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Old 12-29-2011, 10:25 AM   #1
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What do you think? High RT3? Labs inside...

Hello all

for the past 6 years now, I have been extremely tired. It's very hard for me exercise, even though I miss it so much. I never get a refreshing sleep, my hands feet are cold 80% of the day, I have dark bags under my eyes and I always crave some type of carb. I started feeling this way when I was working out a lot and extrememly healthy. I can't figure out what is wrong, at all. I have a great new doctor and the labs below are from 8 weeks ago. My recent labs I will get in 5 days and I will post them, then. I'm also having another ZRT saliva cortisol test done this weekend. I'll post those results, as well. I've been through every test under the sun and don't feel any better and everything comes back fine.

I have taken my basal temp in the mornings (still in bed, left there for 10 minutes, glass-non-mercury thermo) and it's usually between 96.4 and 97.2. However, 3 hours after that it's between 98.3 and 98.5 for the rest of the day (3 times, every 3 hours).

Labs : I will post when I can, now, since I'm at work. I had a lot of lab work ran, so please ask if you would like to see something.

2006DHEAs 3.8 (Range 3.8-10)
Cort Morn 3.8 (Range 3.7-9.5)
Cort Noon 0.9 (Range 1.2-3.0)
Cort Even 0.1 (Range 0.6-1.9)
Cort Bed 0.1 (Range 0.4-1.0)

2011Estradiol 0.9 (Range 0.5-2.2)
Progesterone 25 (Range 12-100)
Testosterone 105 (Range 44-148)
DHEAs 6.9 (Range 2-23) Age Dependent
Cort Morn 5.7 (Range 3.7-9.5)
Cort Noon 2.6 (Range 1.2-3.0)
Cort Even 0.9 (Range 0.6-1.9)
Cort Bed 0.8 (Range 0.4-1.0)

Ferritin was 130 (20-345)
morning cortisol was 19
Vitamin D was low 21 (30-100) (been taking 10,000iu of D3 for 2 months, now)
Reverse T3 was HIGH - 35 (11-32)
TSH - 0.95 (0.40-4.50)
Free T3 - 3.4 (2.3-4.2)
Free T4 - 1.3 (0.8-1.8)

I'm currently taking a multi, EFA-Omega 3's, Mag-chelated, D3, and 50 billion probiotic

Thanks!
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Last edited by AlwaysTired247; 12-29-2011 at 11:14 AM.

 
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Old 12-29-2011, 11:07 AM   #2
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Re: What do you think? Labs inside...

Forgot these ones...

THY PER AB - <10 (Less than 35)
THY GLOB AB - <20 (Less than 20)
Iron was 118 (45-175)
TIBC was 312 (250-425)

I should also note that my doctor prescribed me Armour to try and see if we could get the Reverse T3 down, but I'm hesitant on taking it based on these labs... i thought it was my vitamin D for the longest time, but I still don't feel well after over two months on 10,000iu (yes I take it with a meal and cal/mag). I'll have to see what my labs are when I get them back for this.
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Last edited by AlwaysTired247; 12-29-2011 at 11:12 AM.

 
Old 12-29-2011, 12:03 PM   #3
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Re: What do you think? Labs inside...

Sorry... I keep forgetting things (see... Brain fog!)

I always wake in the middle of the night, for no reason. I usually fall back asleep within minutes, but every single night, it never fails. (yes, I've been tested for sleep apnea and it was negative). I do tend to have anxiety and depression, but I've been on over 5 different types of SSRI's, and nothing helped.
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Old 12-29-2011, 01:25 PM   #4
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Re: What do you think? Labs inside...

Welcome!

Sorry for the reason you're here but, glad you found us.

First off, I only know thyroid stuff so, will defer to others in regards to your "non-thyroid" bloodwork.

I can tell that you had adrenal testing done - mkgbrook on here is very well-versed on adrenal issues. She's not always on here but, searching old threads of hers might prove helpful.

OK...one more comment before I comment on your thyroid labs

Please know that thyroid textbooks confirm that each of us has his/her own "setpoints". These are optimal thyroid hormone levels that meet the individual's specific needs.

Also, those same textbooks indicate that most healthy people have FreeT4 levels towards the higher end of the range....and FreeT3 levels above mid-range.

Unfortunately, based upon my experience and that of countless other thyroid forum members, it seems that most of the doctors we've seen were sleeping during thyroid class.

*But* there are doctors out there that "get thyroid" and it seems you might have found one.

OK..onto your thyroid labs:

I'll cover the easier ones first.

THY PER AB - <10 (Less than 35)
THY GLOB AB - <20 (Less than 20)

These are antibody tests for the antibodies most commonly seen in Hashimoto's thyroiditis, an autoimmune disorder that is the most common cause of hypothyroidism (the others being either medicine-induced or a rare pituitary disorder).

