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Other potential factors impacting T4 to T3 conversion include: Aging Alcohol [7] Chemotherapy [8] Cigarettes [9] Deiodinase gene variation Diabetes [10] Fasting and calorie restriction [11] Growth hormone deficiency [12] Heavy metals [13] Iodine excess [14] Kidney and liver disease [15] Low progesterone [16] Medications Obesity [17] Pesticides [18] Radiation [19] Soy [20] Surgery [21] Furthermore, in recent years, pharmacogenomics (the study of how a persons genes impact their response to medications) has helped us determine which patients may best benefit from particular medications due to their unique genes