Improving T4 to T3 conversion

[Eladee]

Hello All

I’m trying to see if I can improve my T4 to T3 conversion by improving vitamin intake, my GP won’t increase my Levothyroxine as she said TSH is perfect all tests are normal and has diagnosed my ongoing aching lethargy low mood as fibromyalgia.

I’ve started taking Igennus super B complex, should I be adding anything else to help and any ideas on how long to leave before I get next blood test ? 6-8 weeks or leave longer ?

10/01/23 results of private test showing T4and T3 levels

TSH. 2.10 (0.27-4.2) mU/l 46% thro range

Total T4 136 (66-181) nmol/l 60%

FreeT4. 17.1 (12.0-22.0) pmol/l 51%

Free T3. 3.94 (3.1-6.8) pmol/l 22%

B12 291 (145-569) pmol/l

Vit D (25 OH) 106 nmol/l

Folate haemolysed

Ferritin haemolysed

Magnesium 0.91 (0.7-1.0) mol/l

GP test 12/01/23

TSH 1.66. (0.27-4.2) mIU/l 35%

B12 408 ( 180-650). ng/l 48%

folate 3.8 (2.8-15) ug/l. 8,2%

ferritin 221 ( 13-150). ug/l

Previous private tests have shown my T3 to be always under halfway through the range

GP said we don’t go by T3 and won’t do an increase so if I can increase conversion without increasing Levothyroxine will this be beneficial?

currently taking 75mcg mon-sat 100 mcg Sunday.

Thanks in advance for any advice 😊

[GlowCoach Administrator]

Do try a different GP at the same practice. Some are more tricky than others about increasing dose. There is a pinned post about references re getting TSH lower you can show your GP some of those. Also emphasise remaining symptoms and do not back down. Be persistent, make a bit of a nuisance of yourself but nicely!

Thorne Basic B is preferred choice of B complex. There's also another one thats a bit cheaper on Amazon. amazon.co.uk/Yipmai-Liposom...

[Eladee in reply to GlowCoach]

Thanks Jaydee

[SlowDragon Administrator]

Then you need to see different GP

How much do you weigh in kilo

Guidelines on dose levothyroxine by weight is approximately 1.6mcg levothyroxine per kilo of your weight per day

You’re Ft4 shows you are currently under medicated

Request trial increase to 100mcg daily

Which brand of levothyroxine are you currently taking

Taking levothyroxine at bedtime can possibly improve absorption and uptake too

Folate and B12 far too low …..because dose levothyroxine is inadequate

You will need a separate B12 initially as well as vitamin B complex

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week 

B12 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

How other member saw how effective improving low B vitamins has been 

healthunlocked.com/thyroidu...

[Eladee in reply to SlowDragon]

Thanks SlowDragon

The GP’s don’t want to increase even as a trial 😣I’ve seen a couple of others previously, thought I’d try increasing vitamins then get blood test and depending on results maybe see private endocrinologist (got list from thyroid uk)

I take Adcal D3 2x daily for osteopenia and that’s got 400 i u (10mcg D3) per tablet I’ve been taking this for over a year.

I not supplementing any other vitamins not vegan/vegetarian but don’t eat much red meat.

I weigh 69.8 kg

My Levothyroxine are 100 mcg accord

50- mercury 25- wockhardt

I’m on HRT for the osteopenia have got oestrogel initially 2 pumps daily but recently increased to 3 and utrogestan 100mg (progesterone) I always used to take thyroxine at night but changed to morning because of the utrogestan can’t remember why I swapped them around at the minute but I did feel better when taking the Levothyroxine at night, is thyroxine best to take on its own can I take at same time as utrogestan?

Do you know how I save posts or find pinned posts on my phone? ( just found the pinned posts)

Thanks for the information

[tattybogle in reply to Eladee]

This is the pinned post with recommendations for GP's to keep TSH between 0.04/ 0.5 and 2/2.5 in patients on levo .

So you can push that at GP's as it clearly shows there is no reason NOT to try an increase as long as it doesn't send TSH below 0.04/0.5 ish . ( which of course they don't know unless they try it )

I suggest you be a nuisance and keep pushing that line ... ie "what are their reasons for NOT trying it.. when there is clearly no harm in it " ~ some of those rcomendations are taken directly from uk GP 'update sources' ..and one is written specifically for GP's by NHS Specialist Registrars in Cardiology and Endocrinology ~ so there should be no argument about their validity for UK NHS GP's to be guided by them .

healthunlocked.com/thyroidu...

Can't help with the tech bit re. how to find them on the phone though

[Eladee in reply to tattybogle]

Thanks for the link, I’ll print them off and take them next time I see gp.

I’ve found the pinned posts on Home Screen 👍

[SlowDragon Administrator in reply to Eladee]

69.8kg x 1.6mcg = 111mcg as likely daily dose levothyroxine required

And when on HRT it’s common to need to increase dose levothyroxine too

HRT tablets must be at least 4 hours away from taking levothyroxine

Can you take HRT in morning and levothyroxine at bedtime

[Eladee in reply to SlowDragon]

yes I can take the hrt in the morning so I’ll swap and take Levothyroxine at bedtime and the hrt in the morning, that might help me feel a bit better along with getting the B12 and folate increased.

I’ll print off information tattybogle linked to see if gp will increase, if not I might try slow increase on my own with help from forum after vitamins are optimal.

would 6-8 weeks be long enough to see an improvement I’ve already got a finger prick test from blue horizons ready to do but don’t want to waste it if I do it too soon.

[SlowDragon Administrator in reply to Eladee]

wait at least 8 weeks

Or if going to change timing of levothyroxine

Ideally wait 6-8 weeks after changing to taking levothyroxine at bedtime

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Eladee in reply to SlowDragon]

Thank you so much for your help SlowDragon hopefully these changes and improvements to vitamins will make me feel a bit better.

[SlowDragon Administrator in reply to Eladee]

Osteoporosis can be linked to LOW Ft3

 

thyroidpatients.ca/2018/07/...

[SlowDragon Administrator in reply to Eladee]

Adcal needs to be at least 4 hours away from levothyroxine

Are you not taking any vitamin K2 or magnesium supplements?

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...

Interesting article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[Eladee in reply to SlowDragon]

I take the adcal at around 11.00 and 5pm so it wouldn’t interfere with Levothyroxine at night.

No I’m not taking magnesium or K2

[SlowDragon Administrator]

Are you currently supplementing vitamin D

Any other vitamin supplements?