High T4: Hi Greygoose, I've seen your reply to... - Thyroid UK

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High T4

Shellian profile image
15 Replies

Hi Greygoose, I've seen your reply to Helen'shubby. Just wondering about my T4 and T3 . I'm awaiting new test results but my last test showed T4 at 22.4 ( 7.5- 21.1) ( 109.56%)

FT3 4.9 (3.8-6.8) (36.67%)

TSH is always undetectable

B12 351 (110- 914.0) I am supplementing now (nature provides 3000mcg daily along with Thorne Basic B complex)

Ferritin 56 (10-180)

Calcium 2.31 ( 2.2-2.6)

Folate 7.3 (3.1-19.9)

Vit D 55 (60-150) supplementing with 5000iu weekly dose

I have no thyroid or parathyroids due to MEN2a so had Medullary Thyroid Cancer.

I currently take 112mg levo per day plus 100 one Alpha for calcium.

I am wondering about your comments about T4 being over the range . The doctor has told me to reduce levo to 100 per day ( I haven't yet, as don't want to get sluggish again.) But I am worried about heart attacks etc with high T4. Up until now I thought that as long T3 was in range it didn't matter if T4 was over a bit.

I also take Cod Liver oil and vitamaze K2)

How can I increase T3 ? Endo will not prescribe T3. Is my high T4 dangerous?

Thank you

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Shellian profile image
Shellian
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15 Replies
TiggerMe profile image
TiggerMe

I'll tag in greygoose

Strange Endo that won't prescribe T3 when you very obviously need it? If paying for this disservice I'd bin him and look for a new Endo 🤗

greygoose profile image
greygoose

22.4 ( 7.5- 21.1) ( 109.56%)

I am worried about heart attacks etc with high T4. Up until now I thought that as long T3 was in range it didn't matter if T4 was over a bit.

We all thought that! Turns out it isn't. Knowledge progresses all the time.

Is my high T4 dangerous?

All things are relative. And when we say that something 'increases risks', it doesn't mean that you're going to drop dead in the next 24 hours. It means that there is less risk if your FT4 is lower. It depends if it's a risk you're willing to take - after all, all life is a gamble. But it sounds like you don't want to take it. Which is fine.

Your FT4 is pretty high, which means that your T4 will be converting to more rT3 than T3, and that your existing T3 will be down-graded and become less effective. Don't panic! But, I do agree with your doctor that it might be a good idea to at least try a reduction in levo. This could raise your FT3 slightly. But, whether or not that would be enough for you is anyone's guess.

In the meantime, you need to optimise those nutrients.

B12 351 (110- 914.0) I am supplementing now (nature provides 3000mcg daily along with Thorne Basic B complex)

Yes, that's well low enough to cause symptoms! And it's good that you're supplementing with B12 (methylcobalamin?) and Basic B. But 3000 mcg is a bit excessive. Most of that will be flushed out - expensive pee! So, it won't do you any more good than just taking 1000 mcg. That would be quite enough.

Ferritin 56 (10-180)

Much too low. What does your doctor say about this? I think you ought to get your serum iron tested to see if that's low, too, before supplementing.

Vit D 55 (60-150) supplementing with 5000iu weekly dose

I also take Cod Liver oil and vitamaze K2)

Ah, but do you also take magnesium? Vit D and magnesium work together, so it won't do you much good taking vit D without it.

Calcium 2.31 ( 2.2-2.6)

plus 100 one Alpha for calcium.

Taking vit D will increase your absorption of calcium from food. Which is why we take the K2 with it, to make sure the extra calcium goes into the teeth and bones and doesn't build up in the soft tissues and arteries. So, essential to get your calcium checked regularly to make sure you're not getting too much. Excess calcium can also cause heart attacks. It blocks the arteries.

Folate 7.3 (3.1-19.9)

That is too low. But the Basic B should raise it nicely over time.

How can I increase T3 ? Endo will not prescribe T3.

Yes, there are plenty of pig-headed, ignorant, blinkered endos like that around. Sorry you have one of them!

But, those are the two measures that you can take in the immediate to try and raise your T3: optimise nutrients and reduce levo.

You could also try taking selenium. Good levels of selenium are essential for conversion.

And, if all else fails, you could by your own T3...

Shellian profile image
Shellian in reply to greygoose

Thank you GreyGoose.I will maybe try reducing gently , maybe by 12.5 every other day.

I'll ask about Ferritin when I get my endo appointment. Thought about 80 would be optimum . Doctor not concerned about this even tho I have alopecia.

