Does T4 to T3 conversion lessen with age? I'm just trying to figure out why I feel 20 years older than my real age.
No changes to any meds and supplements and TSH and T4 levels are on a par with where they've been for several years. Ferritin is low but I suspect it's been that way for a long time.
I know I'm getting older but when you do a supermarket shop in a morning then are wiped out for the rest of the day, something's changed.
For good conversion of Ft4 (levothyroxine ) to Ft3 (active hormone) it’s important to maintain GOOD vitamin levels
Please add most recent vitamin D, folate, B12 and ferritin results and ranges
If you have low ferritin this can cause exhaustion
GP should be doing full iron panel including ferritin
Conversion often gets worse post menopause as well
Do you always get same brand levothyroxine at each prescription
How much are you taking
Please add most recent TSH, Ft4 and Ft3 results
Please add most recent vitamin D, folate, B12 and ferritin results and ranges
Vitamin D -- 106 (50-250)
Vitamin B12 -- 536 (211-911)
Folate -- 18.3 (>5.4)
Ferritin -- 19 (15-200)
If you have low ferritin this can cause exhaustion
GP should be doing full iron panel including ferritin
Ferritin is within range so fine - GP's words
Trying a DIY approach with supplements
Conversion often gets worse post menopause as well
Do you always get same brand levothyroxine at each prescription
Yes. Always Accord but considering requesting Vencamil as lactose and fructose intolerant
How much are you taking
100mcg daily
Please add most recent TSH, Ft4 and Ft3 results
TSH 0.08 mIU/L (.27 - 4.2) -4.8%
Free T4 (fT4) 21.1 pmol/L (12 - 22) 91.0%
Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 24.3%
Ferritin is within range so fine - GP's words
Obviously that’s rubbish
Low ferritin tends to lower TSH because poor conversion leads to higher Ft4 and lower Ft3
High Ft4 results in lower TSH
Anaemia
cks.nice.org.uk/topics/anae...
"Anaemia is defined as a haemoglobin (Hb) level two standard deviations below the normal for age and sex.
In men aged over 15 years — Hb below 130 g/L.
In non-pregnant women aged over 15 years — Hb below 120 g/L.
In children aged 12–14 years — Hb below 120 g/L.
In pregnant women — Hb below 110 g/L throughout pregnancy. An Hb level of 110 g/L or more appears adequate in the first trimester, and a level of 105 g/L appears adequate in the second and third trimesters.
Postpartum — below 100 g/L."
diagnosis is confirmed (following the Hb result) by a ferritin<30.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
The reason is says "in all people" is because the hb levels are differentiated for sex and pregnancy status, but ferritin is not.
NHS follows Nice guidance, The cks are from NICE, and NICE guides NHS practice.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 5-7 days before testing
Medichecks iron panel test
medichecks.com/products/iro...
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This’s is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
healthunlocked.com/thyroidu...
Posts discussing Three Arrows as very effective supplement
Great replies from @FallingInReverse
re ferritin and Three arrows
healthunlocked.com/thyroidu......
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great reply by @fallinginreverse
healthunlocked.com/thyroidu...
Iron patches
healthunlocked.com/thyroidu...
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue
healthunlocked.com/thyroidu...
Inflammation affecting ferritin
healthunlocked.com/thyroidu...
Updated reference ranges for top of ferritin range depending upon age
healthunlocked.com/thyroidu...
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Age can play a part but the main problem is your thyroid hormone levels
Your conversion rate may have declined for various reasons, which has resulted in very low FT3 and high FT4
100mcg T4 is not a vastly high dose but you would benefit from the introduction of T3....this also naturally reduces T4.
High FT4 is best avoided as it has the potential to cause problems.
For good health every cell in the body must be flooded with T3 by way of an adequate and constant supply.
The T3 must reach the nuclei of the cells , attach to T3 receptors there and so become active before it can fulfill it's function
At 24.3% through the reference range that isn't happening and you are consequently experiencing symptoms of hypothyroidism.
You need more T3⁹
Optimal nutrients, vit D, vit B12, folate and ferritin are essential to support thyroid function
We aim to have both Frees roughly approaching 75% though their respective reference ranges.
