FT4 to FT3 Conversion Problem --- Doctors Do Not Order Correct Tests

[Bird_42]

Back in April 2011, I posted in a different thread that I felt I had an FT4-to-FT3 conversion
problem. My FT4 was rising, while my FT3 was staying the same. My hypothyroidism symptoms
(arthritic pain in hands, pain in knees, sluggishness, memory lapses) were bad.

Here is the thread:

http://www.medhelp.org/posts/Thyroid-Disorders/I-Stop-Taking-Vitamin-D-Free-T4-Goes-Up-Free-T3-Stays-Same/show/1500525



The poster known as gimel said that I should be tested for the following:

(vitamins A, D, B12) and (RBC magnesium, zinc, and selenium).  

gimel said that deficiencies in some or all of these can cause hypothyroidism symptoms.



I sent an email to my endo, asking for these 6 tests. The endo said that he would order the
vitamin D test but that the other 5 tests are not tests that he normally orders. The endo said
that I should ask my primary-care physician (PCP) for the other 5 tests.

I sent an email to the PCP, asking him for these 5 tests. Like the endo, the PCP said that he would
be willing to order the vitamin D test. However, the PCP wanted to see some information about the
usefulness of the other 5 tests.

So, I did some research.



I found the following website:

http://www.thyroid-info.com/articles/topsupplements.htm

This website shows the relation between thyroid function and vitamins E & D, selenium, and zinc.
The website also mentions vitamins A & C, Omega 3 & 6 fatty acids, and free-form amino acids.


I also found this website:

http://www.*************************/lab-values/

This website explains the tests for vitamin B12, ferritin, and RBC magnesium.


However, the most shocking discovery that I made was this website:

http://www.eurekalert.org/pub_releases/2009-04/arf-vdm040809.php

This website explains that, if a person has autoimmune disease, then vitamin D may make the
autoimmune disease WORSE. My hypothyroidism stems from autoimmune disease. If vitamin D will
make my autoimmune disease worse, then that may explain why my FT4 and FT3 levels went down
when I used vitamin D, even though I used vitamin D and Synthroid far apart from each other.



So, I sent an email to the PCP, telling him about all 3 websites. I said that I should
*definitely* be tested for vitamins E & D, selenium, and zinc. I said that *maybe* I should
also be tested for the following: (vitamins A, C, B12), RBC magnesium, ferritin, Omega 3 & 6
fatty acids, free-form amino acids, and the adrenal glands and stress hormones.

The PCP said that he sees no usefulness to any of these tests, other than the vitamin D test. The PCP
did, however, say that he suggests taking a vitamin and mineral supplement + vitamin E.



First of all, why did the endo tell me to ask the *PCP* for the following 5 tests: (vitamins A, B12)
and (RBC magnesium, zinc, and selenium)? If these tests are thyroid-related, shouldn't the *endo* be
handling them?

And why would the PCP tell me to take vitamins and mineral supplements without first testing me to
find out which vitamins and minerals I am deficient in? He tells me to take vitamin E without testing
my vitamin E levels. Without a blood test, how do I know how much of a dosage of vitamin E I need,
if any?

And the one test the PCP *does* want to give me is for the substance (vitamin D) that I can't
swallow, no matter what, because that substance makes my autoimmune disease worse.

What is going on here?

Thanks for any answers.

[Red_Star]

No problem. :)

Your calcium levels are in good range, the mid 9's. That you have vitamin D deficiency with normal calcium levels is likely to be secondary hyperparathryoidism.  This excerpt from the Linus Pauling Institute:

"In vitamin D deficiency, calcium absorption cannot be increased enough to satisfy the body’s calcium needs (2). Consequently, PTH production by the parathyroid glands is increased and calcium is mobilized from the skeleton to maintain normal serum calcium levels—a condition known as secondary hyperparathyroidism. Although it has long been known that severe vitamin D deficiency has serious consequences for bone health, recent research suggests that less obvious states of vitamin D deficiency are common and increase the risk of osteoporosis and other health problems (16, 17)."

I found an interesting article from natural news titled "Know the Importance of Taking Enough Magnesium with Your Vitamin D" Wish i had read this article earlier!

An excerpt:

"Vitamin D, just like all other nutrients, works in harmony with several other nutrients to perform its many functions. Most importantly, vitamin D requires and 'uses up' magnesium to convert from supplements or sun into its active form in the blood. As such, it is a big mistake to simply take large doses of Vitamin D without taking the need for magnesium into consideration."

[Bird_42]

Hi, Red. Thank you very much for your information.



You wrote: "Vitamin D levels below 30 ng/mL (75 nmol/L) are associated with a fall in the absorption of calcium from the intestine."

In mid-July 2011, my vit D was 13 (normal range = 32 - 100). A few days after the vit D test, I took a calcium test, and my calcium was 9.3 (normal range = 8.7 - 10.2). In early February 2012, my vit D was 16.5 (normal range = 30 - 100), and my calcium was 9.3 (normal range = 8.7 - 10.2).

