T4/T3 conversion: Can anyone recommend a good... - Thyroid UK

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T4/T3 conversion

fosterkit profile image
33 Replies

Can anyone recommend a good supplement for T4/T3 conversion please? My T3 blood tests (Medicheck) have been in the 3's since Covid - apart from a brief period when I hit the dizzy heights of 4.4 - but I've always been 'within range' so no chance of getting T3! I am currently waiting for an MRI (10 weeks so far) to try to find the cause of increasing muscle weakness. I suspect there may be a link between this and low T3 but apparently not. Any advice would be welcome.

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33 Replies
SovietSong profile image
SovietSong

Do you have any recent t3 and t4 results?I see your levels from 3 years back we’re something similar to my own.Your t4 was about 21 yet your t3 was only 4.I tried every dose possible of levo but t3 would rarely rise so I am just into my second week of t3 which I sourced myself,which many of us have to do unfortunately.

fosterkit profile image
fosterkit in reply to SovietSong

My last t4 was 20.2 (range 12-21), t3 was 3.4 (range 3.2-6.8), tsh 0.75 (range 0.27-4.2). I have secondary hypothyroidism so my tsh is always at the bottom of the range, sometimes even below range. Good luck with your t3. I think that's what I'll end up doing. Just have to wait for the mri to know for sure that that's the problem.

SovietSong profile image
SovietSong in reply to fosterkit

Crikey that t3 level is awful!!it’s only about 5.5% through range.I’d be very surprised if it’s not causing your muscle weakness.The nhs really would save money and time if they paid more attention to t3 levels.I was sent for multiple X-rays due to constant joint pain,saw an rheumatologist due to raynauds in hands and was at my doctors surgery constantly with an endless list of symptoms.But sure it couldn’t be anything to do with being under medicated on thyroid meds🤦🏻‍♂️

fosterkit profile image
fosterkit in reply to SovietSong

I've just about lost faith in blood tests as a diagnostic tool. All doctors, private or nhs , seem incapable of seeing past 'within range'. It never seems to occur to them that a patient might do better if she wasn't scraping along the bottom of the range in just about everything! My ferritin level was 21 for years - range 12-300 - but that's OK because it was within range! I put that right with supplements but t3 isn't quite that simple. I've tried zinc, selenium, magnesium etc but none of them really helped. I thought when I was diagnosed 7 years ago that things would get better. I couldn't have been more wrong!

GreenTealSeal profile image
GreenTealSeal in reply to fosterkit

May not be this but just to say that when my T4 is high up in range I have awful joint pain and muscle weakness. Can’t seem to have t4 over 18 without it happening and when my t4 is in the 20’s it’s debilitating.

fosterkit profile image
fosterkit in reply to GreenTealSeal

Thanks for that, GreenTealSeal. But if I lower t4, will that lower t3 too?

SlowDragon profile image
SlowDragonAdministrator

First step is to get vitamin D, folate, B12 and ferritin tested and retest at least annually

Never start supplementing until tested first

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/testing/priva...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

fosterkit profile image
fosterkit in reply to SlowDragon

Thanks for the advice SlowDragon. I've used Medichecks since before Covid because our local NHS only usually tests TSH for all things thyroid and that's useless with secondary hypothyroidism because TSH is low to start with. Trouble is a lot of NHS endocrinologists turn their noses up at Medichecks. But then they seem to turn their noses up at everyone, patients included. I volunteer at an animal shelter and, quite honestly, our hypothyroid dogs get better treatment than I've had!

SlowDragon profile image
SlowDragonAdministrator in reply to fosterkit

Even if GP/endo won’t take notice of test results…..you need to know yourself where levels are

Get all four vitamins optimal

Sounds like you have made great progress improving ferritin

Then assuming Ft3 still low (likely/inevitable with central hypothyroid) look at getting T3 prescribed alongside Levo

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

Roughly where in U.K. are you?

thyroiduk.org/contact-us/ge...

volunteer at an animal shelter and, quite honestly, our hypothyroid dogs get better treatment than I've had!

