Trying to Calculate T3/T4 Ratio - Need help, please

[JMN2017]

Would someone please help me calculate my T3/T4 Ratio, please? I'm just getting into a muddle LOL

TSH - 0.64 mIU/L (0.27 - 4.2)

FT3 - 4.1 pmol/L (3.1 - 6.8)

FT4 - 24.4 pmol/L (12 - 22)

So, I have calculated

- FT3 - 4.1 pmol/L x 1.0386 = ng/dl

- FT4 24.4 pmol/L x 0.0777

Then, FT3 / FT4 = 2.24

However, I don't think this is right. Please would you correct me so I can know my Ratio?

I'll be so grateful

Many thanks

[TiggerMe Ambassador]

This is how we all cheat 🤗 thyroid.chingkerrs.online/

Result = Terrible conversion level! Possibly worsened by too much T4 which can inhibit....

TSH 0.64 mIU/L (0.27 - 4.2) 9.4%

Free T4 (fT4) 24.4 pmol/L (12 - 22) 124.0%

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8) 27.0%

T4:T3 Ratio 5.951 

[JMN2017 in reply to TiggerMe]

Thanks Eeyore

I think I must have a different image to see what 'normal' ratio should be as 5.951 puts me way above 'above standard'

I'm just looking for what the normal ratio range should be (UK)

Thanks

[JMN2017 in reply to JMN2017]

Eeyore, would you let me know how you calculated this please, and what the 'normal' range should be?

I'd love to know. Thanks

[TiggerMe Ambassador in reply to JMN2017]

I just use the calculator, it comes down to dividing your fT4 result by your fT3… so you have almost 6 times the amount of fT4 to 3 which means it isn’t being converted from one to the other

A better converter might have a fT4 of 20 and a fT3 of 5-6

The ratio is only relevant to T4 only takers or euthyroid

[JMN2017 in reply to TiggerMe]

Thanks Eeyore

I seem to have made it much more complicated LOL

[TiggerMe Ambassador in reply to JMN2017]

You have plenty of fT4 but just aren't converting it to the active fT3.... it needs good Folate, Ferritin, Vit D and B Vits and hopefully not the DIO2 gene twist which can makes for bad conversion whatever you do 😕

[JMN2017 in reply to TiggerMe]

Yes, I supplement Ferritin, Vit D and B12 (si) and try to maintain mid-level of range minimum. Folate has been 110% but needs testing again now. I've asked for blood requests for Iron, Folate and Vit D, waiting for answer, as not been tested for a while.

I didn't know about the D102 gene being responsible for conversion. I will have to ask GP if that could be included too

Thanks for the info re D102

[TiggerMe Ambassador in reply to JMN2017]

I'm afraid GP's don't do gene testing 😕

I'd suggest this one... bluehorizonbloodtests.co.uk...

If you wait they sometimes have it on offer

You can just get the DIO2 done by regeneruslabs.com/products/...

but it isn't that much cheaper and they insist on sending it to a professional or charging you extra for a consultation which is someone reading you the 3 lines of results for £60-£80 😳

[JMN2017 in reply to TiggerMe]

Wow!!! Expensive test, eh?

That certainly would identify if this gene was having an impact. However, I don't feel too bad, to be honest, and wonder if I've been having too much Levothyroxine. I've reduced, as directed by GP, from 150 mcg, 125 mcg and currently, 100 mcg. 100mcg is the 'recommended' dose for my weight, I have to say.

I'll certainly bear this in mind. No harm asking the GP for testing - you never know, he might add it on LOL I won't hold my breath, tho

I'll see how things go and wait till blood test next month.

Thanks for your help

[TiggerMe Ambassador in reply to JMN2017]

If you find that the reduced T4 drops your fT3 lower and you are going to need some T3 to balance things out, I found that having the proof that my DIO2 was wonky meant it was quite a straight forward conversation with the Endo to get it prescribed... so worth it if you get to that stage.

