ablation of thyroid & consequences from using T4 replacement only

[vivbr]

My partner had an ablation of the thyroid gland. He takes 125 mg Levothyroxine. He says he's doing well, his T4 & TSH are in the normal range. I'm hypo & take natural dessicated boving thyroid extract 115 mg. My partner would never change because he believes the endocrinologist. However I ask myself & thus anyone who can advise how does his body produce T1, T2 & T3 seeing as he longer has his thyroid? He has very dry skin, is highly active, often nervous (my opinion of course). We eat organic & mostly from the garden, does the lack of a thyroid gland affect absorption of vitamins & minerals?

[SlowDragon Administrator]

his T4 & TSH are in the normal range

Do you have any results?

Extremely important to regularly retest vitamin D, folate, ferritin and B12 at least annually

Does he always get same brand levothyroxine at each prescription

Taking any vitamin supplements?

If yes, what

For full Thyroid evaluation he needs TSH, FT4 and FT3 tested.

Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Yes low vitamin levels common when on thyroid hormone replacement

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)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[SlowDragon Administrator]

Just seen on profile you’re in France

greygoose may be able to advise on how to get testing

[greygoose in reply to SlowDragon]

As far as I know, there are no companies in France, like Thriva and Blue Horizon, that do private testing. And, the companies that do private testing in the UK won't do testing on blood coming from outside the UK in case it takes too long to get to them.

All you can do, is ask at the lab where you go for your testing, if they will do any tests the GP refuses to do, if you pay in full from your own pocket. Sometimes they will, sometimes they won't. But, it would only have to be a couple of tests at a time. I doubt the would do a full panel without a doctor ordering it.

how does his body produce T1, T2 & T3 seeing as he longer has his thyroid

From conversion of T4. Basically, T4 converts to T3 and rT3, they both convert to T2, and T2 converts to T1, then the remaining atom of iodine is recycled. This happens in everyone. The only difference is, he will be lacking the T3 made by the thyroid itself, which may or may not be a problem, depending how well he converts. The thyroid only makes miniscule amount of T2 and T1, anyway.

To know how well he converts, he needs to have his FT4 and FT3 tested at the same time.

does the lack of a thyroid gland affect absorption of vitamins & minerals?

Not as far as I know, no. Absorption of nutrients depends on stomach acid levels. But, if the FT3 levels is low, the stomach acid could also be low, affecting nutrient absorption. Which could happen to anyone with or without a thyroid. So, he does need to know his FT3 level.

[tattybogle]

How does he get T3, T2 and T1 ?There are 3 deiodinase (enzymes ?) in and around the cells of nearly all of the parts of the body. They are D1 ,D2, and D3.

So T4 can be turned into T3, and T2 then T1 then T0 (recycled ) by them.

T3 production will be less efficient without a thyroid , as the source of directly produced T3 is now missing, and also because the deiodinases in the thyroid itself are gone, (but the liver is also a big source of conversion of T4 to T3.)

If thyroid is totally absent, he won't get any calcitonin any more. which is to do with calcium regulation)

For some people, their system will still manage to deal with this situation, and they feel well as long as the dose of Levo is correct,

The deiodinases are influenced by TSH..... it can turn the efficiency of D1 / D2 / D3 up or down , individually., as needed.

Some people have a genetic variation on one of the deiodinases (DIO2 )which means they have less efficient conversion of T4 to T3. (normally this might not cause them a problem as their thyroid will adjust to produce more T3 directly.. but some of these people have more difficulty if thyroid is removed as they can end up with lower T3 , particularly in the parts of the body that depend more on DIO2 to make the T3 for those cells.

But some people just don't seem to do so well on T4 only , even if they don't have the DIO2 variation... so it doesn't completely explain why some do better on Levo than others, but it could be part of the reason.

[it's DIO 2 ...as in 3 letters and a number, not D102]

For more reading on the science of thyroid hormone action, this canadian site is very good and up to date., for example this article.. thyroidpatients.ca/2019/11/... the-basics-of-thyroid-hormone-action-transport-and-conversion/

List of all their articles thyroidpatients.ca/home/sit... site-map/

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