Does this mean better conversion

[Thyroid_mum]

Hi all,

Hope you're keeping well.

Quick back story I used to take Levo and Glandular but had an issue with delivery last year and tried to move to T3 and then Slow Release T3 and finally pig desiccated - neither of these worked for me as I had terrible anxiety, palpitations, mood instability. I have swung back to the Glandular as delivery isn't an issue anymore and I wasn't doing well on the other meds I tried. All the adverse side effects I was getting on T3 and pig desiccated have disappeared and I am still increasing the glandular to my initial dose but I have noticed my T4 bloods have gone down and wondered if this is due to better conversion?

I am taking 100mcg levo and 2.5 65mcg glandular (need to get to 4). I've attached my latest results and previous results in comments. Test was taken 12 hours after last glandular (surprised to see the T3 is about the same as the slow release T3 which was 17.5mcg)

Any insights would be appreciated.

Thank you 🙂

[Jaydee1507 Administrator]

If someone were having conversion issues their FT4 would be high and FT3 low.

Free T4 (fT4) 14.1 pmol/L (12 - 22) 21.0%

Free T3 (fT3) 3 pmol/L (3.1 - 6.8) -2.7%

Thats a very low FT4 on 100mcgs levo. When did you last take Levo before the test?

What supplements are you taking?

Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Use this calculator to work out how much to take to get your level to 100-150. wildatlantichealth.com/vita...

Your B12 is too low.

Are you vegan/vegetarian?

Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc

[Thyroid_mum in reply to Jaydee1507]

thanks Jaydee, T4 was taken about 24 hours before. I might redo the test to confirm the result.

I take vitamin ADK

Methyl Folate 400mcg

Methyl b12

Omega

Liposomal Phosholipid Complex

Megamag calmeze

Ashwaghansa

pharma GABA

My TSH has never been that high which is why I’m thinking testing again to confirm the results?

I’ve heard with desiccated your T4 would go down and T3 up which is why I thought with the glandular I’m converting better (I do have DIO 1 and 2 double mutations)

[Jaydee1507 Administrator in reply to Thyroid_mum]

I take vitamin ADK

Do you mean D3 with K2? If so you could take a little more of it.

Methyl Folate 400mcg

Methyl b12

Continue with the methyl B12 but swap out the folate for a good methyl B complex such as this one. amazon.co.uk/Liposomal-Soft...

With glandularls theres no guarantee as to what they contain but you do need more of something for sure.

[Thyroid_mum in reply to Jaydee1507]

not a vegan/vegetarian but have digestive issues which could be causing absorbtion issues. There was more inflammation markers on this test.

[pennyannie]

Hello Thyroid-Mum :

i don't think you can compare this to previous results which were from taking compounded, slow release T3 - we can only draw a comparison from like for like blood tests at the same time of day and when on the same thyroid hormone replacement medication.

We can notice improvements however when switching from one option to another but the finer tuning needs to be with the same base elements.

Conversion of T4 into T3 can be compromised by non optimal levels of core strength vitamins and minerals especially those of ferritin, folate, B12 and vitamin D and inflammation, any physiological stress ( emotional or physical ) dieting, depression and ageing can all also impact and down regulate T4 to T3 conversion.

Your inflammation is high suggesting your body struggling , upset and under stress.

Your core strength vitamins and minerals all need supplementing -

I now aim for a ferritin of around 100 : folate around 20 ; active B12 75++ ( serum B12 500 ++ ) and vitamin D at around 100;

Your T3 is showing under the range with a T4 at just 24% through the range - we generally feel best when the T4 is up in the top quadrant at around 80% through its range as this should, then, in theory convert to a decent level of T3 at around a 1/4 ratio T3/T4.

So first we need to build back up your T4 into the top quadrant of its range - and hopefully your T3 will track / convert at around 20% behind your T4.

[Thyroid_mum in reply to pennyannie]

Thank you, I am wondering if I should redo the test as the T4 is very low compared to passed results.

[pennyannie in reply to Thyroid_mum]

How long have you been on this dose - 100 mcg T4 and did you remember not to take your daily dose until after the blood draw ?

[Thyroid_mum in reply to pennyannie]

I've been on levo for over 20 years and this is the lowest my T4 result has been. I was initially on 200mcg daily before I added glandular and then dropped it. While I was trying other forms of T3 it was 100/125 alternate days and the result was 20. So to drop to 14 doesn't seem right to me as the glandular has T4 and T3?

previous results

[pennyannie in reply to Thyroid_mum]

Yes but how long have you been on this current dose of 100 T4 only -

I'm not sure i can see a date on this screen shot -

What were you taking when this result was run ?

