Off to see an endocrinologist on Wednesday - Thyroid UK

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Off to see an endocrinologist on Wednesday

bikebabe profile image
13 Replies

Due to see endocrinologist on Wednesday. Not seen one since I was 20 and I’m 62.

GP results and blue horizon the same for tsh and free t4 ie 1.1 tsh (0.27-4.2) and ft4 21.4 (12-22). Done early, no thyroxine etc.

The blue horizon test gives ft3 as 3.7(31.-6.8) which is a reduction from 4.4 in March. Am I right in thinking that this is 54% of max and a conversion rate of 5.78.

On this basis is it worth insisting that I be given a trial of t3? I don’t think there’s any research around how this might interact with my targeted cancer meds that affect cell division and my spinal mets are stable. Hard to separate hypo symptoms from cancer therapy but I’m def. constipated since t4 reduction as meds usually gave me diarrhoea and my Nails constantly break. Hair doesn’t grow and No energy but that maybe therapy too. My ccg does show t3 prescribing but it’s all changed with new NHS structures. I tried to get referral to salford to t3 supportive endos but that hasn’t happened.

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SeasideSusie profile image
SeasideSusieRemembering

bikebabe

The blue horizon test gives ft3 as 3.7(31.-6.8) which is a reduction from 4.4 in March. Am I right in thinking that this is 54% of max and a conversion rate of 5.78.

No, a result of 3.7 with a range of 3.1-6.8 gives a percentage through range of 16.22%

Calculator: thyroid.dopiaza.org/

Conversion rate would be FT4 of 21.4 divided by FT3 of 3.7 = 5.78

So yes, conversion is poor but before considering T3 are you key nutrients all at optimal levels:

Vit D - 100-150nmol/L

B12 - top of range for Total B12 or over 100 for Active B12

Folate - at least half way through range

Ferritin - half way through range although some experts say the optimal ferritin level for thyroid function is 90-110ug/L.

bikebabe profile image
bikebabe in reply toSeasideSusie

Hello seaside susie - thank you. My vit results were all ok except folate was in range but suboptimal. My vit d is in range but stays on low side no matter how much in way of extra supplements and lots of sunshine.

SeasideSusie profile image
SeasideSusieRemembering in reply tobikebabe

bikebabe

Previous post suggested you weren't taking enough Vit D

healthunlocked.com/thyroidu...

so you would need an increase from the 1,000iu D3 daily, plus magnesium (which helps the body convert D3 into it's usable form) and Vit K2-MK7 (directs calcium to bones and teeth where it's needed and away from arteries and soft tissues where it can be deposited and cause problems, taking D3 increases absorption of calcium from food, plus you take a calcium supplement).

If all nutrient levels are considered good then I see no reason why a trial of T3 should not be offered but you can check interactions with Drugbank here:

go.drugbank.com/drug-intera...

bikebabe profile image
bikebabe in reply toSeasideSusie

My d3 intake is 1400 units daily due to extra in calcium tabs) plus good diet and sunshine. Magnesium came back as 0.92 (0.66-0.99). But I will double my vit d tabs to get daily 2400 units to see what difference it makes.

SeasideSusie profile image
SeasideSusieRemembering in reply tobikebabe

Magnesium came back as 0.92 (0.66-0.99).

Testing magnesium is unreliable. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status. I'm not really sure why Blue Horizon include this test.

A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test, it's an expensive test and needs phlebotomy so wont be included in any test bundle.

bikebabe profile image
bikebabe in reply toSeasideSusie

I wasn’t aware of that so many thanks. My bone meds may increase rate of calcium and I guess magnesium loss too. Also a few of my rbc measurements are off and indicate anaemia or more folate.

SlowDragon profile image
SlowDragonAdministrator in reply tobikebabe

Don’t double your vitamin D tablets as they contain calcium and too much calcium is bad idea as it can fur up your arteries

Add a separate vitamin D supplement

With thyroid disease we frequently need much higher dose vitamin D than average person …..3000iu-4000iu perhaps

Test twice yearly via NHS private testing service when supplementing to work out what dose you personally need

You might need higher dose vitamin D in winter than summer

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Great article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

bikebabe profile image
bikebabe in reply toSlowDragon

Them you so much Slow Dragon. My magnesium is top of range but I will start taking betteryou. As ever it’s the extra cost that’s offputting.

pennyannie profile image
pennyannie

Hello Bikebabe :

The accepted conversion ratio when on T4 monotherapy is said to be 1 / 3.50 - 4.50 T3/T4 with most people feeling at their best when they come in at around 4 or under:

So, yes your conversion ratio is coming in very wide from the centre ground and showing poor conversion of T4 into T3 - which is the active hormone that runs your body.

Generally speaking we tend to feel at our best when our T4 is up in, or towards, the top quadrant of its range as this should, in theory convert to be good level of T3.

Your T4 is at almost 100% through it's range whilst your T3 is just some 6 % through it's range, and the logical solution is to rebalance your T3 and T4 into around a 1/4 ratio T3/T4 by reducing your T4 medication a little and adding in a little T3 - Liothyronine thyroid hormone.

A fully functioning working thyroid would be supporting you in a daily basis 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 10 mcg.

T3 is said to be around 4 times more powerful than T4 so by having ' lost ' your thyroid you have in effect been down regulated by around 20% of your overall wellbeing.

The thyroid is a major gland and responsible for full body synchronisation, it is the body's engine, and monitors and regulates your physical, mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

No thyroid hormone works well until you ferritin, folate, B12 and vitamin D are up, and maintained at optimal levels and this is another area that you likely need to supplement as just being in the NHS range somewhere is not acceptable as we need optimal levels for effective conversion of any thyroid hormone replacement.

I appreciate it's difficult working out what symptoms are related to what but I think your T3 at this seriously low level will be an obvious culprit.

Some people can get by on T4 only :

Some people find after a period of time, they need the addition of a little T3 to rebalance their thyroid hormones, and take a T3/T4 combo:

Some people can't tolerate T4 at all and need to take T3 only :

Whilst other people feel better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland, derived from pigs thyroid dried and ground down into tablets which are referred to as grains. NDT was the original successful treatment for hypothyroidism for over 100 years prior to Big Pharma launching, on the back of NDT, their own thyroid hormone replacement medications in around the 1950/60's.

bikebabe profile image
bikebabe in reply topennyannie

Thank you so much pennyAnnie

Brightness14 profile image
Brightness14

A pig thyroid is 4 : 1 and a human is 10 : 1 ratio so NDT not ideal but good without a thyroid.

bikebabe profile image
bikebabe in reply toBrightness14

Hello Brightness - i'm not sure what you mean. I do have a thyroid but with pendred's i'm assuming it doesn't produce any thyroxine.

Brightness14 profile image
Brightness14

Sorry what I meant was: When taking NDT Natural thyroid the ratio is 4 : 1 that is 39 mcg of T4 and 9 mcg of T3 plus two small amount of other stuff. A human thyroid is approx 100 mcg T4 thyroxine. to 10 mcg of T3, the ratios are different. I hope this explains it better.

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