I have been educating myself reading other posts on this fantastic forum and think I may have a T4-T3 conversion issue

[Kayakingkim]

as previously posted I was diagnosed with secondary hypothyroidism last June . It really helped me laying out my test results for the first time when I first posted here. After calculating percentages and reading all the helpful posts I think I may have a conversion issue.

I would really appreciate any comments as to whether I am potentially on the right track.

Here are my percentages:-

June 22 - very symptomatic started on Levo 50 then 75mcg

TSH. 42.5%

T4. 0.0%

T3. 45%

Sept 22 - best I felt so far but Levo slightly reduced to 5x75mcg and 2x50mcg due to low TSH

Sorry forgot to do conversion but TSH 0.03 (0.27-4.2) T4 19.9(12-22) T3 5.2 (3.1-6.8)

Jan 2023 still better than when I started but not feeling as good as I did before Levo reduced- TSH now 0.04 (0.27-4.2)

TSH -5.9%

T4 79.0%

T3 4.77%

Still working on raising folate , ferritin, Vit D and B12 as all too low. Have changed products over weekend as previously recommended

Due to see a highly recommended private endo for second opinion in next few weeks as GP will not accept current private endo diagnosis of secondary hypothyroidism.

I am really interested to know your thoughts please 😀

[Kayakingkim]

sorry I meant Jan 23 T3 45.1%

[Jaydee1507 Administrator]

I'm not used to just seeing percentages as opposed to numbers. Anyway, although your conversion isn't equal to the FT4 level it is currently almost 50%. Conversion may well improve once key vitamins are optimal.

Good luck at new Endo.

[Kayakingkim in reply to Jaydee1507]

Thanks Jaydee 1507 my full results are listed on my first post last week

[SlowDragon Administrator]

most recent results from first post

Latest tests show -

TSH 0.04mu/L (0.27-4.2)

FreeT3 4.77pmol/L (3.1-6.8)

Free T4 19.6 pmol/L (12-22)

CRP HS 0.73mg/L (0-5)

Ferritin 46.7ug/L (13-150)

Vit D 70nmol/L (50-200)

Vit B12 127pmol/L (37.5-150)

Folate 3.34 >3.89ug/L

Antibodies fine.

Was test done early morning and last dose levothyroxine 24 hours before test

Folate deficient

Ferritin needs work - aiming for around 100

Vitamin D nearer 100nmol too

[Kayakingkim in reply to SlowDragon]

thanks for your response yes test done 10am which is earliest test I can get at local private hospital and no Levo for 24 hrs. I have just started taking a combo folate/B12 supplement as could not tolerate folic acid. Now considering Ferrous Fumurate instead of Ferrous sulphate as despite max dose for nearly a year ferritin struggling to increase enough has already dropped back to 36ug/L in February

[SlowDragon Administrator in reply to Kayakingkim]

Have you done full iron panel test

It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

retest 3-4 times a year if self supplementing.

Test early morning and stop iron supplements 5-6 days before test. Don’t eat a high iron meal night before test

[Kayakingkim in reply to SlowDragon]

thanks slow dragon yes full test has been done by GP . I have just above range haemoglobin and Haematocrit levels so have mild haemocromotosis (cause not investigated) with low ferritin. Just going to speak to pharmacist now but he probably doesn’t know about impact on healthy thyroid function

I also have high cholesterol good and bad have tried two different drugs simvastatin and atorvastatin but cannot tolerate.

I am now trying a low cholesterol/gluten free / high iron diet !

[SlowDragon Administrator in reply to Kayakingkim]

Then I don’t think you shouldn’t be supplementing

Will tag humanbean and SeasideSusie to comment on this

If other levels are high and ferritin remains low you should only aim to increase by eating iron rich foods

[SlowDragon Administrator in reply to Kayakingkim]

High cholesterol is directly linked to being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[SlowDragon Administrator]

high Haematocrit 

my.clevelandclinic.org/heal...

High haemoglobin

mayoclinic.org/symptoms/hig...

[Kayakingkim]

thanks for all your help and the great links I will take a look 😊