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Old 09-03-2008, 03:27 PM   #1
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Smile Reverse T3---Need advise on new Thyroid Lab report

Hi to all, this is my first post and i could sure use some opinions.

I am posting my report below:

T3Free- 2.56 (2.00-3.90)
T4Free- 0.69 (0.58-1.64)
REVERSE T3- 232 (90-350)
TSH-0.21 L (0.34-4.00)

Thyroglobulinautoabs <20----<40
Thyroid Peroxidase autoabs 28.0------<35

I am feeling very hypo and I have been on 90MG Armour T. for over 1 Yr.
Thanks for any help - Im just trying to find out why i feel so hypo. My endo appt is in two months.

 
Old 09-04-2008, 04:50 AM   #2
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Cool Re: Reverse T3---Need advise on new Thyroid Lab report

Hi 40mills WELCOME!

The number that jumps out at me is your T4. You're barely IN range (personally that make me !) Most people need their T3 & T4's nearing or above the 1/2 way mark in the range to feel optimized. (T4=1.14 / t3=2.95)

So in my non medical opinion, you still feel hypo because your levels low, indicating that you need more med

 
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Old 09-04-2008, 05:57 AM   #3
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Re: Reverse T3---Need advise on new Thyroid Lab report

Welcome to our dysfunctional thyroid family 40mills. Here is my 2 cents worth on your results.

T3Free- 2.56 (2.00-3.90) You are at 29% of normal here. Optimal is in the 50-80% range of normal for women of child bearing age. After Menopause this level drops a bit (45-70/75.. depends on source at the moment).
T4Free- 0.69 (0.58-1.64) This is 10.4% of normal. Once again you are low normal range and not in the 50-80% optimal range. You also ant your FT3 and Ft4 levels to be balanced. You can determine that your levels are balanced by making sure that your fts fall with in 10% of each other. Your FT4 is lower than your FT3 by 19%.. this indicates that you may have too much T3 in the Armour (T4/T3 ratio). I am not saying stop the Armour.. not at all.. I will get into my recommendation a bit further down.

REVERSE T3- 232 (90-350) This shows that you are not converting your T4 to RT3 improperly. Thus you should need minimal T3 supplementation. I am not saying ditch the Armour, but since your T3 levels are 19% higher than your T4 levels you may want to consider asking to mix and match your thyroid meds. My Aunt has found the best results with a combination of Armour and Synthroid (1 grain of Armour with 75 mcgs of Synthroid). She needs some T3, just not as much as pure Armour ratio gives her. She couldn't do straight Armour.. that drove her hyperT in T3... straight T4 left her hyperT in T4 and hypoT in T3.. so she ended up mixing and matching.

I do think you need more supplementation. You might want to see if you can get just a T4 supplement to add to the Armour and see how well your levels balance out after that. Getting the proper medication levels is a chore and a half.. then when you get it right, your body chemistry shifts and it is time for another change.

TSH-0.21 L (0.34-4.00) Since you are on Armour this is suppressed and not a valid indicator of thyroid function.

Thyroglobulinautoabs <20----<40 and Thyroid Peroxidase autoabs 28.0------<35 These are not 100% positive for Hashimoto's, but the TPOAb are awefully close. You may be catching your Hashimoto's antibodies early. A biopsy of your thyroid would be the 100% identifier of Hashi's.. but unless you have need for such I would just roll with treating the hypothyroidism.

So I think you should get an appointment with your MD now or call the Endo and ask if you can add 25 mcgs of T4 given your last set of labs. Explain about your symptoms and desire to be in optimal range. Good luck!

MG
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Old 09-06-2008, 11:41 AM   #4
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Re: Reverse T3---Need advise on new Thyroid Lab report

Quote:
Originally Posted by Suey77 View Post
Hi 40mills WELCOME!

The number that jumps out at me is your T4. You're barely IN range (personally that make me !) Most people need their T3 & T4's nearing or above the 1/2 way mark in the range to feel optimized. (T4=1.14 / t3=2.95)

So in my non medical opinion, you still feel hypo because your levels low, indicating that you need more med

 
Old 09-06-2008, 11:52 AM   #5
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Re: Reverse T3---Need advise on new Thyroid Lab report

My tsh has been much lower than this. Usually about 0001. This always freaks my drs out. I know Armour gives the low tsh, but i guess these drs. just dont get it. Probably worried about getting sued. I passed a stress test and echo so my heart looks ok-
When I was first diagnosed I was put on synthroid and levoxyl and they make me feel much worse.
So lets see--I could stay with 90 Armour and add another brand of t4. But since i did so poorly on syntroid and levoxyl, what other options are there and what dose?

Thanks for your warm welcome,

Last edited by 40mills; 09-06-2008 at 11:53 AM.

