Is this because I have Hashis and there is a finite amount of limited conversion going on , and I have reached my limit?
In the past when Ive added some additional T3 albeit in tiny amounts ie 1.13mcg or 2.5mcg then my T3 levels rise, but if I added another 1/8 grain or 1/4 grain of NDT the T3 level does not budge, stays at 5.4, but as mentioned T4 goes up and TSH drops further.
Any thoughts would be greatly appreciated........still searching a quality of life.
Every best wish , G
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Gillybean1
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Lovely to hear from you and I hope you are doing well ?
For example I mean:
9 weeks on NDT 1 1/4gr TSH 0.08 (0.27-4.2) / T4 15.3 (12-22) / T3 4.7 (3.1-6.8)
9 weeks on NDT 1 3/8gr TSH 0.067 (0.27-4.2) / T4 17.8 (12-22) / T3 5.4 (3.1-6.8)
9 weeks on NDT 1 1/2gr TSH 0.034 (0.27-4.2) / T4 18.8 (12-22) / T3 5.4 (3.1-6.8)
I seem to get to a point where on NDT myT3 levels stick at 5.4 . The blood tests are done at the same time in the morning with the same ceasing of medication of 16 hours, and at the same lab.
When ive been on lower NDT of 1 grain in the past and added 7.5mcg T3....., T4 11/ T3 13.6, all out of range.
I just wondered if with Hashis there is a saturation point where T4 converts up to an individual point and no more....if that makes sense....or am I as confused as always 🙃?
16 hours is too long for NDT. It should be a gap of not more than 12 hours - 8 to 12 hours. So, it's possible that your FT3 was actually higher than that.
I just wondered if with Hashis there is a saturation point where T4 converts up to an individual point and no more....if that makes sense....
It makes a sort of sense, yes. But it has nothing to do with Hashi's.
Only 30% or T4 is ever converted into T3, and 30% into rT3. The rest is disposed of in various ways, excretion etc. But, if the FT4 gets too high - and how high is high depends on the person - it starts converting to more rT3 than T3. This is a natural safety mechanism to try and stop people going hyper.
However, your FT4 has only ever been 68% through the range maximum, which really doesn't look high enough to trigger that rT3 response.
When ive been on lower NDT of 1 grain in the past and added 7.5mcg T3....., T4 11/ T3 13.6, all out of range.
Hmm... Do you have Hashi's? I can't remember. Because there's absolutely no logic in your results, and having Hashi's would explain that.
Do you mean no logic in any of my results ?or just the result referring to 1 grain NDT + 7.5mcg T3 yielding T4 11 and T3 13.6 ....? And I was on that dose for 16 weeks + until a gradual build up of racing heart by about week 15.
Yes, diagnosed with Hashimotos in 2012. Antibodies have come down a bit since on NDT. from 2015. I know thats not the case for all.
Doesn't matter what the level of antibodies is once they've been over-range. They fluctuate all the time but whatever the level, you still have Hashi's. So, that could explain the NDT+ T3 results.
But it doesn't really explain why your FT3 doesn't rise with increasing doses of NDT. Although, as I said, you probably have a false 'low' FT3 there, due to the long gap between last dose and blood draw.
But it has nothing to do with conversion, either, because three grains of NDT contains about 27 mcg T3, anyway. And that should be enough for most people to take their FT3 up to a decent level, plus a little T3 from conversion - impossible to tell how much.
Do you feel you need your T3 higher? Or is this just a curiosity question? If you do feel you need it higher then I would add 5 mcg T3 and see what happens.
Im barely existing,housebound, emaciated at 41kg, chronic malabsorption for a decade now, wasted and weak, and so I still hae not found the balance.
I think I got bogged down with Endo's plural wanting a detectable TSH and so much abuse I turned my back on them , and to be fair they abandoned me post pandemic . I was 'dismissed'... I digress. I have not given up, just started all over again. But the Endo's are correct in saying "you have not got/ felt well on NDT nor T3 only.
