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Can any thyroid experts out there help me out?

vamah

Senior Member
Messages
593
Location
Washington , DC area
Okay, so I finally got my reverse t3 tested. My doctor says everything is normal, but when I calculate the ratios using a guide I found online it looks low to me. Also, my tsh was slightly over 2 for the first time ever and I had heard that that was not good. Also, in went up a great deal in the past 2 months. I'm thinking the cold weather may be the cause. Is that possible? Lab results below. Thanks for any insight you can give.

Tests done 11/2013:
Tsh 1.456
Total t3 92.4 ng/dl
Free t3 2.7 pg/ml

Tests done 1/2014
Tsh 2.052
Reverse t3 15.8 ng/dl
 

vamah

Senior Member
Messages
593
Location
Washington , DC area
Oh, and using the calculator I found, my ratio is 17. It says a normal ratio is 20 or higher. But ugh, I just read that the tests should be from the same blood sample and mine are not. Oh well. This is what I've got.
 
Last edited:

xks201

Senior Member
Messages
740
People are generally concerned about high rev t3 not low rev t3 ....
Low Rev t3 is not a problem. If your TSH is 1 or 2 that most likely means you are could potentially still be undertreated.
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
Okay, so I finally got my reverse t3 tested. My doctor says everything is normal, but when I calculate the ratios using a guide I found online it looks low to me. Also, my tsh was slightly over 2 for the first time ever and I had heard that that was not good. Also, in went up a great deal in the past 2 months. I'm thinking the cold weather may be the cause. Is that possible? Lab results below. Thanks for any insight you can give.

Tests done 11/2013:
Tsh 1.456
Total t3 92.4 ng/dl
Free t3 2.7 pg/ml

Tests done 1/2014
Tsh 2.052
Reverse t3 15.8 ng/dl
If you could include the ranges, that would be very helpful. For now, I'll just assume that they are standard US ones...

I don't put much stock in RT3 despite all that you read on the internet. It can be high as a sign of chronic illness, yes, but the research has conclusively shown that cell receptors are NOT blocked by RT3. In the presence of both T3 and RT3, the cells preferentially take up T3 every single time. This is how people with Graves disease (high FT3 and high RT3 can become hyperthyroid. If the RT3 was blocking the receptors, they would never become hyper.)

RT3 also changes rapidly so it is hard to measure. And elite athletes also often have high RT3 levels...yet are perfectly euthyroid. So, I don't think you have an RT3 problem.

I think most people treated by TSH alone and not by symptoms are under treated and thus still have hypo symptoms that would be relieved by the addition of some T3. And there are certainly people out there with thyroid resistance that would benefit from T3 alone. But not because of RT3...Most people with hypothyroidism will do best on *some* combination of T4/T3 meds (whether or not that is the *standard* in NTH is another matter entirely).

But I digress.

Yes, people generally need to increase their thyroid meds in the winter. So an increase in your TSH doesn't seem that odd to me considering you are not on meds. Your body is asking for more thyroid...

I also think your FT3 at 2.7 is likely too low despite your "normal" TSH. At that point, it really matters if you have hypothyroid symptoms. If you do, I would ask your doctor to treat them. If not, I would let it be. A FT4 would be super helpful though at some point...
 

vamah

Senior Member
Messages
593
Location
Washington , DC area
Thanks. I do have hypothyroid symptoms, which is why I have been pushing my doctor to consider the possibility even though all my tests are in the normalish range. I will discuss this with him next time I see him.
 

Helen

Senior Member
Messages
2,243
Hi @vamah,

I am not an expert of hypothyroidism, very few doctors seem to be either ;) as so many people are suffering from suboptimal treatment - or no treatment at all though obvious signs and symptoms. But diagnosed with hypothyroidism myself I have studied this disease quite a lot.

Your high TSH indicates that you don´t have the best treatment. When on thyroid hormone the TSH usually is around zero. Until you are, I wouldn´t bother about the reverse T3. I do recommend this site (and the book with the same name) , and as an example the information about reverse T3.
http://www.stopthethyroidmadness.com/reverse-t3/

The reverse T3 has been used to evaluate if there is unprocessed T4 floating around, but it isn´t a valid lab tests according to many endocrinologists. I think you´ll have a chance to get much better if you try other treatment protocols then what you follow today. And antibody lab tests should be done too. If high, there are options for this too that is important to consider.

Your signs and symptoms and probably your morning body temperature are the best indications of good or suboptimal treatment (but most doctors trust lab data...). You will read about all this on the site above, or in the book.
 
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Leopardtail

Senior Member
Messages
1,151
Location
England
The aim with ME is never to replace the function of a gland without good cause, rather to give it some help so it may recover. Hence you want your TSH above zero.
What matters is the total picture of TSH + T4 + T3.
Realise too that very low ATP production can prevent T3 working hence Mito supplements might be needed for your T3 to have fully effect.
 

Leopardtail

Senior Member
Messages
1,151
Location
England
Update: tried low dose of synthroid for a couple weeks, but it made me constantly nauseous and worsened my sleep problems so I stopped.
Vamah,

you can get low thyroid symptoms for two reasons:
  1. you aren't producing enough hormone
  2. your cells don't make enough ATP to respond ot it...
What are you doing in terms of Mito supplements? E.g.
  • Ribose
  • CQ10
  • ALCAR
  • NADH
Re the tests. Did you have T4 done? Do you know the lab normal ranges? These norms vary slightly from lab to lab and most (here) print those normal ranges on reports.