Free T3 still low

[sja11]

Hi there

I’m hoping someone can help.

After my last test I asked my dr if I could increase my thyroxine as my conversion seemed poor. He said no. This is my latest test result. My T3 is the same but my T4 is higher. He now wants to reduce my thyroxine. I’m on 125mg and weigh 76kg I’m taking a 6000mg spray of vitamin D with K daily and am mainly gluten free. All my other vitamin levels are ok not optimum but mid range.

Can I ask for T3 on the NHS? I still have most of the under active thyroid symptoms. Does anyone have any info that I can show him to stop him reducing my thyroxine.

[TiggerMe]

Actually he is right to reduce your T4 as being over range will further impede conversion and is known to be bad for you long term. BUT 🎉 you have perfect results to request a referral to Endo and hopefully a T3 trial at the very least

In the mean time don't agree to drop by more than 12.5mcg a day or 25mcg alternate days

Have a look through the list to see if a T3 aware NHS Endo is in your area as you can get them named on your referral request... thyroiduk.org/contact-us/ge...

[greygoose]

Well, your levo needs reducing. Your FT4 is much too high, and that is not a good thing long-term as it increases your risk of other problems. Tell him you'll happily reduce your levo if he'll help you get T3 prescribed - first step: referral to an endo who is T3-friendly. Your conversion is very, very poor.

[pennyannie]

Hello Sja :

When taking T4 only medication we generally feel best when the T4 is up in the top quadrant at around 80% through its range with the T3 tracking just behind at around 70% through its range :

The accepted conversion ratio when on T4 monotherapy and once the T4 is in the top quadrant is said to be 1 / 3.50 - 4.50 T3/T4 with most of us feeling at our best when we come in this conversion ratio at 4 or under.

So - if I divide your T4 result at 23.00 by your T3 result at 3.60 -

your conversion ratio coming in at around 6.40 -

showing your conversion of T4 very wide of the ratio and why your T4 now appears over range as your ability to continue to convert T4 into T3 is further compromised from your previous blood test posted on here, which I believe, was on the same dose of Levothyroxine.

No thyroid hormone replacement works well until the core strength vitamins and minerals - those of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels -

I now aim to maintain with my ferritin at around 100 - folate around 20 - active B12 125 ( serum B12 500++ ) and vitamin D ar around 125 :

Down regulation of T4 into T3 can also occur due to inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing.

The logical solution is to drop some T4 - BUT add in a little T3 to rebalance thyroidal hormones and restore your health and well being.

Sadly in primary care doctors can no longer prescribe T3 - Liothyronine and you need to be referred to an NHS endocrinologist to be assessed -

and I'm afraid depending on where you live you may face a brick wall as in some areas of the country ICB financial constraints rather than the medical need of a patient are being implemented.

You could go into openprescribing.net and see by surgery and then ICB area - how many prescriptions for T3 are being written compared to other surgeries / areas -

Just enter as the drug - Liothyronine :

but it's difficult to ascertain - if any prescriptions are for new patients - and or which doctor by name is supportive of T3 thyroid hormone replacement.

Do you have the Thyroid Uk list of recommended thyroid specialists and endocrinologists - NHS & Private - I think there is now a form to fill in - that you'll find on the main Thyroid UK website - otherwise just email admin @thyroiduk.org asking for the Patient recommended list of thyroid specialists.

Obviously if you can afford to go privately there is an easier route to better health or alternatively you can source T3 yourself and start self medicating as many forum members have been forced into -

[SlowDragon Administrator]

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

Is this how you did your test

Please add actual Vitamin test results and ranges

Which brand of levothyroxine are you taking

Do you always get same brand at each prescription

Gluten Free diet needs to be strictly gluten free to be effective

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

NHS referral it typically a year and if TSH/Ft4 are “normal “ referral often refused

Private referral

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations so you can transfer eventually

thyroiduk.org/contact-us/ge...