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Old 12-20-2011, 01:06 AM   #1
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REVERSE T3 above normal. What's it mean? Lab results included.

Hi, all. I'm new to this. After months of feeling tired, depressed, mentally fuzzy, my girlfriend said to look at thyroid issues. I just turned 46, and I am a Caucasian male.

I started taking my temperature. It's consistently in the 96s to low 97s, whether it's when I awake, during the day, or at night before I go to bed.

Finally, I went to doctor Nov 17. They measured my temp as 96.2 F. The TSH blood test was 4.35. Doctor refused to do any other tests, though when I went back ten days later, he said there was nothing wrong with me and 4.35 for TSH is fine, as it is below the 4.5 level. (I told him the symptoms, including that my toes are often cold. My glucose was measured as 88, and I'm ~ 6'1 1/2", 175#.)

When I went in the second time, my normally irregular heartbeat was regular! Just for that and the following day! Now it's back to irregular. Strange...

I went vegan back in August 2010 to try and lower my cholesterol. So he drew blood to check my B-12 and the result was 488 pg/mL (range of 211-946). He said that was fine. Just this last week, I started to eat meat again, though, thinking maybe I need more protein. I had a few bites of steak a few days before my most recent blood draw. I doubt that would have done anything, though.

I then got my own blood tests Dec 12. (Same company doing the blood work, just purchased it on my own from an online place.) Here are *those* results, with the value and the lab range. (By the way, the only other times I had TSH tested was in 1992, 2.9, and in Dec 2009, 1.096.)

Iron, Serum: 66 ug/dL (40-155)
Cholesterol, Total: 170 mg/dL (100-199) [was 176 weeks earlier]
Triglycerides: 135 mg/dL (0-149) [was 193 weeks earlier]
HDL Cholesterol: 43 mg/dL (>39) [was 42 weeks earlier]
LDL Cholesterol: 100 mg/dL (0-99) [was 95 weeks earlier]

Vitamin D, 25-Hydroxy: 26.0 ng/mL (30.0-100.0)
Glucose, Serum: 90 mg/dL (65-99) [was 88 weeks earlier]

WBC: 4.7 x 10E3/uL (4.0-10.5) [was 6.7 weeks earlier]
RBC: 4.79 x 10E3/uL (4.10-5.60) [was 5.04 weeks earlier]
Hemoglobin: 14.0 g/dL (12.5-17.0) [was 14.5 weeks earlier]
Hematocrit: 41.0 % (36.0-50.0) [was 43.3 weeks earlier]
MCV: 86 fL (80-98) [was 86 weeks earlier]
MCH: 29.2 pg (27.0-34.0) [was 28.8 weeks earlier]
MCHC: 34.1 g/dL (32.0-36.0) [was 33.5 weeks earlier]
RDW: 13.1 % (11.7-15.0) [was 13.0 weeks earlier]
Platelets: 218 x 10E3/uL (140-415) [was 243 weeks earlier]

Neutrophils (Absolute): 2.4 x 10E3/uL (1.8-7.8) [was 3.00 th/mm3]
Lymphs (Absolute): 1.6 x 10E3/uL (0.7-4.5) [was 2.71 th/mm3]
Monocytes (Absolute): 0.4 x 10E3/uL (0.1-1.0) [was 0.63 th/mm3]
Eosinophils (Absolute): 0.3 x 10E3/uL (0.0-0.4) [was 0.28 th/mm3]
Basophils (Absolute): 0.1 x 10E3/uL (0.0-0.2) [was 0.05 th/mm3]

TSH: 1.810 uIU/mL (.450-4.500) [was 4.350 weeks earlier]
Thyroxine (T4): 8.4 ug/dL (4.5-12.0)
T3 Uptake: 31 % (24-39)
Free Thyroxine Index: 2.6 (1.2-4.9)
T4, Free (Direct): 1.13 ng/dL (0.82-1.77)
Triiodothyronine (T3): 99 ng/dL (71-180)
Reverse T3: 376 pg/mL (90-350)
Thyroid Peroxidase (TPO) Ab: <5 IU/mL (0-34)
Antithyroglobulin Ab: <20 IU/mL (0-40) Siemens (DPC) ICMA Methodology
Triiodothyronine, Free, Serum: 2.8 pg/mL (2.0-4.4)

I am new to all this, but it seems I may have "Wilson's Syndrome"? I've read online it's not a "real" disease, but whatever it is, my consistently low temperatures and ratio of T3 to Reverse T3 is off (I forget how or what the ratio is. I also think I have to convert some of my lab values. Regardless, it's off somehow!)

Just before I started noticing these problems, I was in a car accident at the end of August. While there was no visible damage to my car, it did hurt my neck and back. First my neck hurt, then my low back hurt and the pain went into my leg, making it hard to sleep. That messed my sleep cycle all up. Plus, I have lots of stress anyway (in my job), which is compounded as I haven't really been able to get any of my work done the last number of months (I work for myself).

I started taking a multivitamin again (Kirkland Signature Premium Performance Multivitamin) to get my B12 level up as well three 2,000 IU Vitamin D3 pills a day (Kirkland Signature Vitamin D3 2000 IU) to get my D3 levels up. I'm going to order some Thorne B-12 pills (1 mg pills) as well as one of the Thorne multivitamins (to avoid magnesium stearate, etc. though I'm not sure if it's really necessary). Likewise, I'm thinking that maybe I need to eat meat again to get more protein, as I read protein helps thyroid problems.

So, that's a lot of info! Any suggestions? Thoughts? Anyone know what's wrong with me?!

Thanks in advance!

 
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Old 12-20-2011, 05:38 AM   #2
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Re: REVERSE T3 above normal. What's it mean? Lab results included.

Welcome!

