Monitor my health laboratory results

[Sailing14]

Is someone able to explain why I feel unwell if my t3 is converting but t4 high. I did take the t4 two hours before as it was suggested I try this, but my t4 was also above range in March 24 following all the protocols on here for tests (both monitor my health tests).

GP test in between these showed normal t4,t3 and TSH (I took t4 in error before test this time also).

I know this is an NHS laboratory so this is why I choose them to try and be as near to GP results as I can.

My anaemia test failed with them due to clotting so I have to retest.

Thank you for any help and advice you are able to give.

[TiggerMe Ambassador]

This higher level of fT4 ( even though false you were high last time when correct timings used) hasn't improved your conversion so of no benefit, I'd be looking to decrease as over the top fT4 is known to be bad in the long term

[Sailing14 in reply to TiggerMe]

Thank you for this. I will have to look again at reducing as I know it is not good.

However, I am still taking accord brand (in between trying to work out everything as we know). Could it be this brand having this affect on me?

[TiggerMe Ambassador in reply to Sailing14]

I would say the brand is being absorbed well but if you have too much of it it impedes conversion to fT3... time for another tweak

[Sailing14 in reply to TiggerMe]

Thanks a lot. If only our condition was not so difficult and challenging.

[greygoose]

Is someone able to explain why I feel unwell if my t3 is converting but t4 high

FT3: 5.3 pmol/l (Range 3.1 - 6.9) 57.89%

Well, let's just say that some of your T4 is converting to T3, but not very much. That's an awful lot of T4 for relatively little T3. And could be you're one of those people that react badly to high levels of T4. Plus T3 that is too low - you'd probably feel better if it were around 70% through the range instead of only 58%.

Plus the fact that what little T3 you have has been downgraded by the deiodinase that causes poor conversion, so it's not as effective as it should be.

All this to say that you need to reduce your levo, see what effect that has on your conversion, and if it doesn't improve, you will need to procure some T3 to add to your dose of levo.

[Sailing14 in reply to greygoose]

Thank you very much for this reply and explaining everything around the reason for high t4.

Unfortunately, I don’t think I am agreeing with accord brand (acid reflux, lack of energy and other issues that I can only attribute to this make) and have now changed to lactose free brand to see if it helps in any way at al (I am lactose intolerant by my own illimination of foods).

I have also had various infections and I am not sure if this has caused a build up of reflux but again with this condition, I can’t tell to the detriment of my health why it is i.e accord brand or stress and trauma through ill health or maybe high t4.

Would you advise to continue like this for now and reduce also? Although, I know the two together will confuse the issues.

I have got Roseway lab contact details for t3 and another contact/s for NDT but I am trying my hardest to see if t4 alone will get me well at the moment. I do have contacts also for a good endocrinologist but I am frightened he might say no to t3 if I ask and then the GP gets involved and I try to keep a low profile with him for all the reasons we know.

Terrible isn’t it to live like this.

Thanks again for all your help.

Also to say, that I am currently only on 100 mcgs of t4 at present.

[greygoose in reply to Sailing14]

Your acid reflux is probably due to low stomach acid, not the levo. Try the burb test to find out:

healthline.com/health/hypoc...

I think it would be a good idea to start reducing your levo now. That FT4 really is much too high. And you won't know if you need T3 without bringing it down quite a way.

As for the endo, that is absolutely a last resort. Who says he's good? And why? If you don't even know if he's pro T3 you can't really know how good he is. The majority of endos are diabetes specialists who haven't a clue about thyroid, just a few weird ideas, and very often make things worse rather than better. Try reducing levo for a start and see how you go from there.

[Sailing14 in reply to greygoose]

Thank you for your helpful reply. I agree that the endocrinologist can’t be that good if I feel nervous about discussing t3 with him (I haven’t tried yet), but I want to make sure everything is in place before I do - if I do and not choose self sourcing.

I will try the test for low acid and I am going to lower my t4 also (and go back to accord so I can see what affect it has).