Just because you are currently testing negative for Hashi's doesn't mean you don't have it. Many people test negative for the antibodies. The only definitive test for Hashi's is biopsy. Since hypothyroidism is treated the same, regardless of cause, there's no need for biopsy. Hashi's might be evident if you have any nodules that get FNA'd....or a thyroid ultrasound reveals the cellular changes seen in Hashi's.

Now the thyroid function tests....

Reverse T3 was HIGH - 35 (11-32)
TSH - 0.95 (0.40-4.50)
Free T3 - 3.4 (2.3-4.2)
Free T4 - 1.3 (0.8-1.8)

You are a perfect example of the people endo Dr. Ken Blanchard writes about in his book "What Your Doctor May Not Tell You About Hypothyroidism".....suffering with raging hypothyroidism while having "normal" (aka in-range) labs.

However, if you think about the thyroid textbook concepts I shared with you, two things should be clear to you: 1. your levels aren't at YOUR setpoints because you are having obvious hypothyroidism symptoms and, 2. your FreeT4 level is smack at mid-range when most healthy people would have a FreeT4 level much higher and your FreeT3 level is just above mid-range (but is obviously too low for you)

Your rT3 is high because your FreeT3 level is low....this should correct itself with proper treatment.

Now, Armour is made from porcine thyroid that has a larger proportion of T3 compared to T4 than human thyroid. This can result in proportionately higher FreeT3 levels compared to FreeT4 levels. Most people are fine with this.

Those that aren't will still have hypo symptoms after their FreeT3 level has been optimized (towards the high end of the range). In cases such as these, the doctor can add some T4 in the form of Synthroid/levothyroxine to balance things out.

And, to help you understand your symptoms and know what to expect as you adjust to Armour and future dose increases, you might want to read this thread:

http://www.healthboards.com/boards/showthread.php?t=876498

(waking during the night as you describe it is called "interrupted sleep" ....yep, pretty annoying - been there, done that)

Please know that it's entire possible to feel well while dealing with hypothyroidism. I have been symptom-free ever since I stabilized at my optimal levels. It's awesome.

We'll be looking for an update from you with your next set of labs.
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Last edited by sammy64; 12-29-2011 at 01:28 PM.

 
Old 12-29-2011, 02:20 PM   #5
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Re: What do you think? Labs inside...

Sammy,

Thank you SOOOOO MUCH For that awesome reply and info!

I will report back on Monday as to what my doctor said, recommends, what approach we're taking (most likely starting Armour) and what my lab results were.

Do you think I should ask for the Armour, or just T3?

Have a happy new year!
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Last edited by AlwaysTired247; 12-29-2011 at 02:22 PM.

 
Old 12-30-2011, 06:59 AM   #6
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Re: What do you think? Labs inside...

Quote:
Originally Posted by AlwaysTired247 View Post
Do you think I should ask for the Armour, or just T3?
Most people don't take T3 by itself.

You see, T3 is our active hormone. We do need a "base" of storage hormone, T4, to function properly.

Certain body systems (such as the brain and our muscles) need "fresh" T4 to convert to T3.

Since your FreeT4 level is actually proportionately lower in the range than your FreeT3 level, Synthroid/levothyroxine (T4) could very well be all you need.

However, many people fare very well with Armour so, if your doctor is willing to Rx it for you, I'd say take it.

Happy to help.....Happy New Year!
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Old 01-02-2012, 07:19 PM   #7
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Re: What do you think? Labs inside...

Happy New Year to all!

Well, got my vitamin D up, but still feel the same. It's at 68.5 now.

Here are the rest of my recent labs

TSH 1.350 (0.450-4.500)
Free T4 1.39 (0.82-1.77)
Free T3 3.8 (2.0-4.4)
DHEA-S 344.1 (160.0- 449.0)
Reverse T3 371 (90-350)

My doctor still wants me to try the Armour, which I have (started taking today) based off my symptoms at this point (Still having cold hands/feet, 96.0-97.2 morning temps, and exhausted no matter what)

I'm not sure what else to do, at this point. She wants me to take 1/4 grain (15mgs... I believe) for 4 weeks-6 weeks, then retest and see how I feel and where my levels are.

Any ideas?
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Old 01-03-2012, 01:40 PM   #8
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Re: What do you think? Labs inside...

15mg Armour is a very small dose....you might feel something and you might not.

But, with your labs, it's hard to find a doctor willing to help so, at least you have a start.

It would be a good idea for you to keep track of your symptoms so you can give a comprehensive report to your doctor.

Please realize that it's not uncommon for symptoms to worsen after starting meds...it's all part of the body's adjustment process to new amounts of thyroid hormone.