Vets seem far more aware/interested in managing hypothyroid animals. They are usually aware of the relevance of testing 24 hours after last dose levothyroxine

fosterkit profile image
fosterkit in reply to SlowDragon

Thanks for the link. I'm in Southport, Merseyside. I only got diagnosed in the first place because I went private and that consultant diagnosed a pituitary adenoma resulting in central hypothyroidism. That was in 2018. He also diagnosed proximal muscle weakness and I think he assumed that this would be resolved once my t4 levels were improved. If only! When I was still complaining about weakness after 2 years of levothyroxine, he said he couldn't fix everything. I didn't see him again, didn't seem much point. That was the beginning of 2020, and nothing much happened after that. I've been trailing from hospital to hospital since mid-2021 and in the last year I've picked up a knee brace, a back brace and a walking stick. Hate to think what's next.

McPammy profile image
McPammy in reply to fosterkit

It’s a shame they didn’t prescribe you with liothyronine. I was given walking sticks and wheel chair. Problem was I couldn’t even use my arms properly never mind trying to walk.

McPammy profile image
McPammy

My very low T3 results,similar to yours, caused me severe muscle weakness. I could barely walk 10 steps and spent a long time having to lay on my back. It was only adding T3 medication to my usual T4 levo dose that I got my strength and energy back. My T4 was at the top of the range and T3 at the bottom of its range. I’m a very poor converter also confirmed by doing the DIO2 gene test through Regenerous Laboratories as promoted on here. Mine came back positive. I had to go private only to get my diagnosis from the most reputable endocrinologist. I spent time in Southport Hospital and the NHS Endocrinologist there was terrible. I also spent time at Chester hospital and that endocrinologist was equally awful. They just wouldn’t recognise my very low T3 as the problem as they did not want to prescribe the T3 medication due to its cost. After my very successful t3 plus t4 trial privately I eventually was prescribed T3 but that is through Halton Hospital in Runcorn. They actually support my T3 prescriptions now. It is a hospital lottery. My advise is to go private only. If you wish details of my endocrinologist please contact me via private messaging and I’ll gladly share.

fosterkit profile image
fosterkit in reply to McPammy

Hi McPammy, I'd like to contact you for details via private messaging. How do I do that?

McPammy profile image
McPammy

I’ll message you privately…

fosterkit profile image
fosterkit in reply to McPammy

Thank you.

McPammy profile image
McPammy in reply to fosterkit

Just sent you a message

fosterkit profile image
fosterkit in reply to McPammy

Sorry to be so dim but how do I access the message?

helvella profile image
helvellaAdministratorThyroid UK in reply to fosterkit

Look for the Chat icon (screenshot attached). It will change colour and get a number if there is a message for you.

Screenshot of Chat icon.
fosterkit profile image
fosterkit in reply to helvella

Thank you Helvella.

arTistapple profile image
arTistapple

I am answering this after reading your replies. I too have been pushed to the point of using a wheelchair. Could not move it around myself for long and can’t see that sticks would help either.

Not just weak muscles but muscles which do not enter the natural relaxation phase, without actual resting of the muscles themselves = stopping. It’s experienced as painful spasm.

You asked about supplements which might help conversion. I fairly recently (on reading the Grassroots website) doubled my Vit D and K. 10,000 Vit D daily for a number of weeks, which of course would make the medical profession wet themselves. I am a bit nervous but Grassroots seem to be a very knowledgable site (recommended by the smashing SeaSideSusie), so trusting in that for the moment. I do believe I am able to get about the house better and even get some chores done. However there is still a huge amount of “negotiation with self” going on. You know the sort of thing. Food mostly has to take priority before even doing anything remotely ‘fun’. If I am able to do that, will I be able to do the other ? etc etc. I still can’t manage any distance outside and I am thankful for my blue badge, otherwise I would not get out at all.

I am today awaiting to hear from Medichecks as to whether my conversion has improved and maybe some ‘proof’ that upping my D has helped with that. T3 levels dire up till now and getting worse. So far unable to take T3 for any length of time without side issues.

I also have a heart condition I am convinced is due to very long term hypothyroidism, which also is ‘irritated’ by walking and extreme cold weather (now). It’s experienced exactly the same as the other muscles involved and known simply as coronary spasm.

