So many of us with thyroid conditions are put on synthetic meds like Levothyroxine or Synthroid. These meds contain synthetic versions of the thyroid hormone T4.
However, many of us are “poor converters”. This means that our bodies have trouble converting T4 into the useable T3. This is a quick and easy explanation from Dr. Datis Kharrazian (if you haven’t read his book “Why Do I Still Have Thyroid Symptoms If My Lab Tests Are Normal”, I highly recommend a read, it’s well written and easy to understand):
“In the end, only about 60 percent of T4 is converted into usable T3. Twenty percent becomes reverse T3 (rT3), an inactive form the body cannot use. Levels of rT3 can become too high in times of major trauma, surgery, or severe chronic illness. Another 20 percent of T4 can be converted to T3 by healthy gut bacteria in the digestive tract.”
You can read the full post from Dr K here.
So, if you are a “poor converter”, your body may not be able to make that T4 to T3 conversion.
Levothyroxine is a T4-only med. Do you see where this is going? If you’re not converting well, your labs may consistently show low Free T3 in your body. And that Free T3 is what’s needed by the cells in your body for energy, gut motility (the opposite of constipation), body temperature (are you always cold?), mood, skin and hair issues… you know the laundry list of symptoms, so I’ll stop there!
Here are some things to consider if you are a poor converter:
- I was always in touch with my doctor about my labs and how we could tweak and improve them. This sometimes meant raising my meds, lowering them, or trying another med. If your doctor is not willing to discuss this with you, find another doctor if you can. This is your health, not your doctor’s. Find a doctor who will listen.
- Sometimes adding in T3 (liothyronine, one brand is Cytomel) or switching to Natural Desiccated Thyroid (NDT) which has both T4 and T3 hormones (Amour, WP, Naturethroid, etc) is the key to giving the body what it needs. But again, not everyone does well on NDT. One must be mindful of fillers in all meds and any sensitivities one has. For me, I also had to get my iron and cortisol in good shape before NDT worked, as both can affect how thyroid hormones work in the body. More on that in a future post.
- As you heal your gut (see above about the gut converting T4 to T3 – if the gut is not healthy, guess what may not happen? T4 to T3 conversion!) – which we do by removing gluten, dairy, and other inflammatory foods – and your detox pathways heal and open (liver is mentioned as another place where much of the T4 to T3 conversion happens), your body may regain the ability to convert. So stay on top of those labs and symptoms in your journal.
Moral of the story: If you suspect you are a “poor converter”, get that Free T3 lab as well as Reverse T3 to get the best picture of what’s going on in your body, and work with your doctor to find a solution that works for YOU.
See my post Thyroid Labs to Get for recommended thyroid labs.
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