Advice please

[Sailing14]

Please could I receive advice on these latest MMH private test results.

I increased T4 to 100 mcg from 75/100 ten weeks ago due to low T4 (for me but within range) now T4 abnormal. Palpitations were the main reason to increase and these subsided once I did.

All protocols followed on timings etc.

Thank you

[TiggerMe]

So your conversion isn't great but if you are feeling well I'd stick with it or just drop to 75mcg once a week as it might actually improve your conversion... seems crazy doesn't it but fT4 too high can do this.... though I seem to remember you were never that great at converting?

Have you managed to optimize your Vits and Mins?

Free T4 (fT4) 22.2 pmol/L (12 - 22) 102.0%

Free T3 (fT3) 5 pmol/L (3.1 - 6.8) 51.4%

T4:T3 Ratio 4.440 

[Sailing14 in reply to TiggerMe]

Thank you ver much for your help. I have ordered a blood test for vitamins from MMH and will see where my levels are. I currently only take vitamin d supplements as my endocrinologist said they can interfere with T4 (he is quite good), but did say if they are low you would need to supplement.

Sorry to sound like I’m not sure but can you explain why conversion is not good with a high T4 and normal T3?

I would consider the option of one day at 75 mcgs as it seems this trial may help if I can understand why the conversion is poor from your explanation.

Thank you again.

[TiggerMe in reply to Sailing14]

It seems to be a thing that if you are right at the top or a little over fT4 range it can lead to slightly lower conversion as I think the bodies safety system kicks in and can converts some of the fT4 to rT3 which makes it inactive... so finding your own personal sweet spot is the key

How does your Endo feel about T3? Your other option is to try a small amount to balance things up

[Sailing14 in reply to TiggerMe]

Thank you. That makes sense. I didn’t think an Endocrinologist would consider T3 with my current level as it is and also my T4 being slightly over. I don’t feel I am converting but is this enough to take to him? There are the vitamins to be tested also at the moment too would you agree?

[TiggerMe in reply to Sailing14]

Yes to aid conversion you need B12, Vit D, folate and ferritin to be in a good place and to just generally make you feel better... but if you are paying to see and Endo he should be happy to try you on a combination of T3 & 4 as historically you don't seem to have been a good converter and you have reached the top with T4 and fT3 is only 50% through range which may not be quite high enough for you... you may only need a small dose of T3 to get you there 😏

[Sailing14 in reply to TiggerMe]

Thank you for all your help. I will see what my vitamin levels are soon and speak with my Endocrinologist when I go again.

Sorry to ask again but with my T3 at 5, is this not near the top of the range of 3.1 to 6.8? And also how to work out percentages and ratios.

[TiggerMe in reply to Sailing14]

Free T3 (fT3) 5 pmol/L (3.1 - 6.8) 51.4%

So you have a lot of head room for increase

Two handy calculators available.... thankfully they do all the hard work 😏healthunlocked.com/thyroidu...

With your fT4 already top of range you have no room to increase that further so your Endo should be suggesting to you that you need a combination 🤗

On T4 only you would hope your fT3 is only just a little lower than fT4

[Sailing14 in reply to TiggerMe]

Thank you for this advice. It seems clearer when you read through your explanation. Allowing for a visit to see the private Endocrinologist hopefully some time soon, would you decrease T4 to one day at 75 mcg for now or await vitamin results first?

[TiggerMe in reply to Sailing14]

Certainly worth a try and it should drop you just back into range 🤗

Often it's the little tweaks that make all the difference

[Sailing14 in reply to TiggerMe]

Thank you very much. I will start the 75 mcgs today.

Would I need to retest in 6 to 8 weeks as advised here? Also, when would I notice a difference in symptoms?

I posted the MMH private anaemia test yesterday which covers B12, folate and ferritin, and will ask advice further on them when received. I am having vitamin d done at my surgery later on.

[TiggerMe in reply to Sailing14]

It'll be interesting to see where these levels are... I'd probably hold off testing until you either next see your Endo or you've had chance to see if any other supplements are needed to optimise and you've had a little time to sort them out

[Sailing14 in reply to TiggerMe]

Thank you. Yes I am wondering where my vitamin levels are too.

Also, would one day at 75mcg be enough for now?

[TiggerMe in reply to Sailing14]

I would think just that small drop will be enough to get you back into range, you don't want to drop too much else the palpitations might kick back in as we know you have low fT3 but it could be that you are also lacking iron etc

Looking at your last results when on 75/100...

My T4 is 14.3 (9.0 to 19.0)

T3 4.6 (2.4 to 6)

TSH 1.2 (0.4 to 4.9)

So just a little decrease is plenty

[Sailing14 in reply to TiggerMe]

Okay. It is good to know I can decrease slowly due to the palpitations before like you said, and I definitely noticed an improvement in them when I increased following the above results.

I will post back with vitamin results if that is okay.

Thanks

[Bearo]

.” I currently only take vitamin d supplements as my endocrinologist said they can interfere with T4 (he is quite good), but did say if they are low you would need to supplement.”

I’ve not heard this before. Do you have any idea what your endo meant by this comment?

[Sailing14 in reply to Bearo]

I think the Endocrinologist tries to steer clear of supplements due to the metabolism of them and the thyroid medication (but we all know not to take near each other as per helpful advice on this forum), so I will try to find a clearer reason when I visit next and post back.