If you are a woman over 50 struggling with pain, low mood, and weight that just will not shift, this real patient story shows how a hidden T3 conversion problem can tie all three together — and how the right blood work points the way out. Last time we went deeper into the “fat tissue”-pain connection. Today we want to walk you through a recent patient who had the same presentation, and how it showed up in her pathology.
When Jackie came to us, she was living with:
- Pain throbbing through the night that impacted her sleep
- Weight that just would not shift
- Medication that did not feel like it was working
- Arguments so intense that she and her husband were engaging divorce attorneys
I do not know many women who keep their cool when they have as much pain throbbing through their shoulders, hips, and knees as Jackie did when she came to us. She had just had her bloods done and felt like she was living out a bad soap opera. This just was not who she is as a person.
The only thing Jackie knew for sure was that she had hypothyroidism. She had her gall bladder removed five years ago, and she was getting occasional kidney stones. When she came to us, her biggest concerns were her pain, mood, and weight gain.
Jackie was at the beginning of divorce discussions, so we had to be super budget conscious and rely on standard blood work pathology.
What Jackie’s Bloods Actually Showed
What we found was enough to point us in the right direction:
- Thyroid TSH was at 114, even though she was on over 150mg a day of Thyroxine.
- Urate was 42 — this was causing a lot of her inflammation.
- Liver enzymes were elevated: 3 out of 4 of her liver markers were at the top of the reference range, with her GGT one point over the top of the range.
- Ferritin under 30 — she was not holding onto or absorbing iron, even though she ate meat and high-iron foods.
Jackie just did not know what to do. She had done what the doctor asked to help reduce the pain and deal with the kidney stones, but she felt so disheartened that she still had so much pain. The doctor just encouraged her to lose weight, saying that would help reduce her pain and the kidney stones.
The Missing Piece: T3 Conversion
As soon as we saw Jackie’s test results, we knew there was a big problem with her T3 conversion. You hear us talk a lot about the importance of active free T3 hormone. It is the metabolically active thyroid hormone — we call it the on/off switch. Jackie’s test results really showed us that.
T3 is a critical hormone in reducing inflammation. In the coming weeks, we will release new content on inflammaging and the stages of healing — T3 is critical to the last stage of healing. One of the reasons doctors care so much about hypothyroidism is that T4 and T3 are a big part of ensuring your cellular repair can happen.
What is interesting is that 80% of T3 is metabolically produced through the liver and the gut. You can see on Jackie’s test results that her liver enzymes were all elevated, and her ferritin had been below 30 for a number of years. This was an indication that her body was having a hard time holding iron reserves, pointing to gut dysfunction.
Jackie’s arthritis pain was really high. Urate, mostly used to look at gout, is a really good marker for that arthritis-type inflammation. Two-thirds of urate is eliminated through the kidneys, and one-third through the gut. Can you see why her active T3 conversion had an impact on her extremely high TSH?
One of the things about elevated liver enzymes is that they impact detoxification. This can drive feelings of anger, rage, and anxiety.
Where We Started
The very first thing we started on with Jackie was supporting her detoxification and metabolic pathways. This also really helped take the pressure off her adrenal glands, as she appeared to be converting her very high dose of thyroxine into Reverse T3, which was putting her under adrenal distress.
The diagram above shows the T4 to T3 (or Reverse T3) conversion pathway. Jackie needed supplementation support to help get her body working optimally, and she needed to change the timing of her meals.
42 Days Later
Within 42 days of following the food plan, Jackie looked and felt like a new woman. She had been living in anger, pain, and discomfort for years. She had compromised her sleep, her marriage, and felt hopeless. She could not believe that just a few small changes made such a big difference. She:
- Lost 10 kilos
- Had a reduction in pain from a 10/10 to a 5/10
- Started sleeping at night, no longer woken by pain
- Was calm and “felt normal again”
Her husband really embraced the process and learnt alongside Jackie that her changing hormones and metabolic dysfunction played a massive part.
One Year On
Fast forward one year, we caught up with Jackie and the emotions we felt are indescribable:
- She and her husband have decided to stay together.
- Her mood is stable and she feels so much better.
- She is sleeping through the night.
- She has lost a total of 20 kilos and is maintaining her weight happily.
She does still have some pain, though nowhere near as bad as it used to be. Her urate levels are coming down slowly, and her iron has only just come up slowly, which she is still working on along with her gut absorption. Low iron stores (low ferritin) can also increase pain in the body.
Her test results below compare August 2025 to July 2026 (nearly 12 months) and are really helpful for seeing the detoxification, metabolic, and symptom changes in her blood work.
Lipid (cholesterol) metabolism also happens mostly in the liver. Check out the changes in her cholesterol over the last nearly 12 months:
That active free T3 conversion being down has a greater impact than just thyroid. Yes, T3 — that metabolic switch — is down, but there is a lot more to it. For Jackie, she was having detoxification issues, methylation issues, gut absorption issues, arthritis pain, mental health issues, and extremely high TSH (hypothyroidism). Within one year, the majority of her markers that were just too high came back within normal ranges.
If Jackie’s story resonates, our related deep dive on weight loss resistance, pain, and what blood work misses is a great next read.
Want to Go Deeper?
Tiaan has just done a massive update on our webcast, “A Deeper Look at Thyroid: The Thyroid-Adrenal-Gut Connection.” It is a little more detailed and technical than our other webinars, but if you resonate with Jackie’s story or feel like you are missing a piece of the puzzle, this is a really good place to start.
We hope you are finding these patient stories helpful. If you would like more support, you can organise a free introductory consultation with us.