This screen shot shows that you not converting the T4 well into T3 which is usual after a thyroidectomy and you need to look at full spectrum thyroid hormone replacement, which you seem to have tried, apart from maybe T3 only.

Looking back i can see you have tried treatment options but not with much success :

Could there be an absorption issue ?

[Thyroid_mum in reply to pennyannie]

The image above is from March I was taking 100/125 levo and 17.5mcg Slow Release T3 and I was on that dose for 6 weeks.

I have been on the 100mcg with 2.5 capsules of Glandular (97.5mcg)

I definitely think absorption issue - I have had Sibo and working on my gut bacteria

[pennyannie in reply to Thyroid_mum]

Ok then - that's likely part of the issue - have you tried liquid T4 ?

[Thyroid_mum in reply to pennyannie]

No, I haven't heard of liquid T4 - is this from a compounded Pharmacy?

[pennyannie in reply to Thyroid_mum]

I think doctors prescribe it - have no knowledge of what compounding pharmacy stock - presume it's a stock item.

[Thyroid_mum in reply to pennyannie]

Does the NHS cover liquid T4?

[pennyannie in reply to Thyroid_mum]

No idea - logically I say yes as it's better patients are helped get better than left ill -

but they refused me any treatment options after RAI thyroid ablation and left me very unwell and I've had to self medicate and do it all for myself.

[Thyroid_mum in reply to pennyannie]

I'll definitely discuss with my doc on friday *fingers crossed*

[Jaydee1507 Administrator in reply to pennyannie]

Thyroid_mum liquid levo is firstly in very short supply since last summer. It is also extremely expensive - several hundred pounds a bottle as opposed to pennies for tablets. For this reason alone your GP may be reluctant to precribe liquid Levo.

[pennyannie in reply to Jaydee1507]

Well i just thought it best to mention all the options and know of two forum members who have been prescribed said option.

[pennyannie in reply to Thyroid_mum]

Well your T3 looks low but that reading is a false low - so it's difficult to say much -

More importantly how did you feel back then ?

[Thyroid_mum in reply to pennyannie]

I had a lot of palpitations (periods of 20 minutes) and it was definitely the slow release T3 17.5mcg (didnt get it on 15mcg slow release T3) - I had random periods of feeling unwell for 1-2 days (hungover without the alcohol). I was also very anxious all the time and a feeling being overwhelmed and unable to relax.

I dont have anxiety now and my moods are more stable. Still get the periods of unwell feeling which I think is low thyroid level related. I have brain fog, intolerance to cold. Definitely need a nap daily.

I am meeting with endo to go through the new results. I want to try get to 6 capsules of glandular and retest. If levels haven't improved on T3 then I will try add small amounts of T3. As Glandular's are considered supplements, i am hoping the Endo will be on board.

We did a cortisol test which I am waiting for the results as that may be the reason I can't tolerate much T3. But i will only get these results at the consult on Friday.

[Thyroid_mum in reply to pennyannie]

there was 24-hours between dose and blood test, been on this dose for 6 weeks.

[pennyannie in reply to Thyroid_mum]

OK - what other medications are you taking that may have imping on the T4 being absorbed ?

[Thyroid_mum in reply to pennyannie]

I do try keep a few hours between thyroid meds and food and supplements.

I take Oxytech and Resolor at night with Calm Eaze Mega Mag .

I do take 2 antimicrobials as well with are herbs.

then all these supplements :

I take vitamin ADK

Methyl Folate 400mcg

Methyl b12

Omega

Liposomal Phosholipid Complex

Megamag calmeze

Ashwaghansa

pharma GABA

I take them 4 hours after my thyroid meds

[pennyannie in reply to Thyroid_mum]

I'm sorry but my knowledge of all these supplements and medicines is very limited.

[SlowDragon Administrator]

what was reason for your thyroidectomy

do you always get same brand levothyroxine at each prescription

Have you tried gluten free diet

[Thyroid_mum in reply to SlowDragon]

I had a goitre and hyperactive thyroid

Same brand each prescription

I am normally gluten, diary and sugar free - I did go on holiday before the test and wasn't as strict which may have affected the results due to the inflammation?