poor conversion and low free t3

[Tuesday28]

TSH. 0.19 (0.27 - 4.2)

FREE T3 5 (3.1 - 6.8 )

FREE T4 19 (12 - 22)

Morning everyone

What can I do to increase my poor conversion and low free t3 please ?

Thanks in advance , H x

[Tuesday28]

greygoose

You mentioned I have low free t3 and poor conversion, could you please suggest ways I may improve this?

[Tuesday28 in reply to Tuesday28]

hopefully it doesn’t involve increasing levo

[greygoose in reply to Tuesday28]

In a word: no. It's always suggested on here that you need to optimise nutrient levels - so they need testing first if you haven't already done so - and trying selenium. But I've never seen anyone come back and say thank you, that worked. So, I conclude it didn't. And, it would seem, that if you have Hashi's there's just nothing to be done about it, anyway. That is just the way Hashi's people are: poor converters.

There are many, many possible causes of poor conversion, such as not consuming enough calories, that I don't think many - if any - people ever find the cause. So, the only solution is to obtain T3 and take that - either as mono-therapy or with T4. Sorry, but I don't know of any other sure and certain way to raise FT3 levels.

[Tuesday28 in reply to greygoose]

Thank you! I’ve just ordered a medi check full thyroid panel to include vitamins.

What should my t3 be ? I thought these results were good/ optimal. I clearly don’t know much 😂

[greygoose in reply to Tuesday28]

FREE T3 5 (3.1 - 6.8 ) 51.35%

FREE T4 19 (12 - 22) 70.00%

If you were someone with no thyroid problems (euthyroid), your FT3 would be good. But your FT4 would be abnormally high. As you're hypo, you probably need your FT3 up around 70%, too.

But, optimal is how you feel, not a number. No-one - no doctor - can look at your results and say 'they're optimal'. Because we're all different and whilst some people might feel good with these results, others might feel terrible. So, how do you feel?

For the same reason, I cannot tell you what your FT3 should be - there's no 'should' about it - or, rather, the numbers should be where they make you feel well. All I can say is that in general, most hypos need their FT3 higher than that to feel well.

Your FT4 isn't a bad level - although there's room for a small increase. But what shows poor conversion is the gap between the two sets of percentages. The FT3 should be just slightly lower than the FT4. Your gap is almost twenty. That shows poor conversion. Should be more like a gap of 5 or 6 if your conversion was good.

So, you could try a very small increase in levo - say 12.5 mcg a day. But there's no guarantee that that would take your FT3 high enough to make you feel better. Also, if your FT4 goes too high, your conversion will get worse, not better. So we have to be careful not to increase levo by too much.

[Tuesday28 in reply to greygoose]

This is such good knowledge thanks so much! I think I’ll screen shot that comment. Thank you for taking the time to write it , I’ll be back with vitamins results if that’s ok.

In reply to how do I feel, I feel slightly more tired and my hair has thinned quite a bit. So nothing definitive or helpful at all really there, hopefully the test will help.

Thanks again

[greygoose in reply to Tuesday28]

Yes, being tired and thinning hair could be down to nutritional deficiencies. And that's the problem with thyroid: all the symptoms could be due to 'something else'. We only know if they were hypo symptoms if they improve on raising thyroid hormone levels.

[Tuesday28 in reply to greygoose]

Please can you tell me why if ft4 goes too high the body will decrease conversion to t3? Is it the body’s way of putting the breaks on ?

Also perhaps this explains my high ft3 at diagnosis but very low ft4 ? My body trying to keep my alive

[tattybogle in reply to Tuesday28]

deiodinases (clever enzymes inside cells that remove iodine atoms ... hence the name de - Iodine -ase)

There are 3 of them Dio1 Dio2 Dio3 :

Dio1 and 2 can convert T4 into either T3 (active) or into reverse T3(inactive) .

Dio3 gets rid of T3 , by turning it into T2

(that is over simplified, but it will do)

The amounts of and rate of activity of each Deiodinase inside the cells is variable , it's affected by the levels of T4 and T3 (amongst other things)

if the T4 is high, then more T4 is converted to reverse T3(inactive) .. as you correctly say , to slow things down , (the body is trying to stop you going hyper).

if there is low T4 ,then more T4 is converted to T3 ( active ) in an attempt to make certain the cells get enough T3 even if the T4 is low. (the body is attempting to stop you going hypo).

So T3 often remains pretty good in early hypothyroidism , even though T4 is falling .

and when T4 is high (eg from levo) .. the amount of T3 often falls .....because the deiodinases have slowed down conversion of T4 to T3 and are turning more of the T4 into reverse T3.

Kind-a-thing .... more or less ... lol

[Tuesday28 in reply to tattybogle]

Thank you both

This is really interesting for me because I once tried to take 100mcg years ago and after 6 weeks my bloods showed both over range. But I stayed on it hoping it would balance out. I tested at 3 months and my ft4 was still high but my ft3 was low and extremely n low tsh.

So clever, the feedback loops the body has to keep us alive. I will read up some more on it, thanks both so much

[greygoose in reply to Tuesday28]

Yes, exactly. The body starts converting more T4 to rT3 than T3 when the FT4 gets too high, to stop you being over-range on T3.

Not quite the same thing with the high FT3 on diagnosis, but it is your body's way of keeping you alive: when the thyroid starts to fail it lowers production of T4 and makes straight T3, which doesn't need converting, to keep you going. Because a lot of conversion is actually done in the thyroid itself.

When you are on T4 only (levo) you lose that conversion that is done in the thyroid, so it's not surprising if people on T4 mono-therapy have low FT3. We call it 'poor conversion' but it's more likely to be that part of the conversion system is missing - i.e. the conversion done by the thyroid itself.