conversion testing

[rex1924]

Hello everyone, i am looking for some help from those exerienced with thyroid medication. I think I might have trouble converting my T4 medication (levothyroxine) to T3 and am considering supplimenting with Liothyronine. I was looking for some help with what levels I should have checked before and after starting on T3 to see if I am having trouble converting and if the T3 is causing me any harm. I only get TSH checked by my GP. The test I was looking at measures my Free T3, Free T4 and Total T4 amongst other things, is this enough? Thank you all for your time and help.

[SeasideSusie Remembering]

Rex1924

The tests you need to know how well you convert are

TSH

FT4

FT3

If you are a poor converter the FT4 will be high in range and the FT3 will be low in range. As a general rule if you divide FT4 by FT3 (as long as units of measurement are the same) and the result is over 4 then your conversion is poor, eg

FT4 20

FT3 4

20 ÷4 = 5 = poor conversion

FT4 20

FT3 6

20÷6 =3.3 = good conversion

For good conversion take place we need optimal nutrient levels:

Vit D

B12

Folate

Ferritin

Do you have any current test results for thyroid and nutrients that you can post? If so please add them, including their reference ranges as these vary from lab to lab, and members will comment.

[SlowDragon Administrator]

Welcome to the forum

What’s the reason for your hypothyroidism?

How much levothyroxine are you currently taking

What’s your most recent TSH ?

Do you always get same brand levothyroxine at each prescription

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

When were vitamin levels last tested

What vitamin supplements are you currently taking

Low vitamin levels are extremely common, especially if under medicated…

or with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s.

Gluten intolerance is often a hidden issue too. Request coeliac blood test BEFORE considering trial on strictly gluten free diet

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 and last dose levothyroxine 24 hours before test

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...

If you can get GP to test vitamins and antibodies 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

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[rex1924]

Hello Seaside Susie and Slow Dragon, thank you both for your replies, my underactive thyroid is caused by Hashimoto's, I am currently taking 125 levothyroxine every morning, i'll take a little time to read your replies properly, many thanks for the help and guidance.

[doiganator]

I would also ask the provider to test for the thyroid antibodies. I wish I had known that! I was put on Levo and not all tests were run. Turns out I have Hashimottos .... which may be cause my Celiac ..... So far confirmed after recently going gluten free and taking supplements like selenium, probiotic, ext. If I had known than it was autoimmune, changes in diet would had prevented thyroid damage and other issues.

[playtime2]

TSH is pretty much worthless, although Endos are in love with it. They are wrong. Seaside Susie has a very good reply to your question.