 
Old 09-06-2008, 07:30 PM   #6
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Re: Reverse T3---Need advise on new Thyroid Lab report

You could try a generic T4 supplement. The inert ingrediants would be different. Also the FDA has now stipulated tighter requirements on production and active ingrediants. This may make a generic a better fit for you. All in all it is trial and error.

MG
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Old 09-08-2008, 10:19 AM   #7
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Re: Reverse T3---Need advise on new Thyroid Lab report

Thanks very much MG for taking the time to write that long valuable post. I will definitely refer to it a lot.
Also, I am going today to get the results of my saliva for adrenals etc., and I was wondering if you could respond to the adrenal tests when I get them today?
I am already sure my cortisol is low by my symptoms. I'm thinking maybe that is why dr. doesn't want to raise Armour now because of the low cortisol. Does this make sense?
So far, all of my hormone tests have come back very low.

Sorry for the double post. I am still trying to figure out the forum........
Carol

Last edited by 40mills; 09-08-2008 at 10:20 AM.

 
Old 09-08-2008, 10:49 AM   #8
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Re: Reverse T3---Need advise on new Thyroid Lab report

Once I reply to a thread I check on it when it comes back around in circulation. When you get your adrenal tests results, I will add what I can. Adrenal dysfunction and testing is new to me as well. I do have the benefit of my chemistry back ground to help with data interpretation. I am not an MD by any means though.

Good luck and hopefully you will get the answers you need. As to increasing thyroid medication when cortisol is low. Most often people with hypoadrenalism have low T4 levels and high T3 levels. Continually adding T4 or T4 and T3 to this body chemistry can drive you hyperT in T3 while you remain hypoT/normal in T4. Cortisol acts as a stop to T4 to T3 conversion in your liver. If you do not have enough your T4 to t3 conversion can go into overdrive. This causes a wierd mix of hyperT and hypoT symptoms and EXTREME fatigue. If you do have low cortisol and adrenal function, it is treatable. It may mean you need to take a lot more pills through out the day, but you will feel alive and not like a walking zombie. I am wishing you the best of luck with your MD.

MG
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Last edited by mkgbrook; 09-08-2008 at 10:51 AM.

 
Old 09-08-2008, 11:15 AM   #9
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Re: Reverse T3---Need advise on new Thyroid Lab report

Thanks again!
I wonder why drs dont check adrenals before prescribing Thyroid meds?
According to the drug insert from the pharmacy, there is a warning to 'always test adrenals before giving this medication'. No one I know of has ever had their adrenals tested first. If the drs would check for adrenal insufficiency first, like the recommendation says, I dont think there would be all of these dosing, symptoms problems. Actually from what I have read, it can actually be dangerous to give t4-3 without first checking adrenals.

 
Old 09-08-2008, 11:22 AM   #10
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Re: Reverse T3---Need advise on new Thyroid Lab report

I have a series of posts that you might find helpful. The one to start with is week 2. Let me get the link..
[url]http://www.healthboards.com/boards/showthread.php?t=597479[/url]

...it might help you understand the basics of thyroid care and management. Most MDs are not up to snuff on managing Hashimoto's and hypothyroidism.
I will repeat myself.. just a habit, this is just week 2 in a series of 7 threads on thyroid cares and concerns. It is the starter on basics and lab interpretation, etc. Hope you find it helpful.

MG
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Old 10-07-2008, 11:35 AM   #11
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Re: Reverse T3---Need advise on new Thyroid Lab report

Hi MG, yesterday I had my appt. with FNP, We talked about my labs and my low t4, barely in range. I asked for the 25 mcg of t4 that you recommended. she said o.k. but she also said: "your t3 is low too" I said: yes but why not get the t4 and t3 more balanced? She said ok. I hope i did the right thing. But I know my t3 is still low.

I have been working with her on my low adrenal reserves (this is low only past 12 noon).
and also my bioidentical progesterone/est. replacement which i began about a month ago.

Here is what she said: " I thought by treating adrenal fatigue and sex hormones, to get them balanced, that this would 'fix' the thyroid levels"

I would like your opinion on this if you would please?

thankyou, Carol

 
Old 10-07-2008, 03:38 PM   #12
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Re: Reverse T3---Need advise on new Thyroid Lab report

Quote:
Originally Posted by 40mills View Post

Here is what she said: " I thought by treating adrenal fatigue and sex hormones, to get them balanced, that this would 'fix' the thyroid levels"

I would like your opinion on this if you would please?

thankyou, Carol
She is right that treating the adrenal fatigue will effect your thyroid function...but it wont fix it. What it will enable you to do is to stabilise on thyroid meds. So the idea is to treat the adrenals prior to 'fixing' the thyroid.

Your FT3/RT3 ratio is a bit of a concern to me. At the moment your ratio is 9% and everything I've read indicates it should be 20%+. My ratio at the moment is 10% and my GP wasnt happy with it. At that point I was only taking T4 medication but I've just moved across to NTH in a hope to correct this.