Thanks for your reply. Have a good weekend ( nearly here!)

greygoose profile image
greygoose in reply to Shellian

Optimal would be more like 100 for a hypo. But, it's a question of how you raise it. You need to know what your serum iron is because if that's high, taking iron supplements is not a good idea, and you would need to raise it by eating more iron-rich foods like liver.

SlowDragon profile image
SlowDragonAdministrator in reply to Shellian

Thought about 80 would be optimum . Doctor not concerned about this even tho I have alopecia.

with hair loss the medics should recognise that you need full iron panel and good ferritin levels maintained

Also good B vitamins

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

And vitamin D

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

SlowDragon profile image
SlowDragonAdministrator

Get all four vitamins tested regularly and maintain OPTIMAL levels

Retest thyroid again in 2-4 months

You should see improvements in conversion rate of Ft4 to Ft3

If hypothyroidism is autoimmune it’s always worth trying strictly gluten free diet and/or dairy free diet too

Shellian profile image
Shellian in reply to SlowDragon

Hi Slow Dragon, it's not auto immune. I have MEN2a which means I had Medullary Thyroid Cancerand a tumour on parathyroid ( non cancerous) and had bilateral neck dissection to remove parathyroids,and thyroid , many lymph nodes and I think thymus . A few years ago, after an intensively stressful time, all my levels came back dire. NHS endo refused T3 so I have been trying to raise levels with eating healthily, supplementing and exercising sensibly. . I am awaiting new blood results but will ask for iron panel. What would this show up as on a blood test?

I have to be very careful of calcium levels not too high , should be low normal.

Hope this helps.

Doctor not concerned about alopecia, they have given me Ketoconazole shampoo fir sebaceous dermatitis. It is beginning to grow back but is also still coming out more than it should.

Greygoose suggested 3000mg B12 too much so will try and get lower dose next time and take half doses from tomorrow.

Thank you so much for taking the time to reply.

SlowDragon profile image
SlowDragonAdministrator in reply to Shellian

Full iron panel

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking iron supplements, stop 5-7 days before test

Medichecks iron panel test

medichecks.com/products/iro...

Never supplement iron without doing full iron panel test for anaemia first

retest 3-4 times a year if self supplementing.

Shellian profile image
Shellian in reply to SlowDragon

Thank you.

TiggerMe profile image
TiggerMe

Vit D 55 (60-150) supplementing with 5000iu weekly dose

Do you really mean weekly or daily? To get up to 100 you'd need to be taking 3000-5000 a day or you could do a loading dose for a week at 25,000iu first to kick start

Shellian profile image
Shellian in reply to TiggerMe

Hi Eeyore, I was trying to take 5000 daily but it was affecting me too much. I then realised that it actually says that it is a weekly dose. ( Doctor's Best) on the website. Then after researching on the Parathyroid Uk website, it says that recommended supplement of Vit D in addition to alfacalcidol ( the One Alpha) I take is 400-800 a day. I am not sure how the unactivated Vit D is activated in my body as it is PTH that usually does this in the liver? I asked the doctor but they don't know either. I will ask the endo when I eventually get my appointment, in March.

Have to be careful not to raise my calcium any more as it is already edging a little high at 2.31. Ideally it should be 2.26 ish.

Thank you so much for replying. There are so many knowledgeable people on this site. I am learning so much from you all and am very grateful.

TiggerMe profile image
TiggerMe in reply to Shellian

Makes it all the more tricky doesn't it, thanks for explaining... I wonder if a sub lingual might be kinder on your system and easier to take a daily smaller dose as it would be absorbed into the blood stream rather than through the stomach?

Are you not allowed K2 MK7 to help direct the calcium to the right places?

Shellian profile image
Shellian in reply to TiggerMe

Hi Eeyore, yes I do take the k2. Not sure how it works but I take it anyway. I tried the Vit D spray but most Vit D give me bad headaches the Dr's Best version seems to be ok as it has less expedient I think.

Hopefully, I'll try reducing the levo gradually but when I was on 100 before it wasn't enough. Can only try.

Thanks again

TiggerMe profile image
TiggerMe in reply to Shellian

K2 is essential to send the calcium to bones and teeth etc rather than letting it build up in the arteries.... excipients are a pain I tend to use Nature Provides which just uses black seed oil as the carrier or more recently I've changed to one with a higher level of K2 and is coconut oil based

Shellian profile image
Shellian in reply to TiggerMe

Thank you. I'll have a look for next time

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