See how you go with the reduced dose and shout if you need us 🤗

[JMN2017 in reply to TiggerMe]

Hi Eeyore, again

Thanks for your recent advice in your last post. I agree that sounds entirely logical and that's what I'll progress to if/when I feel it's appropriate. It's good to know a 'Plan A' for when I need it

I've also learnt that Selenium is very important in T3/T4 conversion so that's another avenue to go down. Again, I'll see if I can persuade GP to request blood test LOL

I've worked out how to calculate T3/T4 ratio, so here is the website I've used, (in case it helps you / anyone else)

optimaldx.com/blog/free-t3-...

It's an interesting article but if you scroll down to the bottom, there is a sliding graph showing the 'normal' range, plus how to calculate. Needless to say, the units need to be converted accordingly first.

I found out - UK units

pmol/l to pg/ml multiply (T3 pmol/L) x 2.6691

pmol/L to ng/dl, multiply (T4 pmol/L) x 1.5884

SO, my T3 / T4 ratio is 1.68 - which is very low, according to the graph in the above link. Interesting and I will work out how it might have changed with previous results.

Other, automatic converters are available on line.

As always, thanks very much

[TiggerMe Ambassador in reply to JMN2017]

Interesting site.... I think the confusion is that we tend to use a fT4 : fT3 ratio and you were looking for the reverse... same outcome though

The link we tend to use was set up by a clever husband of a member and tweaked after various requests and leave options to add other results and copy them in the layout that I added yours above

thyroid.chingkerrs.online/

Pretty sure selenium is another expensive test that they won't perform and the general guidance is that 100mg daily is likely ok and not to exceed 200mg

If you get all the other test done you'll be doing well, if you want to push your luck ask for zinc / copper ones 😏

Sounds like you are gaining plenty of knowledge to ask all the right questions 🤗

[JMN2017 in reply to TiggerMe]

Eeyore

Thanks again for yet more info

Ratios

If you look carefully at the bottom, of that site I linked in last post, the ranges were very different from yours -

1.00 - 2.20 = Below standard

2.20 - 2.40 = Below Optimal

2.40 - 2.70 = Optimal

2.70 - 2.90 = Above optimal

2.90 - 6.00 = Above standard

Your '6' does not compare on this scale, so I think the link you sent must be based on a different scale from the one I've used.

SO, I've used the calculations given just above this chart. Going by that, at 1.4, I'm very low - I've recalculated again but not sure I'm using correct conversion figures (ie T3 pmol/L to pg/ml; T4 pmol/L to ng/dl)

I've just done a comparison between T3/T4 Ratio from a few years back, when I had T3 measured. Interestingly, it seems to have lowered, gradually, over the years. This could well indicate elements such as Selenium, plus other vitamins, stress, and other things that I've read (but can't remember LOL) that have changed in my life over the past 12 yrs, in particular. So, I think it would be worth me trying to find the articles again to see what I could try etc.

Selenium

Just my luck that Selenium testing is expensive, eh? Thanks for suggesting a reasonable dose to supplement with. I think it worth trying this as a first option, as it would be a much cheaper option than all others. Be great if it was a solution, eh?

Yes, as you say, I'm certainly gaining lots more information, which is all to the good.

Thanks again

[TiggerMe Ambassador in reply to JMN2017]

Yes whichever ratio you use you are a bad converter and like you say likely caused by various other elements lacking or being depleted over time

If you used my figure which is the reverse ratio (so would need to reverse your scale) it would be 'below standard' 🤗

[greygoose]

Doesn't matter what the ratio is, you're obviously a poor converter and your FT4 is too high, and your FT3 too low. That's all you need to know. Ratios are for euthyroid people. When you're hypo, you need what you need. And that varies from peson to person. I expect you feel pretty awful with that low FT3, don't you? So, forget about aiming for any particular ratio, and aim for feeling well.

[JMN2017 in reply to greygoose]

Thanks greygoose, I'd really like to know the calculation, if only out of interest. If you, or anyone, would let me know, I'd be very grateful. Thanks

[greygoose in reply to JMN2017]

Sorry, can't help you there. Maths is just not my thing!

[JMN2017 in reply to greygoose]

Thanks greygoose

I'm sure others do know so, hopefully, will post

[greygoose in reply to JMN2017]

Doubtful, as they haven't done so already. Can't you just use the calculator Eeyore linked you to?

[JMN2017 in reply to greygoose]

Will give it a try