Still confused

[40sgirl]

I have just had my latest results from Monitor My Health, they are as follows:-Triodothyronine T3 4 4pmol/L (normal)

Thyroxine T4 27.6pmol/L (high)

Thyroid Stimulating Hormone 0.02mu/L (very low)

The last time I saw the GP (three months ago) he wanted to reduce my levothyroxine because he was convinced I had hyperthyroid and would keel over with an heart attack, but I managed to convince him I certainly had no symptoms of that.

Can anyone advise me as to what would be the best plan going forward, given these results, ready for when I get the dreaded message to make an appointment with my GP.

[TiggerMe Ambassador]

You need to request an Endo referral as your fT4 is too high and your fT3 is too low, it could be that a small reduction in your levo dose might improve your conversion... ideally less T4 and an addition of some T3 as above range fT4 is not a great place to be

Have you checked your vit and min levels especially folate, ferritin, B12 and Vit D?

Request the list and you can name your preferred Endo... hopefully you have a T3 friendly one in your area... thyroiduk.org/contact-us/ge...

[40sgirl in reply to TiggerMe]

Thank you for you reply, I'll check them out

[humanbean]

You might find this of use when talking with doctors :

healthunlocked.com/thyroidu...

[40sgirl in reply to humanbean]

Thank you for you reply. I'll read it through so that I'm suitably armed with the correct information

[greygoose]

Well, to try and clear up some of your confusion, let's have a look at those results from your GP's point of view:

Which is not difficult because all he looks at is the TSH.

The majority of doctors firmly believe that a low/suppressed TSH means you are 'hyper'. The do not seem capable of distinguishing between a low TSH caused by exogenous hormone and low TSH caused by over-production of hormones by the thyroid itself. They just don't know that much about thyroid. But, if you are hypo and taking thyroid hormone replacement, you cannot suddenly become hyper because the thyroid cannot regenerate.

So, over-medication: two possibilities:

a) you are genuinely over-medicated, with very high FT4 AND very high FT3

b) you are taking too much levo which your body cannot convert very well, so you have high FT4 and low FT3

But, as your GP probably won't even look at those numbers - and probably wouldn't even know what they were if he did - he's just looking at the TSH and jumping to wrong conclusions such as the one that says a low TSH causes heart attacks! It doesn't. TSH has nothing to do with your heart.

So, let's look at your results from your point of view:

Your FT4 is very high - which is why your TSH is so low. But it's only that high because your body cannot use it correctly. For some reason - and you'll probably never find out why - you cannot convert T4 - which is basically a storage hormone - to the active hormone T3 very well. So, you need that high level of FT4 just to get enough T3 to keep you going.

Now, whilst high FT4 might not be causing you any symptoms, and although it's a storage hormone that doesn't do very much until converted to T3, it has been discovered that, long term, high levels of FT4 are not good for you. They are associated with a higher risk of developing cancer and heart problems. So, funnily enough, your GP was right about suggesting you reduce your dose, but for the wrong reasons!

So, what can you do about it? Probably not a lot, but there are some things you could try:

a) reduce your levo and bring your FT4 back down into range. You haven't given ranges (please, always give ranges) but I'm guessing it needs to come down to about 19. And, due to the complicated way in which all this works (won't go into details right now) that might raise your FT3 enough to make you feel better

b) check your nutrient levels: vit D, vit B12, folate, ferritin, zinc. And supplement any that aren't optimal

c) try taking selenium

d) make sure you're getting enough calories - no low-calorie diets!

e) ask for your cortisol to be tested

And, if all of this fails, then you will need to obtain some T3 to take along with your levo. Either through a T3-friendly endo or by buying your own.

[40sgirl in reply to greygoose]

Thank you so much for your reply, I'm waiting on my GP requesting I make an appointment to see him. I have increased my protien intake as advised by a nutritionalist to improve my metabolism. My vitamin D is OK, my cholesterol is 5.6 which is a bit high I know. I was offered Statins but having previously tried them they didn't suit me. I do feel fine, spend a lot of time gardening and get about fine.

[greygoose in reply to 40sgirl]

Fine is not the same as optimal. Do you have the exact numbers? What about the other nutrients?

Your cholesterol is high-ish because your FT3 is low. It's not a problem in itself, you do not need statins, you just need to raise your FT3.

Without higher T3 protein is not going to do much for your metabolism. You need optimal thyroid hormone levels for that.

[40sgirl in reply to greygoose]

Thanks for that extra information, when I do see my GP I will ask for a referral to see an endo. If it's a long wait, which seems to be the case in our neck of the woods, I will see one privately. Thanks again

[greygoose in reply to 40sgirl]

You're welcome. But chose your endo wisely. Most of the are diabetes specialists who know nothing about thyroid.

[40sgirl in reply to greygoose]

I will , one of the members sent me a list of endos I will chose from that