Reduced T4 to T3 Conversion

We are back for another Thyroid Thursday and today, I'm discussing reduced T4 to T3 conversion. The first question is, does it matter whether you convert T4 to T3? T4 needs to convert to T3 inside the cells and tissues bind to receptors and support your metabolism. T3 in circulation can also get inside the cell, bind to receptors and support physiology, but the T4 that's converted to T3 - that T3 stays in the cells and tissues longer than the T3 that's just coming from the bloodstream. A lot of cells prefer to have a balance of the T3 coming from the bloodstream and the T3 that they bring in because then they can self-regulate their metabolism.
So does it matter? It absolutely matters when somebody says I don't feel well on my thyroid medication and you start looking at T3 and free tT3, you're going to find that these levels are lower than we would consider healthier or optimal.
I've had clients say they have been told that they can't convert T4 to T3. Even if you have a genetic polymorphism, you're typically only down-regulated about 20 percent. So if your T3 is around 70 or 80, that's probably not just a genetic issue. Can you take T3 to raise your T3 levels? Sure. It'll raise the blood T3 levels but it may or may not influence all the tissues evenly. And so it may not necessarily increase your metabolism or restore all your symptoms. You may get a short term bump when you first take it, but if there's a cell stress inflammatory mechanism going on, T4 is getting deactivated to reverse T3 and that T3 is going to get deactivated and metabolized as well. So it'll last short term.
Check out the full explanation in this video and let me know what questions you have. Hope this helps!
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[@absolutelypitiful3837]

Eric have you ever seen cases of people developing symptoms like paranoia and hallucinations due to poorly treated hypothyroidism, as in symptoms that are very similar to schizophrenia?
There are quite a few case studies about this condition that is called myxedema madness (or myxedema psychosis) but sadly there is very little information about it.
Based on your detailed studies of thyroid physiology, do you see this as something that could indeed happen in some rare cases, perhaps with individuals who for instance have poorer sensitivity of thyroid receptors in the brain, or another similar process?

[@askdrbalcavage]

Yes, I have.