If my conversion has improved, I will be on here telling everyone!

fosterkit profile image
fosterkit in reply to arTistapple

I hope your conversion does improve. I'm waiting for an MRI of my spine to look at other possible reasons for weakness, this is after nerve conduction studies. Trouble is I have a pacemaker so have to wait until it can be done at a heart hospital because no other hospital will do it. I hate to think what the waiting time will be! But at least now I have a name to go to when the MRI is done and shows nothing! Personally I have been convinced for years that this is just levothyroxine not doing its job. I'll be doing Medichecks tests again to make sure all my vitamin levels are optimum before seeing a private endo.

arTistapple profile image
arTistapple in reply to fosterkit

Got the thyroid results back. I am just about to check with last time. They look exactly the same though! They have not tested the vits etc. Why? No idea. I have written to find out. Pah! However got my cardio appointment and quite soon so ……. Good blooming luck to the both of us!

fosterkit profile image
fosterkit in reply to arTistapple

I'll second that👍

McPammy profile image
McPammy in reply to arTistapple

You could do with having a private only opinion on your condition and trialing some T3 liothyronine along with T4 levo. It just might be your answer to getting your life back. It was for me. If you want my brilliant endocrinologist’s details please private message me. Private only as if they are private/nhs then they still often follow the nhs rules which often do not want to prescribe T3 in my experiences.

kiefer profile image
kiefer

"Can anyone recommend a good supplement for T4/T3 conversion please?"

The supplements that I'm aware of that might improve t4 to t3 conversion are Magnesium, Vitamin A, Zinc and Selenium. I don't know of any particular brand to recommend but here is the information I've found on two of the four supplements:

Dosing

The Vitamin A dosage was 25,000 units per day. While this may seem high, I think toxic levels would be somewhere in the range of 100,000 units/daily. I had taken 15,000 units / day for a few years and can't recall any issues.

pubmed.ncbi.nlm.nih.gov/233...

The Magnesium dose - This is from The Thyroid Pharmacist Izabella Wentz:

thyroidpharmacist.com/artic...

"Studies have shown that magnesium can lower TSH (by an average of five points in the study)"

ncbi.nlm.nih.gov/pmc/articl...

What does this mean? To me, this means that magnesium supplementation may help if you're not already taking an adequate dose (~400mg daily elemental magnesium) using a brand with good absorption qualities (forget Mg Oxide, think Mg Glycinate)

As you can see, the researchers followed the usual protocol of measuring TSH to determine improvement, although they mentioned that FT4 wasn't affected much. I suppose they're implying that FT3 is increased because TSH is lowered...?

fosterkit profile image
fosterkit in reply to kiefer

Thanks for the information Kiefer. I've taken these supplements since I was diagnosed but without much success. I came on here yesterday to see if there was one I was missing but sadly not. From what I have been told on here it seems my main problem is with my TSH. At the last test this was 0.75 and has been suppressed in the past, mainly because it was hardly there in the first place (pituitary adenoma) and dropped even lower when I started taking levo. So if increasing T3 depends on lowering TSH, it's never going to happen.

HealthStarDust profile image
HealthStarDust

I believe selenium and zinc and iron gets mentioned the most for improving conversion of T3 from T4.

I believe excercise does too, whatever you can manage.

fosterkit profile image
fosterkit in reply to HealthStarDust

Thanks HealthStarDust, but that's the problem. Exercising was something I enjoyed, walking, dog walking, aerobics etc. But increasing muscle weakness has made that more or less impossible.

HealthStarDust profile image
HealthStarDust in reply to fosterkit

I get that.

helvella profile image
helvellaAdministratorThyroid UK in reply to HealthStarDust

Repeat of my previous reply:

But it would be 100% wrong to consider either selenium or zinc as 'conversion improvers'.

If you are LOW in either, then recovering to adequacy is all that is required.

If you are not low, then taking additional selenium and/or zinc as a bad idea. More is not better.

As for iron, it is so fundamental to absolutely everything that it should take its place as a vital factor regardless conversion being poor.

fosterkit profile image
fosterkit in reply to helvella

Agreed. In fact I've always been a bit nervous of both selenium and zinc. I meant I've taken them from from time to time but in small doses and not for long. I know that if your body gets too much of either you can easily end up worsening the problems you're trying to resolve!

helvella profile image
helvellaAdministratorThyroid UK in reply to fosterkit

If only we could get cheap, quick tests for all these things!

Far too expensive, unfortunately.

fosterkit profile image
fosterkit in reply to helvella

Exactly. I've done my own thyroid tests since covid but just can't afford to test regularly for everything.

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