So, my vit D amounts were low, but my calcium amounts seemed normal. Or is 9.3 too low?



Also, you wrote: "Magnesium is the most important co factor for vitamin D absorption. Vitamin D supplementation can worsen an existing magnesium deficiency."

In late August 2011, I started taking 1000 IU vcaps of vit D3. I took these vcaps four times per week, for three weeks. Then I started taking these vcaps every day.

In early December 2011, my vit D was 26 (normal range = 32 - 100), up from 13 in mid-July 2011. So, I don't think that I have a problem with absorption of vit D. This is, of course, consistent with my high level of magnesium RBC that you pointed out.

As far as my ear problems, I have experienced the crackling sound and the pulsating sensations. However, I have not experienced the noise sensitivity where everything is too loud, and I have not experienced loud ringing.

Also, my new endo says that magnesium serum is the best magnesium test. Who knows? :)



As for the theory that vit D exacerbates autoimmune disease, there is one way to test this theory. I could resume taking vit D, as my new endo suggests. After about six weeks, I could do a blood test for Anti-TPO and Anti-TG antibodies. I have never before been tested for these antibodies while taking vit D. Are there any *other* kinds of antibodies that could attack the thyroid gland?

Thanks to everyone who has responded so far.

[artfemme]

To Red and all....butting in here, stumbled upon the thread while posting a new question.

Low B12 turned out to be one of the first most obvious signs of my developing hypothyroidism. I went to a blood specialist at Cedars-Sinai in Los Angeles because I had unusual and persistent bruising, lasted forever though often I couldn't recall bumping myself. the specialist did a lot of testing in her office and told me I had pernicious anemia based on enlarged Red blood cells, w/ the bruising as a presenting symptom. I later found out that, yes, pernicious anemia is auto-immune related and also related to HYPO.

Don't have time to spend here but wanted to tell you that the blood specialist told me that B12 sourced from methylcobalamine is the one that is most easily absorbed into the body, and that without that source other B12s are a waste of money and the Bs excreted. She recommended NOW brand sublingual as the one most readily absorbed, especially since it doesn't go through the digestive tract. She said that the other recommended one is JARROW, which is a capsule. I have been taking the NOW Ultra B12, which contains the other Bs as well, since 2005. When I get lazy and don't take it, I not only feel fatigued after a short while, but the bruising comes back too. I was told to take a minimum of 1500 mcg a day...I take 3 droppers (they only fill about 1/2 way) which is about 2000.

As for Vit D....15 - 30 minutes a day in the sun without sunscreen gives you what you need , but that isn't always possible and in any case low D IS associated with hypothyroidism and we may have trouble synthesizing it. When I was finally tested, I had way below the norm and my calcium labs were off too. My PCP resisted testing me, but after I insisted and we got the labs back, she was shocked. At first I was prescribed 3000 units a day. After a year or so, my gynecologist, who deals with hormonal issues and seems more familiar with thyroid issues than any endo I've gone to looked at me latest labs and said the D3 was still too low, down at the bottom of the range. She said it should be around 50 in the range and raised my dose to 5000 units a day. I found a sub-linual 5000 unit sublingual SPRAY that makes it so easy to take....even when I'm lazy with my other vitamins, I can always take D and B-12, and the taste is good too. The sub-lingual D3 doesn't have any soy or calcium. The brand I found is L.A. Naturals, and I feel much better since I've started taking it. Strangely enough, it's manufactured in Indiana, not L.A., where I live.

I don't test positive for Hashi's , although my sister has it, so I can't speak to whether it affects your levels or not. All I know is that these brands work for me. NOT selling them, pimping them, nothing like that what-so-ever. Just FYI, my experience.

Good luck.

[blsdnsvd]

You're absolutely correct, knowledge is power! One thing i can truly say about everything that i'm going through because of not having a thyroid is this: I'm more educated about the power of a  functioning thyroid. :))

[Red_Star]

No problem. :) Knowledge is power.  My doctor told the receptionist no action needed when i called for my vitamin D results (16ng/mL/40nmol/L). Ummm O_o My doctor's office is a nutritional power free zone. :P

[blsdnsvd]

Vitamin D levels below 30 ng/mL (75 nmol/L) are associated with a fall in the absorption of calcium from the intestine.  Levels under 38ng/mL (87nmol/L) are associated with double the risk of respiratory infection.  The risk of breast, colon, and rectal cancer fall as vitamin D blood levels rise at least up to 40 ng/mL (100nmol/L).  The average person only begins to store vitamin D at 40 ng/mL (100 nmol/L) whereas at 50 ng/mL (125 nmol/L) virtually everyone begins to store it for future use.

I read this part and became alarmed. I have been Vit D deficient since I had a TT and that's been over 2yrs. I haven't been consistent with taking my Vit D supplements, so my levels vary on labs, the lowest being 16 and the highest at 20. I recently became persistent with taking all of my vit's due to the fact that I feel like crap from hypo symptoms. Thanks for the info.