However, could you advise how soon I would notice a difference after lowering t4.

Thank you again for all your help and advice.

[greygoose in reply to Sailing14]

How long is a piece of string? Any time between the day your reduce it and six weeks. And, to be honest, one single reduction might not even show any improvement because it won't be enough. But, you really shouldn't reduce by more than 25 mcg every six weeks. Only time will tell. But, even if it doesn't ever make you feel better, that FT4 has got to come down. It's just not good for you long-term.

[Sailing14 in reply to greygoose]

Thank you. I was going to reduce from 100 mcg a day to 75/100. Would you consider this too much?

[greygoose in reply to Sailing14]

I would say that's not enough. If it were me, I'd go the whole 25 mcg a day. If you only reduce by 12.5 a day for six weeks, it's going to take a long, long time to get that FT4 down.

[Sailing14 in reply to greygoose]

Thank you for this helpful advice.

However, at 75 mcg a day I became very underactive and unwell so had to go up to 75/100 at the time (2 years ago).

Would you still advise 25 mcg drop? Also, is there a possibility that my t4 is not converting due to absorption problems and therefore my t4 is high and would this mean liquid is required?

Although, I haven’t got on too well with liquid.

[greygoose in reply to Sailing14]

If you weren't absorbing your levo, your FT4 would be low, not high. A high FT4 means you're absorbing it very well. What's more, absorption has nothing to do with conversion.

So, how high was your FT4 when you were on 75 mcg before? It's not about the size of your dose, but what your body does with it.

[Sailing14 in reply to greygoose]

My TSH has usually always been a sign of over or underactive thyroid for me (although another occasion not so), and when I changed to 100 from 75/100 in November last year, my heart palpitations stopped and I didn’t feel weak and nauseous. My t4 was around 16 (nhs result range 9 to 19) I had had a steroid injection at the time and put on half a stone since it so I’m not sure if that was why I needed increase. I have only lost a few pounds since.

The t4 two years ago was 14 same range as above and TSH above 3 I had terrible pains in wrists and ankles and was very much under medicated but when I increased to from 75 a day to 75/100 I felt better but then caught a bad dose of covid and it all went wrong.

I read a report on the internet that high t4 can be absorption issues and with the courses of antibiotics/antifungal over 6 months, I thought this was the reason and I am now on lansopraxole for acid reflux (I’m not sure if this is due to stress of all the medication due to infection or if my thyroid hormone is causing it (high t4 or brand). But I have always got on with this one and thought I could tolerate the small amount of lactose in it.

The lansoprazole helps but is the acid from too high t4? I just don’t know but it is making me very unwell.

Hope you are able to advise further.

Sorry for the long reply.

[Sailing14 in reply to greygoose]

Also to say add that I was taking accord 50 mcg on the 75 mcg days at the time two years ago, and I have heard reports of potency issues with 50s, so I am not sure this had an affect on why I went so underactive then.

Thanks

[McPammy]

I’d say you are feeling unwell due to T4 being far too high. You need to reduce you T4 intake. You don’t need that much. T4 too high can make you feel awful. It needs to be in range, at the top, but not above and that’s 2hrs after taking your T4 prior to a test. A healthy person would never have over range T4.

[Sailing14 in reply to McPammy]

Thank you very much for your reply.

Could it be possible that the brand is doing this though?

Also, earlier in the year, not long after a monitor my health test I was retested at the GP surgery and the T4 was lower and within normal range (after taking the t4 that time too).

Would you know the reason for this?

I have had two test this year with monitor my health and both showed high t4.

[McPammy in reply to Sailing14]

I doubt the brand would affect your levels of T4. Lower your dose slightly for a week and see if your symptoms improve.

[Sailing14 in reply to McPammy]

Thank you. I am going to have to decide on the best thing to do with all this helpful advice.

I just can’t understand the very difficult acid reflux and why it would be connected to high t4,but I won’t know until I try reducing.

Thanks again