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

And, sorry to say, you are dealing with hypothyroidism - plain and not-so-simple.

In fact, you might have been dealing with since 1992 when your TSH was above 2.

You see, TSH > 2.0 is suspect for hypothyroidism.

Since TSH fluctuates as much as 200% throughout the day, checking that level only will not provide accurate information about thyroid function (especially since TSH is actually a pituitary hormone).

Your RT3 is high because your body isn't getting enough of the active hormone which is measured by your FreeT3 level (tri-iodothyronine, free serum)

While it looks like you got a standard thyroid profile done, many outdated tests were run.

The tests that "count" are the FreeT3 (tri-iodothyroine, free, serum) and FreeT4 (T4, direct, free) - those are the measurements of thyroid hormone that are usable by the body.

That said, both of your results are below lab median - no one feels/functions properly with those types of levels.

Your symptoms confirm this.

Most people need FreeT4 levels towards the high end of the range and FreeT3 levels above mid-range. This is published in the latest editions of thyroid textbooks.

It seems that many doctors must've been sleeping through thyroid class since all-too-many people go undiagnosed for a
l-o-n-g time. And, those that finally get a diagnosis often don't get the proper treatment.

If you read some of the personal stories in the permanent section on here, you'll see what I mean.

Unfortunately, it's not uncommon for people with "normal" (aka in-range) thyroid levels to be declared normal when they are anything but.

Endo Dr. Ken Blanchard writes about this in his book "What Your Doctor May Not Tell You About Hypothyroidism".

You need to start some thyroid hormone replacement.....and I hope you can find a doctor that recognizes this.

Many of us have had to see a succession of doctors before finding one that can properly diagnose/treat. I'm on #5 myself. But, it's worth every effort.

A starting point would be to call local pharmacists to get contact info for doctors that Rx Armour and/or Cytomel. These are two forms of thyroid hormone replacement that thyroid-savvy doctors Rx.

You could very well be like the majority of hypothyroid people and fare perfectly well with Synthroid but, the key is to partner with a thyroid-savvy doctor because that is truly your only chance of achieving wellness.
__________________
Graves' 2007...remission 2009....hypo 2010

Last edited by sammy64; 12-20-2011 at 05:41 AM.

 
Old 12-20-2011, 09:31 AM   #3
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Re: REVERSE T3 above normal. What's it mean? Lab results included.

Chronic stress or illness causes the body to make reverse T3 instead of converting T4 to the active hormone, T3. This is a way for it to conserve energy. Some experts believe that, even after stress/illness is corrected, the off-kilter process sometimes continues, causing hypothyroidism at the cellular level. The way to clear reverse T3 from the bloodstream is a temporary course of T3-only (Cytomel) treatment.

Also, if your intake of soy protein was heavy during your vegan days, that probably contributed to a hypothyroid state. Soy is a potent goitrogen that has the potential for a struggling gland to shut down altogether.

 
Old 12-21-2011, 05:45 PM   #4
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Re: REVERSE T3 above normal. What's it mean? Lab results included.

Well, I got my iron results. Not sure what they all mean, but here goes:

Iron Bind. Cap. (TIBC): 295 ug/dL (reference interval: 250-450)

UIBC: 235 ug/dL (reference interval: 150-375)

Iron, Serum: 60 ug/dL (reference interval: 40-155) [was 66 ug/dL eight days ago, but I started taking a multivitamin containing 50% USDA iron, plus ate some steak, since eight days ago. Shouldn't it be higher?]

Iron Saturation: 20 % (reference interval: 15-55)

Ferritin, Serum: 171 ng/mL (reference interval: 30-400)

Transferrin: 259 mg/dL (reference interval: 200-370)

N.B. My TSH on Nov 17, 2011 was 4.35. 3 1/2 weeks later, on Dec 12, 2011, my TSH was 1.810.

Oh, regarding stress, my job is super stressful with tons of deadlines, I'm very behind in my work, and I have no helpers. It's just me. And I'm a 46 year old single, unmarried male. (I think men have different iron level requirements than women.)

So, what does it all mean?

Also, up until recently starting to eat steak and turkey this last week or so, I was totally vegan since around Aug 2010 (to lower my cholesterol, which seems to always be low HDL and high LDL, despite past exercise and trying to eat healthfully). I avoided soy for the most part, but my diet was (is?) rich in goitrogens (as is recommended for a healthful diet): steamed broccoli; unsteamed cabbage; microwaved or baked sweet potatoes; steamed corn; Ezekiel 4:9 bread (containing soybeans); four grain hot cereal (rye, barley, oats, wheat) (nuked); steel cut oatmeal (nuked); Brussels sprouts (steamed); etc.

What's a guy to do?!

What's it all mean?

 
Old 12-22-2011, 09:38 AM   #5
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Re: REVERSE T3 above normal. What's it mean? Lab results included.

I have no idea what the iron panel means. I only know what your thyroid results are saying.

Cooked goitrogens aren't a problem, except for millet. Cooked millet is higher in goitrogens than uncooked. Heavy amounts of raw goitrogenic food can significantly impact an already struggling gland's output.

Even though your TSH came down in the second test, it isn't a great indicator of thyroid status in any case. Plus, it isn't static... It's meant to move up and down on a daily basis. (Although your degree of fluctuation isn't usually a sign of a healthy gland. Quite the opposite.) The main focus should be on your free T4/3 levels, which are both below lab median. Coupled with high reverse T3, it means you need some kind of thyroid treatment... Probably a course of T3 only to get the RT3 down; then T4 replacement to bring the FTs up.

I wouldn't expect most MDs to take any of this seriously. But if you search out a more open-minded doctor, you might get somewhere. Try Sammy's suggestions for finding a more thyroid-friendly MD.

Last edited by midwest1; 12-22-2011 at 09:41 AM.

 
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