Suggest you see an endo with a view to having a trial of T3.....they prefer trial requests to requests for T3!!
Since diagnosis and Levo replacement I've always felt ok-ish but never back on top form which leads me to suspect that I've had issues converting T4 to T3 all along.
My GP, although generally a good doctor who listens, is very TSH focused and refused my request for referral to Endo.
I think I'm going to have to self refer to a private Endo.
I really can't go on like this. I feel like I'm existing not living.
You could save yourself the £££ and hassle of finding a decent Endo as you already know what you need.... I'd suggest having a consultation with rosewaylabs.com/patients/ who will monitor and can also supply... word is they are excellent and considerably cheaper than an Endo 😏
They are excellent. I use them. Great service.
so do I, Roseway Labs very good , much cheaper…only disadvantage is I let slip their prescriber is a GP and not an endo ( not that makes much difference we know), but he said that was not good enough and he needed a specialist to advise on thyroid hormone dosing. I had had one, privately, and letter on my notes about dosing etc but it gets expensive to keep them on the books just to say ‘ok’ to my own privately funded blood tests, and to get a private prescription out of him every 3 months or so. I refused to go back to him, so for the very first time , in 25 years, he has referred me out of Trust to an NHS endo.
I don't know why doctors are so clueless about thyroid disease....and as for TSH mania....
Good advice from TM re Roseway labs.
I self medicate with T3-only....hit a brick wall with medics!
Yes I suspect your conversion may have gradually deteriorated over time with cellular T3 level falling.
Good luck, we're all here to help.....just ask!
I second the suggestion to use Roseway Labs. Their prescribing pharmacist is so good and kind.
I’d been taking levothyroxine only for years then suddenly when I was 59 I hit a wall so to speak. I was never great just on levothyroxine but I use to muddle along. At 59 suddenly my energy levels plummeted. My gp increased my levothyroxine even though it was already at the top of its range. I went over medicated and ended up collapsing and into hospital. There they did a t3 test. First ever in my life. My t3 was only 8%. NHS still refused t3 trial criminally in my mind. I could barely walk for months. I went private after being advised on here. I was given t3 medication immediately. Oh my goodness what a change that made. Suddenly and I mean within 2/3 days I could walk normally and had lots of energy and strength. I’ve read a few articles about metabolic rate after 60. It nose dives from 60 onwards gradually. I believe I could struggle on in my 50’s but at 59 onwards naturally my metabolic rate declined. I am a poor converter of t4 to the magic t3 hormone so I did need the help of the addition of T3 liothyronine
I do believe t4 to t3 can lessen with age and 60ish is the gradual point it starts. But people also have a conversion issue on top too. I did the DIO2 test also which came back positive.
Today I’m symptom free as I keep my TSH just about in range therefore levels in range also. I’ve been symptom free since starting t3 5 years ago now. Prior for over a decade I had lots of symptoms just in levothyroxine t4. I also now have liquid levothyroxine which I think helps too.
Muddling along. That's me exactly. I really think I'm going to have to cut my GP out of things and start to take back some control of my wellbeing.
My GP, although very good at listening and will follow through with tests (diagnosed me with lactose intolerance by symptoms before test results came back and admitted that some diagnoses are catch-all bucket type things) still insists that I can't possibly still be hypo as my TSH says I'm not. My symptoms are down to other things but can't find out just what they are!
I have bought Paul Robinson's Thyroid Patients Manual and will read it cover to cover.
Just nervous about going my own way in case things go wrong 😨
Your GP needs to move out of the misleading TSH groove! He is wrong!
T3 is key!
We're all here to help....just ask
Things shouldn’t get any worse than a gp recommendation. Focus on getting g your vitamins really good and keeping them there with regular blood tests. Eat as healthy as you can and exercise even if that’s brisk walks daily. I do these things and for myself I keep my TSH and t4. T3 levels in range just like a healthy persons would be.
A huge thank you to SlowDragon DippyDame TiggerMe FancyPants54 McPammy
I'll be doing a lot of research over the next few days and may just have the need of a little hand holding 🫂❤️
have you considered it might be your short in other hormones as they tend to lower as we age
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