion ratio when on T4 only you simply divide your T3 into your T4 : and I'm getting 6.17 - so yes, your conversion is way out : and further out than it was in February.

Conversion can be compromised by low ferritin, folate, B12 and vitamin D.

I maintain mine with ferritin at around 100: vitamin D at around 100 : folate around 20 and active B12 70+ or serum B12 500+ : range dependant obviously but rule of thumb aim for a good 50%.

Comversion can also be compromised by any physiological stress ( emotional or physical ), inflammation, dieting and ageing and while we can't turn back to clock it's worth noting.

Taking a quick look back at your previous posts, I don't know if the cause of your hypothyroidism might also have restricted your abilty to convert T4 well.

Since your T4 is over range it's a little pointless running this higher than range, as you are not benefiting by a higher enough T3 to relieve your symptoms.

The logical solution is to drop a little T4 and add a little T3 so your T3 and T4 levels can rebalance, come into range and at a high enough level in the range to relieve your symptoms.

I'm with Graves post RAI thyroid ablation and manage lingering Graves, thyroid eye disease and hypothyroidism and self medicating I was unable to have prescribed anything other than T4 - Levothyroxine through the NHS.

[Oakwood4321 in reply to pennyannie]

Thanks penny Annie for your reply and for taking the time to read my previous posts. Yes, I think there’s a link between the cause of my hypothyroidism & my ability to convert T4 well.

I’m focusing on the guidance re vitamins I’ve had and am looking into getting an appointment with an Endo.

I really needed to read what you put re stress . I had read about that before but probably haven’t taken it as seriously as I should. One of my daughters asked if she could stay with her her 2 small dogs for 2/3 months till she saved a rental deposit. I’m in a 1 bed bungalow so it would be on the sofa bed. I said yes but, reading your reply gave me a wake up call . have now put my thyroid first and said I can’t do it. 🙏🏽

[pennyannie in reply to Oakwood4321]

Hey there again ;

I've just " looked " and see there are several links between your previous treatment and hypothyroidism.

I would hope you could use this as a reason why you may need the addition of T3 -

Liothyronine alongside your T4 - Levothyroxine.

So to restore the balance between both these vital hormones and at a high enough level within the ranges to give you back your well being and your " you " :

I see it as a chemical imbalance and a bit like needing to balancing cream of tartar and bicarb when making scones :

My other analogy is a seesaw - most fun happens when you have children of equal weight as then they bounce off each other and enjoy the game :

If one's is stuck up in the air ( T4 ) and one with their bottom stuck down ( T3 ) - they can't respond well, whether it be the bumps, or simply go back and forth, like everyday life.

The trouble with stress is that you can end up beating yourself up as guilt likes to jump in as well, as none of us enjoy feeling incapicitated especially when we can " look " all right, as we try so hard to hold on to everything and be strong and independant.

[Oakwood4321 in reply to pennyannie]

I love your metaphors pennyannie, added some lightheartedness to relieve feeling weighed down by it all/stuck on the ground on the seesaw.

I remember being told of possible thyroid issues before I started the year

on Interferon. I’ve just read up about it too. Thanks for looking at that. I imagine it could be of help with getting the correct thyroid treatment.

Guilt is always waiting in the wings ready to jump in with stress I get. So glad you added that initial paragraph on stress. I needed reminding. Last time I let 2 daughter move back in I ended up with Opthalmic shingles. I have my space and timing to get well and, in turn, be a better mum to my daughters. 👌😊