Percentage thro range

[Nutty56]

Sorry I know this has been mentioned numerous times but I can’t find info

What are the ideal percentages through that range for T4 and T3

Thanks

[Lalatoot]

The ideal percentages through range are the ones where you feel well. It is individual. You arrive at them through trial and error, patience and gradual adjustment of individual doses.

[Nutty56 in reply to Lalatoot]

Thanks Lalatoot I just wanted general idea because I don’t feel too good ! Gp just saying it’s fine must be something else going nowhere !

[SeasideSusie Remembering]

Nutty56

What are the ideal percentages through that range for T4 and T3

The answer to that is ... whatever is right for you. We are all different and we don't all need them at the same certain percentage through range.

It's generally said that most hypo patients on Levo only seem to feel best when FT4 and FT3 are in the upper part of the reference range, but the exact level is for each of us to find ourselves. So the aim generally is to get over 50% but exactly where over that 50% is trial and error. I think it's fairly common for FT4 to be around 70% or a bit more, with FT3 a bit lower, but you really do need to find out for yourself because someone else's optimal isn't necessarily going to be your optimal.

[Nutty56 in reply to SeasideSusie]

Thanks SeasideSusie I just wanted a general idea ? I want to discuss with gp on Friday because they keep dismissing thyroid and I am not convinced !

Levels

[SeasideSusie Remembering]

What you have there Nutty56 is poor conversion of T4 to T3. Your FT4 is 92% through range and your FT3 is a paltry 29.19% through range.

Calculator here: thyroid.dopiaza.org/

However, your TSH is rather high for a treated hypo patient, especially considering your FT4 level. Normally we would say you need an increase in your Levo to bring your TSH down to 1 or below, this then gives the highest FT4 and by looking at FT3 we can see how well we convert.

Did you do the test as we always advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day.

In fact, 9am is the perfect time, see first graph here, it shows TSH is highest around midnight - 4am (when we can't get a blood draw), then lowers, next high is at 9am then lowers before it starts it's climb again about 9pm:

healthunlocked.com/thyroidu...

If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Nothing to eat or drink except water before the test - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Certain foods may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin). See

thyroid.org/patient-thyroid...

biotin use can result in falsely high levels of T4 and T3 and falsely low levels of TSH

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

We need optimal nutrient levels for good conversion to take place, so have you tested those and are they:

Vit D - 100-150nmol/L

B12 - top of range for Total B12, if Active B12 tested then 100 plus

Folate - at least half way through range

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

So there are these things to think about first.

So if your TSH was 1 or below, and if all your nutrient levels were optimal, and if you left 24 hours from last dose of Levo before blood draw, and then you had results like yours it would suggest poor conversion and you may benefit from the addition of T3 to your Levo.

[Nutty56 in reply to SeasideSusie]

Thanks again yep I followed the guidelines ! I just wanted to be a little prepared when I once again tackle GP

[SlowDragon Administrator]

When were vitamin levels last tested

What vitamin supplements are you currently taking

[Nutty56 in reply to SlowDragon]

Thanks SlowDragon I had private test done in April also gp checked folate B12 !This has been ongoing for months and every GP has diff theory Aneurysm PMR to list a few ! Am going to push for endo to look at them as I’m convinced it’s thyroid related

I take Thorne B complex , evacal D3 occasionally B12

I stopped vits prior to blood test

Vitamins

[SlowDragon Administrator in reply to Nutty56]

So you probably need addition of T3 prescribed alongside levothyroxine

Ft3 is too low

Conversion often gets worse after menopause and/or as we get older

Roughly where in U.K. are you

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

[e-mail]

Have you ever had high thyroid antibodies (hashimoto’s)

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Looking at your profile you highlight prednisolone

Are you still taking this?

Prednisalone can lower TSH

Low TSH can reduce conversion rate of Ft4 to Ft3 when taking replacement thyroid hormones

pubmed.ncbi.nlm.nih.gov/114...

The effect of exogenous prednisone on serum thyrotropin (TSH), thyroxine (T4), and triiodothyronine (T3) concentrations was investigated in four patients with non-functioning thyroid glands receiving T4 replacement therapy. Orally administered prednisone, in a dose of 20 mg each day for nine days, resulted in a significant decrease in mean serum TSH levels (p less than 0.01)

[Nutty56 in reply to SlowDragon]

I am in Liverpool I have got an endo someone recommended on here . I am not prednisolone GP initially diagnosed PMR but I saw rheumatologist and I didn’t have it ! Worried what GP will come up with next ?