Thyroid Results Help Please

[paul80]

Could anyone give me any advice about these results please?

 

[WillowJ]

Your Reverse T3 is slightly higher than lab range: lab says normal is 9-35 (ng/dl), while your reading is 36. Some doctors will ignore a change barely outside of range (maybe unless it persists or worsens), while others will treat slightly inside range if there are related symptoms.

Your Vitamin D (25-hydroxycholecalciferol; Calcidiol) is in the "borderline ranging to insufficiency" range.

Everything else is within the lab normals, as far as I can see.

 

[paul80]

Thanks.
From your link:
"So many people seemingly have normal thyroid levels, but if they have high Reverse T3, they're actually suffering from hypothyroidism."

So this means i have an underactive thyroid?
Do you think i should try some medication for this?

 

[Ema]

Do you have any symptoms of hypothyroidism? Low basal temp, weight gain, dry skin, etc?

 

[paul80]

Yes i looked up the symptoms and i have all of them, although a lot of them are the same symptoms of m.e.

Is the treatment for it harmful if you don't have hypothyroidism or is it worth trying to see if if helps the symptoms?

 

[Ema]

Yes i looked up the symptoms and i have all of them, although a lot of them are the same symptoms of m.e.

Is the treatment for it harmful if you don't have hypothyroidism or is it worth trying to see if if helps the symptoms?

Agree, hypothyroid symptoms are often nonspecific and overlapping.

Your thyroid frees are pretty good. Your FT4 is pretty close to optimal. Your FT3 is a little low but not dreadful.

The high RT3 may suggest cellular hypothyroidism though this point is terribly controversial. The scientific literature has shown fairly conclusively that the thyroid receptors will bind to T3 preferentially even in the presence of RT3. So, in my opinion, as long as there are adequate levels of FT3, one would likely not benefit much from thyroid replacement.

Further, the the treatment for high RT3 is typically using T3 meds only rather than a combination of T4 and T3. Too high T3 levels can have very serious side effects (ie heart attack) and I would not proceed down that path without a plan to have regular (ie every few weeks or more) labs at the very least.

 

[paul80]

Ok thanks for the advice.

 

[WillowJ]

yes, what @Ema said. I posted that link as much for the message that the test was controversial, than for the message about how to use the result. I have not looked into thyroid as much as she has, however.

I was mostly responding to what you said on the other thread:

I think the antibody one is no but i'll wait and see if anyone can look at them

 

[paul80]

So should my answers for B and C be

(B) Have you had positive thyroid autoantibodies - Yes
(C) Have you had abnormal thyroid function tests - Yes

?

Sorry, my knowledge on this is poor and i want to make sure i give the right answer.

 

[Helen]

Hi @paul80 ,

No, your labtests according to antibodies have been normal, so the answer should be NO. The thyroid function tests that Prof. Edwards is asking for does not include rT3, so a NO is an appropriate answer to the third question.

The rT3 test is debated among endocrinologists as it is said to be very changeable from moment to moment. Therefore it is of limited value if not the symptoms point to a build-up of T4.

I agree with @Ema that the signs and symptoms are very important, as sometimes labtests fail to show thyroid problems.
I wouldn´t say that ME/CFS and hypothyroidism present with the same symptoms. A check of basal temperature and your morning puls is a good start. This site www.stopthethyroidmadness.com has a lot of good information.

 

[wastwater]

Hypothyroidism usually shows as high:thyroid stimulating hormone and low:total t4.
Youre results are within normal ranges.

 

[paul80]

Ok i updated my post on the other thread. Cheers.

 

[drob31]

Your bloodwork doesn't go far enough to explain hypothyroid symptoms.

I'm going through the same situation, but t3 is dependant upon cortisol levels as well. Have you had a cortisol saliva test done? A high reverse t3 could suggest high cortisol. you may have 1.8 nmol/L t3, but how much of that actually gets into the cells? Perhaps your t3 was lower if your cortisol was lower. (assuming that's the problem).

Based on your numbers, I would investigate your adrenal glands.

 

[paul80]

Ok drob31, thanks. I wanted to ask you all something else about my results. On this web page i found it says:

"With the RT3 labwork, you are not necessarily looking for a Reverse T3 result high in the range, though that in itself can be a good clue. Instead, you are looking for a problem in the ratio between the RT3 and the Free T3. i.e dividing the Free T3 by the Reverse T3 (Free T3 ÷ RT3)…though they need to be in the same measurement. See the I hate math heading below). For healthy amounts of RT3, The ratio result should be 20 or larger. If lower, you may have a problem. Janie has noted that many patients without an excess RT3 issue have a result of 23 or 24."

So i used this calculator to convert my RT3 from ng/dl (36) to nmol/l(0.55).

Then i used this calculator to get the ratio from my free T3 (4.5 pmol/L) to my RT3 (0.55 nmol/L)
So this means my free T3 is about 8 times higher than my RT3 unless one of the calculators is wrong.

On that website it claimed that it should be at least 20 times higher or the T3 will not be getting into your cells.

I was just wondering if anyone can confirm if this is correct?

 

[drob31]

The ratio used there is very controversial. I've read that as well, and my ratio is 14. However, there are allot of factors and variables, and you can't really base everything on the ratio.

If your body is taking much of the t4 and converting it in to rt3, instead of t3, it is doing so to down regulate. If the adrenal glands aren't recieving the proper signals to produce enough cortisol or at the proper times this can cause the elevated rt3, as can high cortisol.

The problem is rt3 is allot more complicated. Your body could be down regulating metabolism because it thinks you're starving. So if you're dieting this can happen or if you have issues with leptin, this can happen as well. Of course this could be fixed by dieting, such as low carb.


I think your first step is to do a cortisol saliva test to see where you are at with that. The adrenals seem to be the most complicated part of the puzzle to solve.

 

[paul80]

Yes I'll definitely do the cortisol test. thanks for the advice.

 

[Rand56]

Hi @paul80

I agree with @Ema that the signs and symptoms are very important, as sometimes labtests fail to show thyroid problems.
[/quote]

hi Helen

I can attest to this. My blood test showed normal in all thyroid parameters and yet I am convinced that I am hypo.

Atleast according to Ray Peat, a couple signs of hypo would be low CO2 levels and high estrogen levels. I have both of those. Also body temps and and pulse bpm's may not always be that predictive. According to him, norepinephrine can be raised which will help in keeping temps and bpm's up to compensate. Haven't taken my temp recently, but anytime I have, they have been normal and sometimes slightly low, but never low enough to alert me to being hypo. As far as my resting pulse bpm's, they have been consistently around 85 bpm's. And according to Peat, a more predictive measure would be the Achilles heel reflex test, where if your leg on return comes back slowly like a nuismatic door closing. When doing this to myself, mine does the same.

Rand