Hi. I have a meeting with Endo tomorrow and would appreciate help with Interpretation of results. It looks like I have the defective Gene but need and opinion
Test Results for DIO2 Gene.Comments Please - Thyroid UK
Test Results for DIO2 Gene.Comments Please
rick2525
Impossible to read on my large PC monitor, it is quite blurry. Can you resubmit with a clearer image.
Struggling to read this!
Is this supposed to confirm that you have the Dio2 polymorphism (snp) because I cannot see ( make out) an actual confirmation of that or a confirmation that the snp is heterozygous ( from one parent) or homozygous ( from both parents)The latter has some significance.
If you inherit from both parents the effects on T4 to T3 conversion are said be greater than if from one parent.....that is, the rarer CC genotype of the rs225014 polymorphism.
If the snp exists and response to T4 is not good then adding a little T3 may help
You can also check T4 to T3 conversion status by comparing your FT4 result with your FT3 result....
High FT4 with low FT3 = poor conversion
On that basis your results below, 2 months ago , indicate poor conversion and a need for some replacement T3
Your FT4 is very high!
First you must ensure vit D, vit B12, folate and ferritin are optimal
Free T3 4.2 (3.1-6.8)
T4 21.1 (12-22)
Hope I've read the letter correctly
Good luck
PS. I have the Dio2 snp/ homozygous
Test page 2
OK so as far as I can make out from your images you have the Dio2 polymorphism ...Indicated by gene variant rs225014 I thought I read type CC in the above copy but it's so fuzzy that it may instead be type CT
Can you please check your hard copy and confirm?
I'll focus on CT now... a
The snp is heterozygous ( type CT)
The normal allele is aT
The risk allele is C.....inherited from one parent only
This means any effect on T4 to T3 conversion is likely to be fairly low
This article will explain in more detail...
paulrobinsonthyroid.com/dio...
Sorry it's a bit of a ramble....not sure why the download is so poor
However, Paul's article will help you join up the dots!
Are you still on 87.5 mcg T4 + 25mcg T3?
If so with labs....
FT3: 5.6 pmol/l (Range 3.1 - 6.8) -- 67.57%
You have room to increase T3 dose.
You will not be overmedicated unless FT3 goes over range.....no matter what TSH is!!
T3 needs to be taken in a regular dose....unlike T4 which can be taken in different daily doses
Good luck for the appointment....
Hi . Thank you so much. Yes you are right it is CT and yes my mother was Hypothyroid but not my father. I am currently on 125mcg Levo daily with no T3 as GP cant prescribe and wont discuss it. So for 2 years i have suffered many adverse symptoms.
Time to push for some some T3....
or self medicate!
Hi Dippy Dame. So my first visit to Endo and I went prepared with test results from private and GP ones. He advised that I had a conversion issue of T4 to T3 and has written to GP recommending a 3 month trial period of T3. I dont know what reaction I will get from GP because she has previously said that it was unobtainable from my practice. The Endo has recommended reducing Levo by 25 mcgs and replacing with 20 mcg of T3 split twice daily. Do you think this is excessive? I really appreciate the people who have given me the advice on here to understand Thyroid issues so I was able to hold a meaningful conversation with Endo.
rick
Is this a private endo or NHS?
NHS prescribed T3 must be initiated by NHS endo for a trial of 3 months (sometimes 6 months) and only then, if trial is deemed to be successful, does GP take over prescribing. Private endo asking NHS GP to prescribe isn't likely to be successful.
Also, reduce Levo initially, a week later add 5mcg T3, don't start on 20mcg it's too much of a shock for the body. Start with 5mcg, give it 2 weeks then if all OK add another 5mcg. See how you feel. Some people like to test at this point because we don't all need that much. Never add more than 5mcg T3 at a time.
Good, it's a start
I see Seaside Susie has given good advice re adding T3....
We are advised to change only one thing at a time
Also, starting on 20mcg T3 could be a bit like putting high octane fuel in an old Mini!!!
Instead, increase low and slow
I doubt a 3 month trial will be long enough....
It will be interesting to see how that pans out
If it doesn't work out there is always the option to self medicate
It is utterly ridiculous that this should be the case
Meantime, follow Susie's advice and you won't go wrong.
Impossible to read text on image
Please reattach new picture
Ensure any Dr names are blacked out
Do you have autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies?
