Private Thyroid Results

[Pollydolly]

hi, good morning… just wondering if anything stands out like a sore thumb to anyone re my latest results. I only ask because I’m having spells of sporadic dizziness and, possibly, what feels like heart palpitations but it always happens so quick that’s it’s over before it’s registered with my brain! Otherwise, generally, I feel quite well. I’m 53 and have gone through the menopause. Many thanks to anyone who feels they can help with my query x

[pennyannie]

Hello Pollydolly :

Looking back I see you have Graves Disease and went through RAI thyroid ablation some years ago.

I too was diagnosed Graves but at age 56 and had RAI thyroid ablation the following year, though well on the Carbimazole and finding no help with my symptoms some 8 years later I purchased Elaine Moore's first book - Graves Disease A Practical Guide - and started my own research.

A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1, T2 and calcitonin + a measure of T3 at around 10 mcg + measure of T4 at around 100 mcg .

T4 - Levothyroxine is a storage hormone that needs to be converted by your body into T3 the active hormone that runs the body which is said to be around 4 times more powerful than T4.

Some people can get by on T4 - Levothyroxine only :

Some people find that T4 seems to not work as well as it once did and by adding a little T3 - Liothyronine they can restore vital T3/T4 hormonal balance and feel better - this is especially true if your thyroid has all but stopped working - or you haven't a thyroid and need to replace that little bit lost when you lost your own thyroid hormone production.

The NHS guess estimated a dose of T4 for you, after RAI but didn't restore your own T3 production as RAI is a slow burn and no-one knows how long it takes for RAI to fully burn out the thyroid is situ and the symptoms created and experienced can be insidious.

Some people can't tolerate T4 and need to take T3 - Liothyronine only.

Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland and derived from pig thyroid dried and ground down into tablets.

Sorry my laptop has hic- cups :

We generally feel at our best when our T4 is up in the top quadrant as this should in theory convert to a good level of T3 at around a 1/4 ratio T3/T4.

The accepted conversion ratio when taking T4 only is said to be 1 / 3.50 - 4.50 - T3/T4 with most of us feeling at our best when we come in this range at 4 or under and so if I divide your T4 by your T3 I'm getting your conversion coming in at around 5.42 showing very poor conversion.

Conversion of T4 into T3 can be compromised by non optimal levels of ferritin, folate, B12 and vitamin D pls inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing can down regulate conversion.

I can't see a folate result and your B12 could be built up a little but the most obvious thought is to think of adding back in a little T3 to rebalance T3/T4 hormones.

For all things Graves Disease - elaine-moore.com

For reference :-

ncbi.nlm.nih.gov/pubmed/306...

pubmed.ncbi.nlm.nih.gov/338...

[Pollydolly in reply to pennyannie]

thank you for your reply. Am I right in thinking that most g.p’s don’t prescribe T3 Liothyronine? Kind regards,

[pennyannie in reply to Pollydolly]

Yes, around 20 years ago your doctor had all 3 treatment options in his tool kit but now I'm afraid s/he only has T4 and the second line for all ills, antidepressants at his disposal.

You will need a referral to an NHS endocrinologists to assess your need and I'm afraid it has become a post code lottery and more dependent of local funding restrictions than medical need.

Thyroid UK the charity who support this amazing forum hold a list of our recommended patient to patient NHS / private thyroid specialists and endos so you can email admin for this list. thyroiduk.org

Before you choose / book any appointment you can start a new post asking for feedback on same but as we can't openly discuss people on the forum your post will be replied by PMs - private messages - and your Chat icon above will light up if you have any answers.

I was refused any help through the NHS and refused ith T3 and NDT and in 2018 started self medicating, buying my own full spectrum thyroid hormones and have my life back.

[Pollydolly in reply to pennyannie]

Thank you for your help. It’s much appreciated x

[shaws Administrator in reply to Pollydolly]

Not all endocrinologists prescribe T3 but may be more willing nowadays because the cost has reduced.

My body doesn't like levothyroxine at all and gave me severe palpitations particularly during the night and the cardiologist was contemplating putting an implant in heart to try to figure out why this was happening. He didn't need to do this as Liothyronine (T3) resolved the palpitations and I am now prescribed T3 alone and feel well with no symptoms.

Many people find that levothyroxine suits them and they wont be searching the internet.

In the past we could get NDTs (natural dessicated thyroid hormones) which were the very first replacements that saved thousands of lives but has been withdrawn, despite it being the very first replacement that saved lives from 1892 onwards (without the need of blood tests and doctors being aware of all of the clinical symptoms of a patient who had hypothyroidism).

[Pollydolly in reply to shaws]

Thank you for responding. Very interesting. I shall look into this further x

[SlowDragon Administrator]

Was test done early morning, ideally around 9am and last dose levothyroxine 24 hours before test

FT4: 20.4 pmol/l (Range 12 - 22)

Ft4 is 84.00% through range

FT3: 3.76 pmol/l (Range 3.1 - 6.8)

Ft3 only 17.84% through range

Shows very poor conversion rate

Most people when adequately treated will have Ft3 at least 50-60% through range

Likely to need T3 prescribed alongside slightly lower dose levothyroxine

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

What vitamin supplements are you currently taking

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

[e-mail]

[Pollydolly in reply to SlowDragon]

Thank you for responding. Very helpful and I shall look into T3 in more detail. Test was done at 12:30pm and yes slightly more than 24 hrs since last dose of levothyroxine. Usually same brand, but not always… currently take 125/100 alternate days. Vitamin supplements are vit d, calcium, magnesium and iron

[SlowDragon Administrator in reply to Pollydolly]

Ferritin is high

You very likely do not need iron supplements

When did you last have full iron panel test

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Why calcium?

Not recommended unless tested and low

Ideally next test include folate test alongside B12

Many members need to improve low folate levels

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

[e-mail]

number of prescriptions is increasing back up now price has fallen significantly since more suppliers licensed

Currently 59,900 prescriptions in England in last year

(Up from 56k 3-4 years ago)

openprescribing.net/analyse...

price gouging and £100m fine imposed

news.sky.com/story/regulato...