I had a follow up nutrition appointment with Dr. Fiona on Thursday, October 13, 2016. We discussed that I’m still feeling somewhat fatigued. She took a look at my labs and saw that while my T3 free had improved, it’s still low. Then, she noticed that my Reverse T3 was high.
Here’s what she explained to me. Synthriod is generally the first medication prescribed when someone is diagnosed with Hashimoto’s. It contains a synthetic version of T4. Our bodies convert T4 into T3. T3 is the more metabolically active thyroid hormone. However, some people don’t convert T4 into T3 very well. Therefore, all the T4 in the world isn’t going to benefit them as much as it would someone who makes the conversion easily. The fact that my Reverse T3 is high suggests that I am one of those people that don’t convert T4 into T3 very well. Since I am seeing some benefit from taking Synthroid, Dr. Fiona said that we could increase the dosage and see if that helps.
Another alternative would be to change my medication to one that contains a combination of T3 and T4. As I was researching these medications, I came across an interesting fact: when we are stressed, our bodies tend to convert T4 to Reverse T3 rather than T3. With all the stress in my life, it’s no wonder my Reverse T3 is high! For more information on thyroid medications, see this article I reposted from Dr. Izabella Wentz, The Thyroid Pharmacist. Anyway, these combination medications are made from desiccated thyroid extracted from animals. It’s felt that these natural compounds work better in our bodies than the synthetic ones. Also, the addition of T3 in the medication would keep my body from having to convert T4 in order to work better.
After some discussion, I decided to try the T3/T4 combo. It will be interesting to see if my energy levels improve!
After the thyroid discussion, Dr. Fiona took a look at my food diary. Overall, she was happy with how I’m eating and pleased with how I’m doing. She had been concerned that I might gain a lot of weight when I switched to the insulin diet. She has found that women like me, who have lost weight on low calorie, meal replacement diets have VERY slow metabolism (and my thyroid issues serve to compound this problem). Therefore, they tend to gain weight when they switch back to eating food. In my case, I gained about 3 pounds initially, but have been stable since then. Dr. Fiona and I discussed a few tweaks that she wants me to make to my diet, but the changes are small and will be easy to do.
Overall, it was a good visit! I really like Dr. Fiona, and I’m so thankful she’s part of the PCOS Project!