Have you had coeliac blood test done
Are you on strictly gluten free diet
originalText
1.1 Recognition of coeliac disease
1.1.1 Offer serological testing for coeliac disease to:
people with any of the following:
persistent unexplained abdominal or gastrointestinal symptoms
faltering growth
prolonged fatigue
unexpected weight loss
severe or persistent mouth ulcers
unexplained iron, vitamin B12 or folate deficiency
type 1 diabetes, at diagnosis
autoimmune thyroid disease, at diagnosis
irritable bowel syndrome (in adults)
first‑degree relatives of people with coeliac disease.
Report looks different to usual Regenerus report …
Did you get consultation with Regenerus to discuss result
Heterozygous Dio2
So you are already on levothyroxine plus T3 ?
How much levothyroxine
Which brand
What time do you take levothyroxine
Do you split dose
How much T3
Which brand
What time are you taking T3
Do you split dose
What are your most recent vitamin D, folate, ferritin and B12 results
what vitamin supplements are you currently taking
Hi . I am not taking any T3. I'm hoping the Endo appointment tomorrow will lead to it been prescribed. I take 125mcg Levo Accord usually between 3am and 5am daily. My other results were posted on here recently which you commented on. I have had no consultation with Regenerous. This is how my result was sent back in this format from Saliva test. Dippy Dame has interpreted the CT and code as my having inherited the gene from single parent which makes sense as my mother was Hypothyroid but not my father. I am seeing Endo in morning who is from the list supplied by Thyroid UK. I have several Medicheck results for Full Thyroud function to take with me plus Cortisol test result. Plus full blood count and Parathyroid test result inc Calcium.
Also Testosterone result. All these show normal results. So perhaps the DIo2 result may prove poor converter of T4 to T3.
I have been battling with GPs for 2 years. Hoping Endo can help
Apologies…I should have read previous posts
healthunlocked.com/thyroidu...
So last thyroid test
Ft4 was 21.1 (12-22)
Assuming you are prescribed T3
Start SLOWLY
As Ft4 right at top of range…..reducing levothyroxine a little for 4-5 days before starting on just 5mcg T3
How much levothyroxine you should reduce…..difficult to say
(Endocrinologist will almost certainly want to reduce by at least by 25mcg…..)
Assuming 5mcg T3 is ok
After week or so add 2nd 5mcg dose mid/late afternoon
Wait 6 weeks and retest
Hi SD . Yes the Endo has prescribed T3. I have put the info in reply to Dippy Dames blog. I note your comment re dosage of T3 gradually. I need guidance. The Endo is recommending reduction of 25 mcg Levo and replacing with 20 mcg T3 split in two doses, 1st dose of 10mcg early morning when I take Levo and second dose an hour after lunch. Then retest after 6 weeks. Do you think this should be more gradual? Is T3 more powerful as my last T4 test showed me near the upper threshold of range.
Some people are fine adding 10mcg ….others need to go slower
I would suggest you reduce levothyroxine by 25mcg ….wait 4-5 days…then add 5mcg waking
Assuming that’s not “too much of a whoosh”
After a week consider adding 2nd 5mcg dose T3 mid- late afternoon
After another week or so ….either increase morning dose to 10mcg ….or add 3rd 5mcg dose T3 at bedtime
Many people find small 5mcg dose T3 at bedtime improves sleep. But not everyone does
You may or may not need to add last 5mcg of T3
See how you get on
Retest thyroid levels after 6-8 weeks on constant dose levothyroxine and T3
Last dose levothyroxine 24 hours before test
Last 5mcg dose T3 approx 8-12 hours before test
Always get same brand levothyroxine at each prescription
T3 ….
Which brand is this….is it private prescription?
If yes…..Likely to be Thybon Henning 20mcg tablets
Personally I cut 20mcg tablets with sharp craft scalpel into 1/4’s
Other people use pill cutter
I can’t seem to get on with pill cutter
you don’t want T3 capsules as they can’t be split
One other suggestion
Quite a number of members on levothyroxine plus T3 find it better to also split levothyroxine into two smaller doses.
I have been on T3 since 2017
As an experiment….in April this year I Started splitting levothyroxine into two doses, half daily dose waking and half at bedtime. Astonished to discover I find it so much better
Seems to improve conversion rate for many members that try it. I am now slowly reducing T3 from 20mcg daily to 15mcg. Currently at 17.5mcg…..waiting to retest after 6-8 weeks on this dose.
Thanks SD. When I suggested to Endo to take 2nd dose at bedtime he said no as it would probably keep me awake. Good point re pill. Must check to make sure. Dose T3 pills come as 20mcg or 10mcgs?
T3 comes in 5, 10 and 20 microgram tablets and/or capsules.
helvella - Thyroid Hormone Medicines
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