If I up the NDT another 1/8 or 1/4 I will get thinner if thats possible..... but on the other hand it might decrease the gut inflammation (always gallbladder ....which smacks of lack of T3)
I think the chronic gut inflammation for a decade has caused damage to my gut lining causing the malabsorbtion. Yes I do take enzymes and betaine when I can (caution with gut flare up though)
And been GF, DF, SF for a decade+, and nearly all grain free (intolerant) for many years.
T3 is increasingly difficult to source at a reasonable price as is NDT. I seem to need some NDT, so maybe I could try a bit more, and if that doesnt help, drop back and try adding extra T3 in, but less than before.
Have you ever heard of the Baltimore study? I cant find it , but its been mentioned on here before and reckons TSH should be detectable at 1.5 that T3 should be 4.4 and T4 should be 14-15.............but surely all these studies should-be, could-be bla bla are based on healthy individuals. Which was the last vibrant discussion I had with Endo before I was dismissed and put in the corner with my Dunce hat on.
Have you had the chronic malabsorption investigated? Sure it could by Thyroid related, but there's many auto-immune related issues that target the liver, stomach, pancreas etc.. I would have expected the NHS to have given you an endoscopy, ultrasound/CT scan of gallbladder, liver, duodenum area.
Have you had the usual tests (FIT, calprotectin etc.?) How's your cholesterol, which is a good indication of liver operation under your current levels of NDT.
Gastro gave me an Endoscopy 2012 showing flat villi. No explanation given as Id been strictly gluten free for 18 months at the time. They couldnt explain why. Back then numerous scans were done, all normal. All smooth muscle gut antibodies normal back then too. It was flagged back in 2013 as Vagus nerve inflammation or skewed responsed due to double whiplash accident from 2006 and advised it would settle. They were amazed back in 2014 that a 'homeopathic dose from Endo of 25mcg Levo" (gastros words not mine) improved the gut flare. I found that suggestion of 'homeopathic dose insulting and indicated that maybe they did not have a solution.
Recent bloods 2024/ 2025 all normal, cholesterol normal, slightly elevated ALT in line with gallbladder issues. I have requested gut antibodies to be redone 2024 this was declined by Endo as not necessary and no treatment if positive ......
I have not done FIT and dont know what calprotectin etc is so I will research this.
Can you expand a little for me on NDT levels and liver, what did you mean please?
Sorry you've been suffering with gut issues for so long, it's a horrible thing to have to deal with.
So the Liver is probably the organ that suffers the most when the body Thyroid hormones are out of the expected range, primarily T3. It knocks out of whack the levels of proteins it produces that are responsible for many processes within the body. Iron homeostasis, Fat/lipid metabolism also suffers, changing the lipid profile (hence cholesterol levels), and thus altering bile acid production.
Therefore, when people are under-dosed, it's common to see Cholesterol higher, with a raised LDL/HDL ratio. If Cholesterol is good/normal, then I would say it's a possible indicator that you're not horribly undermedicated (although it's never as straight forward as that).
ps GG I didnt realise that 16hrs was too long a space for T3 reading, I think I was aiming to get the T4 side of the equation to be as spaced enough to read as low as possible for the medics......but thinking it through it probably wouldnt make that much difference if i did do a blood test with meds taken up to 8- 12 hours prior.
Although I did note once following a thyroid storm when I stopped all NDT for just 4 days ,in that 4 days my T4 dropped from 21 - 12.... the Endo was astonished. I guess its variable metabolisms.... G
I don't think medics are interested in T4, are they? It's usually the TSH they hone in on. But in any case, to have a lowering effect on the FT4, you would have had to leave a gap of over 24 hours, which would have given you a very false low FT4.
It's always difficult with NDT, but as FT3 is the most important number, it's best to go with the most accurate reading possible of that.
That result of mine of T4 11 and T3 13.6 was when i was on 1/4grain of NDT + 7.5mcg of T3..... not 1 grain,.my apologies, too tired. But this would make more sense.
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