All of your levels look low to me indicating you definitely need more meds...you're right to fix your adrenals before working on the thyroid though for sure. Thats what I've just done. I'm now taking 28mg Hydrocortisone per day and now that my temps have stabilised I've started the change over to NTH.

Good luck with it

Rach
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Adrenal Fatigue
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Old 10-07-2008, 06:03 PM   #13
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Re: Reverse T3---Need advise on new Thyroid Lab report

40mills,

Good to hear from you again.

I had my appt. with FNP, We talked about my labs and my low t4, barely in range. I asked for the 25 mcg of t4 that you recommended. she said o.k. but she also said: "your t3 is low too" I said: yes but why not get the t4 and t3 more balanced? She said ok. I hope i did the right thing. But I know my t3 is still low.
Good for you. Nice that you are sticking to your guns and that your FNP is working with you. It doesn't hurt to start slow. Adding a T4 supplement when you have low cortisol is easier on your system than adding T3. The main reason is we tend to over convert our T4 to T3.

I have been working with her on my low adrenal reserves (this is low only past 12 noon).

How are you treating your low, late day cortisol levels? 10 mg of hydrocotisone? DHEA? Pregnenolone? What is your treatment regime here? If you are taking a small dose of steriods it will slowly stall your T4 to T3 conversion. This is going to allow your T4 to rise as your T3 stays the same or drops a bit. It can take time to balance out. It took my body 3 months to stabilize out on adrenal meds and then a second Endo I was trying out took me off of them and threw me into a hormonal basket case. I am back on them and the Endo has taken a hands off approach.

and also my bioidentical progesterone/est. replacement which i began about a month ago.
It can take a few months for this to settle out. It doesn't take too long for your blood levels to equilibrate, but how your body processes and uses the stores will change over time as demands increase and reawaken from dormant states.

Here is what she said: " I thought by treating adrenal fatigue and sex hormones, to get them balanced, that this would 'fix' the thyroid levels" This sounds good. You should be able to treat your adrenals and begin with a small dose of thyroid meds. Just don't push it to fast or you will risk a hyperthyroid trip. Been there done that.. a couple times.

I would like your opinion on this if you would please?
I think you are on the right track. GO back and get your Fts rechecked after 4 weeks on your increased T4 supplemental regime. Then if things seem to be stable add another 12.5-25 T4. Just make sure you keep an eye on those levels. You are doing just fine in your own care management. Keep up the good work!

MG
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Last edited by mkgbrook; 10-08-2008 at 05:48 AM.

 
Old 10-07-2008, 10:57 PM   #14
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Re: Reverse T3---Need advise on new Thyroid Lab report

Quote:
Originally Posted by 40mills View Post
Here is what she said: " I thought by treating adrenal fatigue and sex hormones, to get them balanced, that this would 'fix' the thyroid levels"
There are instances where getting the adrenal stuff balanced DOES fix the thyroid problem. It is believed, and I see the merit in this line of reasoning, that when the adrenals can no longer provide adequate Cortisol to deal with the stresses you face, the hypothalamus and pituitary start slowing your metabolism.

They do this by the hypothalamus lowering TRH which subsequently tells the pituitary to lower TSH. The net result is that you have low-ish or middle range TSH along with lowish T4 and T3 levels. Of course, in your case, adding the Armour, while your adrenals are still struggling is not helping the situation, other than speeding up your metabolism a tiny bit, if at all, right now--based on your labs, at least, because it is suppressing your TSH, as well.

Once the hypothalamus sees adequate cortisol, it is possible that over time the metabolism will correct itself, and you'll not need the thyroid meds.

There is a Dr. Rind who has written some interesting articles on the interactions at play there, and you might find him interesting to do a web search on.
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Old 10-09-2008, 11:13 PM   #15
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Re: Reverse T3---Need advise on new Thyroid Lab report

Quote:
Originally Posted by Meep View Post
There are instances where getting the adrenal stuff balanced DOES fix the thyroid problem. It is believed, and I see the merit in this line of reasoning, that when the adrenals can no longer provide adequate Cortisol to deal with the stresses you face, the hypothalamus and pituitary start slowing your metabolism.

They do this by the hypothalamus lowering TRH which subsequently tells the pituitary to lower TSH. The net result is that you have low-ish or middle range TSH along with lowish T4 and T3 levels. Of course, in your case, adding the Armour, while your adrenals are still struggling is not helping the situation, other than speeding up your metabolism a tiny bit, if at all, right now--based on your labs, at least, because it is suppressing your TSH, as well.

Once the hypothalamus sees adequate cortisol, it is possible that over time the metabolism will correct itself, and you'll not need the thyroid meds.

There is a Dr. Rind who has written some interesting articles on the interactions at play there, and you might find him interesting to do a web search on.

 
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