New results relation between T4 and T3

[Jasper79]

I have just got the results from a new Blue Horizon test. I would appreciate comments on the relationship between T4 and T3 readings.

Currently on 100μg levothyroxine

TSH. 0.11 (0.27-4.2)

T4. 20.8 (12 -22). 88%

T3. 4.8. (3.1 -6.8) 46%

Previously when on 75μg levothyroxine readings were (same ranges):

TSH 1.29

T4. 14.5 25%

T3. 4.21 30%

There is a big increase in T4 but a much smaller increase proportionally in T3, which is still in the bottom half of the range.

As previously reported, my main issue is chronic peripheral neuropathy and I believe it is possibly caused by my hypothyroidism. I thought I had some improvement after my levo dose increase, but then reluctantly agreed to try statins again because after a new diagnosis of aortic aneurysm and also possible angina. Within 4 days my legs were very much worse. I have stopped and my medical notes now state “patient is adamant he will never take another statin”.

That was about 7 weeks ago and I do not feel I have got back to feeling as good as before the statins.

[greygoose]

Your cholesterol is high - if, indeed, it is high - because your FT3 is low. High cholesterol is a hypo symptom.

And your FT3 is low because you are a poor converter. Possibly. But this is not clear because in the older test your FT3 was higher than your FT4...

So, I have to ask: do you have Hashi's?

If you don't, what could have happened is that by increasing the levo you raised your FT4 too high so that the T4 is now being converted to more rT3 and less T3. However, that doesn't really sit right because the FT4 went up rather a lot for an increase of just 25 mcg. And the gap between the FT4 and FT3 also went up rather to much to be 'normal'. So, I'm guessing you have Hashi's, and that has something to do with it.

How long have you been on 100 mcg?

[Jasper79 in reply to greygoose]

Yes, I have Hashimoto’s - tested earlier.

Been on 100 levo since end October. Earlier NHS tests after increase were similar for TSH and T4 (no T3 of course).

[greygoose in reply to Jasper79]

OK, so it's more than likely the Hashi's responsible for that high FT4, not the dose. So, this isn't the right time to asses conversion. You'll have to wait and see how things progress.

[SlowDragon Administrator]

so results 4 months ago

Anti-Thyroidperoxidase abs H 232 <34 IU/mL

Anti-Thyroglobulin Abs 35 <115 IU/mL

Vitamin D (25 OH) 68 Optimal 75-200 nmol/L

B12-Active 61.0. 37.5 - 150 pmol/L

Serum Folate 12.60 8.83 - 60.8 nmol/L

Confirms cause of you hypothyroidism is autoimmune thyroid disease aka Hashimoto’s

Have you had coeliac blood test yet

Assuming yes and negative you can now trial strictly gluten free diet

Essential to maintain GOOD vitamin levels for good conversion of Ft4 to Ft3

Vitamin D at least over 80nmol and between 100-125nmol may be better

Active B12 at least over 70 and over 100 better

Folate at top of range

What vitamin supplements are you now taking

Have you retested since these results

[Jasper79 in reply to SlowDragon]

I take B complex daily and 1000 iu Vitamin D also trace elements. I have not done full test since but B12 NHS test was 555 (197_771), folate 7.5 (3-20), ferritin 263. (30_400). On 11/12/23

Stopped B complex a few days before test as inc. biotin but took B12 alone.

[SlowDragon Administrator in reply to Jasper79]

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Perhaps unlikely vitamin D 1000iu is high enough

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

Are you also taking a daily magnesium supplement, afternoon or evening…..at least 4 hours away from levothyroxine

And now on gluten free diet?

[Jasper79 in reply to SlowDragon]

yes re magnesium although lapsed for a while in Dec 23 back taking now and think slight improvement in neuropathy .

In last BH test 0.96 (066- 0.99)

Do take folate drops and B12 when stop Bcomplex.

Not gluten free….

[Jasper79 in reply to SlowDragon]

Forgot to say yes tested for coeliac, negative.

Gluten free I will find really difficult although I have cut down on it.

[SlowDragon Administrator in reply to Jasper79]

There’s little point being almost gluten free

If gluten is an issue…..Every time you eat gluten it takes several weeks for gut to recover

You need to trial 3-6 months absolutely strictly gluten free

Post discussing gluten

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