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    Old 04-21-2009, 05:20 PM   #1
    mellymermaid40
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    Do I have a conversion problem?

    I was diagnosed with hashimoto's in 2006 and began with 50mcg synthroid. I am now after many adjustments up to 125mcg synthroid. But here is my question. My ft3 has barely budged this whole time. I have included a history of my ft3 records for you experts to evaluate for me. Any advice is greatly appreciated.

    What should I do? My doctors don't pay any attenion to past labs so I don't think anything will be done without my insisting that they look at these.

    here they are....


    History of free t3 since diagnosed in November of 2006

    Date Ft3 Ranges

    11/21/06 2.72 (2.24-4.08)

    03/15/07 2.75 (2.24-4.08)

    03/23/07 2.73 (2.24-4.08)

    06/26/07 2.98 (2.24-4.08)

    08/14/07 2.71 (2.24-4.08)

    05/15/08 2.5 (2.3-4.2)

    07/28/08 2.7 (2.3-4.2)

    09/09/08 2.6 (2.3-4.2)

    12/01/08 2.9 (2.3-4.2)

    04/15/09 2.7 (2.3-4.2)

    Thanks for looking.

    Melanie

     
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    Old 04-22-2009, 04:23 AM   #2
    keav
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    Re: Do I have a convertion problem

    I am having the same problem. My t3 is always low also--actually lower than yours and never budges with increased t4. See my post today.

     
    Old 04-22-2009, 12:23 PM   #3
    Scootersmom
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    Re: Do I have a convertion problem

    I'm having the same problem as you girls are. My endo doesn't test for T3 Free, just T3 Total, FreeT4 and TSH. I was diagnosed with Hashi's in January and before starting any meds whatsoever my TSH was 60, my Free T4 was 0.7 (low) and my T3 Total was 0.94 After 7 weeks of 75 mcg of Synthroid my TSH came down to 43 and my Free T4 went up to 1.2 (mid-range), but my T3 Total remained at 0.94 EXACTLY THE SAME SPOT IT WAS BEFORE TAKING ANY MEDS!!! The endo seemed totally unphased by this. I understand that Synthroid is pure T4, but I don't understand why I'm not converting some of it to T3. It should have gone up some. She doesn't want to add any Cytomel because I felt a little hyper (and I'm far from clinically hyper) on 75 mcg of Synthroid. It had to be lowered to 50 mcg. and she's afraid that Cytomel would start up the racing pulse, palps, anxiety, etc. again.

    I'd love to know why I'm not converting better than I am.

     
    Old 04-22-2009, 03:37 PM   #4
    hopalong_too
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    Re: Do I have a convertion problem

    I was taking Synthroid 50mcg and Cytomel 5mcg. My latest labs were:

    TSH 1.037 (.45-4.5)
    FT4 1.07 (.61-1.76)
    FT3 2.6 (2.3-4.2)

    I am still having cold hands and feet as a major symptom which apparently has to do with T3. My Endo has just added more Cytomel (doubled it) but in exchange he lowered the Synthroid to 37.5 for 5 days and 25 for 2 days. Maybe you could try adding Cytomel but lowering the Synthroid?

     
    Old 04-22-2009, 06:22 PM   #5
    Scootersmom
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    Re: Do I have a convertion problem

    Hopalong your numbers look great!! I should only live long enough to see numbers like that My TSH was 43 when my last lab work was done a month ago. My Free T4 rose after being on Synthroid 75 mcg for 7 weeks, but the T3 didn't budge. My endo, for some reason, doesn't think a T3 Free test is important, just a T3 Total, but when I have blood work done next month I'm checking off the box for "T3 Free". I'm the one paying for the tests for crying out loud. Last go-round I myself checked off for the TSI test and although I'm clearly Hashi/hypo with antibodies through the roof, my TSI numbers came back just under normal range. She more or less shrugged that off and said don't worry about it, you're hypo.

    She doesn't seem inclined to add any Cytomel, probably because I felt so hyper on the 75 mcg of Synthroid and with my TSH I don't know if lowering the Synthroid dosage from 50 mcg to 37.5 would be enough, even with a touch of Cytomel added, but I'm definitely gonna be concerned if my T3 hasn't gone up at all and beg for some Cytomel.

     
    Old 04-22-2009, 08:23 PM   #6
    hopalong_too
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    Re: Do I have a conversion problem?

    You should check out my other post where MG helped me with the conversions. The T3 in Cytomel is faster acting but you need to multiply by 4. For example: UGH! I may get this wrong, it is better if you just look at the other post.

    http://www.healthboards.com/boards/showthread.php?t=675022&page=2

     
    Old 04-23-2009, 05:49 PM   #7
    mkgb
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    Re: Do I have a conversion problem?

    It does look like you have a T4 to T3 conversion issue. The question is what issue. How are your FT4 levels? Where are they in the normal range? Are they above normal range?

    If you have normal/optimal FT4 levels with these suboptimal FT3 levels I would suspect a dominant flaw in the conversion process where your body is stripping off the wronge iodine from the T4 and creating a REVERSE T3 molecule. You need to get an MD to run an RT3 test for confirmation of this issue. If your RT3 levels are high that is grounds with a knowledgeable MD to get a T3 supplementation regime implemented.

    Now if your Ft4 levels are high with your suboptimal T3 levels... well this may be an adrenal issue where you are putting out too much cortisol and aldosterone and suppressing the conversion of T4 to T3.

    So to know for sure what is causing the suboptimal T4 to T3 conversion you need to look at two factors.. adrenals and conversion mechanism. Tests to do this are:
    Basic Adrenal:
    ACTH, Cortisol, DHEA-s fasting blood serum tests at 8 am.
    Thyroid conversion:
    T3 uptake and RT3

    If you get these tests done then you will know if and what the conversion issue is. Either way your levels indicate that you need T3 supplementation despite the supporting test results.

    MG
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