The best we can do is get labs every 6 wks. and continue to ask for dose adjustments until levels have been optimized.

Best of luck to you moving forward.
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Old 01-03-2012, 01:47 PM   #9
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Re: What do you think? Labs inside...

Right, I got yah!

Well, depending on weather or not these labs come back in 6 weeks (my Reverse T3 levels) I'm going to suggest going to T3 only, if they don't.
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Old 01-03-2012, 01:52 PM   #10
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Re: What do you think? Labs inside...

T3 isn't a good idea for you at all.

If anything, I could see you taking T4 instead.

You see, T4 is our storage hormone and our bodies convert it to T3, our active hormone.

Your FreeT4 level is a measurement of all the T4 that is available for your body's needs....same concept for the FreeT3 level/T3 needs.

Your FreeT4 level is actually proportionately lower in the range than your FreeT3 level.

Right now, your FreeT4 level is at 60% of range and your FreeT3 level is at 75% of range.

Most people need both their FreeT4 and FreeT3 levels at least 60-80% of range.

For whatever it's worth, I need my FreeT4 level at least 95% of range and my FreeT3 level at least 75% of range to be symptom-free.

So, if anything, this means you could benefit from a T4 med (such as Synthroid/Levoxyl or their generics - levothyroxine).

Some of that T4 would get converted to T3 so, by taking a T4 med, you should see improvement in both your FreeT4 and FreeT3 levels.

Taking a T3 only med will increase your FreeT3 level and, due to a biochemical response, might actually lower your FreeT4 level.
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Last edited by sammy64; 01-03-2012 at 01:56 PM.

 
Old 01-03-2012, 05:21 PM   #11
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Re: What do you think? Labs inside...

My friend and I have both been hypo and on meds for 20 years. She recently started taking a time released T3 and said she has had significant improvement with her energy level. I personally haven't taken that, but she's been very pleased with how much better she feels. Not sure if you would need that, but it's something to consider just in case. Best of luck to you!

 
Old 01-04-2012, 08:36 AM   #12
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Re: What do you think? Labs inside...

Quote:
Originally Posted by sammy64 View Post
T3 isn't a good idea for you at all.

If anything, I could see you taking T4 instead.

You see, T4 is our storage hormone and our bodies convert it to T3, our active hormone.

Your FreeT4 level is a measurement of all the T4 that is available for your body's needs....same concept for the FreeT3 level/T3 needs.

Your FreeT4 level is actually proportionately lower in the range than your FreeT3 level.

Right now, your FreeT4 level is at 60% of range and your FreeT3 level is at 75% of range.

Most people need both their FreeT4 and FreeT3 levels at least 60-80% of range.

For whatever it's worth, I need my FreeT4 level at least 95% of range and my FreeT3 level at least 75% of range to be symptom-free.

So, if anything, this means you could benefit from a T4 med (such as Synthroid/Levoxyl or their generics - levothyroxine).

Some of that T4 would get converted to T3 so, by taking a T4 med, you should see improvement in both your FreeT4 and FreeT3 levels.

Taking a T3 only med will increase your FreeT3 level and, due to a biochemical response, might actually lower your FreeT4 level.

Hmmmm... i get what you're saying, but what I'm concerned about is the high RT3. this is the second lab now in 2 months that has shown it being too high. From everything I have been reading and a few people I've talked to online, including one doctor, they believe that taking T3 will remove the T4 from my system, thus removing the high reverse T3 from my blood. They said this can be done in a matter of months, then lowering T3 until completely off, allowing T4 to rebuild naturally in the body. Not saying what you're saying is wrong, by any means... I'm just so confused with this. RT3 is the only thing showing issues in my blood work.
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Old 01-04-2012, 08:38 AM   #13
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Re: What do you think? Labs inside...

Quote:
Originally Posted by Kab164 View Post
My friend and I have both been hypo and on meds for 20 years. She recently started taking a time released T3 and said she has had significant improvement with her energy level. I personally haven't taken that, but she's been very pleased with how much better she feels. Not sure if you would need that, but it's something to consider just in case. Best of luck to you!
Kab164:

Thank you for your reply!

I'm going to stay on Armour for now, at least until my next lab work (5 weeks). From there, I will see what my levels are and work with my doctor on possibly going T3 only.
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Old 01-04-2012, 09:07 AM   #14
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Re: What do you think? Labs inside...

post deleted due to being incomplete....and need to run out for an appointment.....I'll be back
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Last edited by sammy64; 01-04-2012 at 09:10 AM.

 
Old 01-04-2012, 09:38 AM   #15
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Re: What do you think? Labs inside...

Quote:
Originally Posted by sammy64 View Post
post deleted due to being incomplete....and need to run out for an appointment.....I'll be back
LOL! No worries!
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