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What is the difference between T3/T4 ?

My lab work results are finally ready I will receive a copy in the mail shortly. But I was told over the phone that I have Hashimoto as well as high T4 low T3. Very low B-12, etc.  I know that’s rather sketchy information ( and I will fill in all the blanks when I actually have the results in my hand ) my question is more general. Dr. wants to lower my levothyroxine meds. from 75 MCG’s to 50mcg.  Additionally she wants to put me on Liothyronine 5mcg.   Any knowledge or opinions on this initial information?
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1530171 tn?1448129593
Hey judithmhol.

Yes, I'm familiar with all this.
Your doctor is one of the few who looks at T3 levels and put you on  Liothyronine, which is T3 and does not need conversion.
However, like most conventional doctors, does nothing to address the underlying  cause (in your case the conversion of T4 to T3 problem).

A fast 101 on T4 to T3 conversion.

Necessary for the conversion are:

---The enzyme deiodinase, the minerals zinc, selenium and the anti-oxidant glutathione are essential . Any deficiencies in these might impair T4 to T3 conversion and consequently thyroid function.

Furthermore, Magnesium,  NADPH, Thiamine, B6 in P5P form, B12 as Methylocobalamin, vitamin C, vitamin E  , cysteine, glutamine and glycine,
play a synergistic/supportive role to varying degrees.
Again any deficiencies in some of the above will impact T4-t3 conversion.

---Digestive and/or G/I issues will affect the absorption of many  of the above nutrients and vitamins.

---Liver function must be optimized, as some of the conversion and some  thyroid associated enzymes take place in the liver.
Again, beware of conventional doctors may test you and find  no issues with the liver.
The blood test results simply may only indicate absence of serious liver disease and not  diminished capacity  to convert T4 to T3 and/or thyroid--associated enzymes.

---Finally, should you have  high stress levels or other  factors affecting your cortisol and adrenals in general, this would contribute to thyroid conversion problems and
reduced thyroid function.
Free T3, Free T4 and Reverse T3 (RT3) tests will  accurately indicate thyroid function and  the RT3 will indicate possible adrenal issues.

If you need more details or have any questions, please post again.

I hope this helps, however, please note that my comments are not intended as a replacement for medical advice.

Best wishes,

I read your response a couple of times. I have very slowly entered into this world of Endocrinology. Oblivious of the all encompassing  and for me overwhelming amount of information. I am now finding that this disease is not something that anyone can solve. It requires constant perseverance and patience and tweaking so to speak..
I find myself feeling betrayed because I  thought that this was what my doctors were supposed to do be interested in doing. As of yet I have not found that doctor.  I’ve never had to beg and plead with a doctor to do the right thing. I understand the constraints of insurance and I understand the unrealistic expectations  that medical Practices  place on their physicians.   All that being said I simply cannot force my doctor to care.   Or recognize that her attitude is one of not  really caring about learning what I don’t know.  
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