T4/T3 converter

[MeMe1970]

How I know if I’m a good converter. I have low cortisol all day long and below is my lab test. Please advise. Taking T4 70 mcg/T3 18 mcg. I struggle to add T3 even in small doses.

[Forestgarden]

Hi there, as you're already taking T3 it would be really difficult to tell how well you convert t4 into t3. Were you taking just levothyroxine before you added liothyronine? What were your blood test results then?

[MeMe1970 in reply to Forestgarden]

I’m taking T4 / T3 over years but always have a problem increasing the dose because low cortisol

[Forestgarden]

Your T4 is very low. Have you tried increasing your levothyroxine to bring up your ft4 and ft3?

[MeMe1970]

my ND didn’t accept to increase T4. I don’t know why. I’m working to drop T4 and be on T3 only

[Forestgarden in reply to MeMe1970]

Why do you want to drop t4, and go to t3 only if you find it difficult to add in t3?

[MeMe1970 in reply to Forestgarden]

I thought I will be able to drop T4 and add small T3 doses to increase free T3.. I don’t know if I’m converting. That’s why I’m asking. What’s your thoughts?

[greygoose]

To know how well you convert you need to be on T4 mono-therapy, with a TSH of around 1. Once you add T3 it's impossible to tell how well you convert.

But even if you're a poor converter, some people still need good levels of FT4. Could be you're one of those people. Worth trying an increase in levo to bring your FT4 up over mid-range and see how you feel.

T3 mono-therapy should be a last ressort, and I don't think you're quite there, yet.

[MeMe1970 in reply to greygoose]

I feel lost. I’m doing this because I want a good amount of free T3 to recover from adrenal fatigue. I’m in bed most of the day suffering. I shifted my dosage using CT3M Poul Robinson because I have similar symptoms and don’t want to stay ten years in bed. I’m about to lose my job with so many symptoms

[greygoose in reply to MeMe1970]

Yes, I understand. But I'm afraid no-one can tell you how well you convert, now.

So, did the CT3M protocol help at all?

Thing is, if you cannot increase your T3 dose, going onto T3 mono-therapy isn't going to help. The usual reason for doing that is if you cannot tolerate T4, as some people can't. But if you cut out the T4 and cannot increase your T3, your FT3 is going to drop because you must be converting some of that T4, even if it's only a small amount.

[MeMe1970 in reply to greygoose]

I’m trying CT3M for a couple of days and it’s too soon to see the results but I can feel l’m a little better. I ordered Recovering with T3 book and will receive it in a couple of days. The only thing that bother me is blood pressure when increase T3. I’m sure there is a reason for that and hopefully the book will tell me the answer.

[greygoose in reply to MeMe1970]

So, your blood pressure increases when you increase T3? Is it low to start with? Optimising thyroid hormones is supposed to optimise blood pressure, too.

[MeMe1970 in reply to greygoose]

Yes. I have normal blood pressure but when I add a small dosage my blood pressure reach 148/88

[greygoose in reply to MeMe1970]

OK, well, I hope you do get your answer in the book.

[SlowDragon Administrator]

Your Ft4 is low

Easier to try increasing levothyroxine as first step

Aiming for both Ft4 and Ft3 at least 60-70% through range

Currently

Free T4 (fT4) .89 pmol/L (.82 - 1.77) 

Ft4 only 7.4% through range

previously

Free T4 (fT4) 1.11 pmol/L (.82 - 1.77) 

Ft4 only 30.5% through range

What dose levothyroxine were you taking at previous test?

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)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

is this how you do your test?

Also ….no vitamin results?

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

what vitamins are you taking

Please add most recent vitamin results

If you were considering T3 only you would need to be on substantially higher dose. T3 really is only the choice of last resort