More advice please

[nursey]

Hey all, sorry to keep asking but am trying to get my head around the info available to put my case to my gp on Monday. From what I have read and from my results (posted on Wednesday) I think my problem is converting t4 to t3. My b12 and feritin are also at the bottom of the range which may be contributing to this problem. My hb is good (14 gdl) so no anaemia as such, more a problem of converting again. If my gp is still saying there is nothing wrong with me should I be asking for b12 injections and a trial of thyroxine or just b12.? Or should I ask for b12 and t3 meds.? I find it amazingly wants to prescribe a trial of anti depressants to help me but no trial of thyroid meds! I was down last year as a close family member died of cancer but I had already seen my gp in 2008, 2010 and 2011 with this long list of symptoms. So just trying to get straight in my mind what I should be asking for?

[nobodysdriving]

I would go first with fixing B12 and ferritin/iron as when these are optimal again then your body can start converting properly. If after a while of being optimal with things it still does not convert then I'd look at combined therapy or T3 only (best to try combined first probably).

If you are undiagnosed I can't remember your whole story but a trial of levo alongside these measures above may be a good thing.

[greygoose]

Nursey, you can't say that you have a conversion problem.

Both your FT3 and your FT4 are too low, below mid-range. That means that you have very little T4 but you are still managing to make some T3.

A conversion problem would show up if your FT4 was way up near the top of the range and your T3 near the bottom. Your problem at the moment would seem to be that you don't have enough T4 to convert.

You obviously need some sort of thyroid replacement hormone but you can't prove to your doc that you have a problem converting and saying that, I think, might weaken your arguement.

Just my humble opinion, Grey

[nursey]

Hey thank you. I am so confused by all this. I thought that because all my numbers are in 'normal' range I need to show that I understand. Last time I has this discussion with my gp and stated that all the numbers were just in range and therefore only borderline normalmy gp comment was 'no not really, stop going onthe internet!' I want to try to show that I am rational, informed and determined. My t4 is 14.20 (range 10.5 - 20) and free t3 is 4.4 (range 3.5 - 6.5) so I fear I am going to get the same response. I will not mention converting!! Thank you so much.

[greygoose in reply to nursey]

Yeah, well, your doctor, like most doctors, doesn't know what he's talking about. He might do well to spend a little time on the internet himself! No, all you can say is that your T4 and T3 are too low for you to feel well.

I don't remember what your TSH was, I'm afraid, and he probably only goes by that anyway, so your best bet might be just to ask (beg?) for a trial of T4 to raise levels of the actual thyroid hormones, and see if you feel any better on it.

But I'm afraid I'm not the one to advise you on how to talk to doctors, I've never been any good at it myself! I usually just throw a hissy fit and walk out, find a new doctor. But that's easy in France.

Good luck, Grey x

[nursey]

Ha, a hissy fit may be on the cards! My tsh was 3.76 (range o.35 - 5.5). I so want to feel well again. I am going to be calm, to the point and show the gp I am willing to share my care with him. If he prescribes thyroid meds and b12 I will go back to exercise (I used to run 5k twice a week and I play netball) and do my bit with the right diet etc. I have started a new job which I love and it's s big year for birthdays and we have a lovely summer holiday planned and I want to be well to enjoy it with my family. If he disagrees I will throw a hissy fit and move to France!!

[debjs]

The book by Dr Toft talks about some people needing results higher or just above range to feel well. This is a BMA book so maybe your Dr will take more notice of that. It was not expensive to buy.

[Marz]

Maybe take a look at drrind.com just in case you have an Adrenal problem. There is a page that shows various conditions based on thyroid results.....eg. Low TSH FT4 FT3 could just indicate such a thing. There is also a Matrix where you answer questions on Thyroid v Adrenals to establish things. You may just find this helpful. Then there is the minefield of Adrenals and their health !.....medics like to ignore insufficiency and just acknowledge them when they are completely broken - Addisons.

Apparently thyroid hormones have difficulty getting into the cells when there are Adrenal problems. Wishing you well soon for your busy and exciting year ahead.,.....