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Old 01-03-2013, 12:08 PM   #1
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I'm still trying to figure out this RT3.

Welcome back! Yippie!

You don't know me, but I'm a big fan of yours. After all the amazing guidance on this forum, I always search out your posts in the archives. In fact, just this morning, I was following your discussions on RT3. (ha, I must be psychic!)

I am doing a HaPpY dAnCe seeing you back on the board!

Lin (who just had a blood test this morning, so hopefully, I'll be "reading" from you soon.) {{{hugs}}}

 
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Old 01-03-2013, 12:19 PM   #2
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re: I'm still trying to figure out this RT3.

I lurk about a lot. But life has been busy with new jobs and the like. Two kids... The perpetual roving viral bombs... And my mom, grandma, and aunts to run herd on thyroid health wise... OH and a dog and a cat! Yes! My family is full of thyroid dysfunction. But who wants to be normal... Not ME!


MG
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Old 01-04-2013, 11:34 AM   #3
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re: I'm still trying to figure out this RT3.

"Normal"? That's just a setting on the dryer!

Wowzers, it sure sounds like you're a busy little camper - so I truly appreciate your valuable time on this forum. {{{ big snuggly hugs }}}

If I may pick your brain a bit...... I'm still trying to figure out this RT3. (apparently, most Doc's don't understand it - just like me!)

Mini background: when I found this forum back in July, I was taking 50mcg Synthroid. My lab values were: FT3 1% and FT4 30% (yep, felt like puppy poo) Now (since Oct test) I'm on 100mcg Synthroid and 25mcg Cytomel,(generics) my values are FT3 68% and FT4 50%.

My new PA checked almost everything like B12, D, Iron, etc - but not rt3.
Gosh, with such a dramatic rise in my FT3, you'd think I'd be bouncing off the walls. But no, I really don't feel that much different. I'm thinking I may have a RT3 issue, because of my history of chronic dieting (600 calories a day for the past 30 years) and a low body temp. (between 94 and 96)

May I ask your opinion? It's confusing (especially with brain fog!) since my FT3 "looks" great. ARGH!

Thank you for any guidance,
Lin

 
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Old 01-04-2013, 12:44 PM   #4
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re: I'm still trying to figure out this RT3.

Quick question because great is relative at your levels I still felt like a dish rag. My optimal is bumping the 80% of normal in both FTs.

I am of childbearing age, premenopausal. Are you?

If so you are barely in the recommended 60-80% of normal recommended range. You could probably push for another increase. Baby steps now you are on the edge of the optimal range.

You have 18% more T3 than T4. This is trending towards adrenal support needed possibly. The main reason for over conversion of t4 to t3 is low cortisol production out of the adrenals.

If your cortisol levels are 75-100% of normal range.. Then it can simply be a need to boost your t4 intake... Not your t3. This will tell you a lot if your md and you want to try it actually. My md did this with me as a confirmation of hypoadrenalism test.

They increased my t4 from 50mcgs to 100mcgs. The result? My ft4 levels stayed at 30% no change and my ft3 levels jumped from 65% to 105% of normal range. All the addedt4 was converted to t3 when I didn't really need it. Solution 20 MG of hydrocortisone tablets spread out before 5pm. Now my ft3 and ft4 levels stay with in 10% of each other. Balanced.

Now I am not an MD, but reverse t3 levels are the humm.. Splenda version of t3. It is a chiral isomer of t3... Uh... Sorry chemistry geek just took over there..reverse t3 is a mirror image version of the usable t3. It uses up valuable t4 starting material and generates a component that doesn't fit in any of your metabolic gloves.

Think of it as trying to use two right handed gloves or shoes. Only one will actual work so you have lost half of what you need. The end result is normally higher levels of t4 and lower levels of t3 no matter how much t4 you take.

Make sense?

I truly do not think that you have to worry about your reverse t3. Did you have an abnormally high result of rt3? If so your t3 supplementation regime is compensating well for it.

Now if you are post menopausal: optimal is 40-60% of normal range. You are right in at range.. But not balanced. You may need to balance your levels to get rid of lingering symptoms.

Well I am not sure if this will help, but I hope so. Just my chemically biased opinion.

MG
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Old 01-04-2013, 04:48 PM   #5
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Re: I'm still trying to figure out this RT3.

LPD January 4, 2013

A question and some comments.

LPD - you say you are on 100 T4 + 25 T3 now, since October. But it is not clear what dose you were on for your October labs - was it 100+25 or 88+25? Also, it would be useful if you posted the actual numbers for your TSH, FT3 and FT4.

Reverse T3:
It is good that you are aware of RT3, because it can turn into a real problem. I would agree that it is unlikely that you have high RT3, because 100 T4 is not a very high dose. However if you keep increasing your T4 intake, RT3 could become a problem. My RT3 went very high when I was on 150 T4. Of course the easy way to find out for sure is get a RT3 test done when you get your next labs.

Your High FT3:
It is my opinion that your FT3 is high relative to your FT4 simply because you are taking 25 mcg T3. That`s quite a bit of T3. I know lots of people take more. But if you consider that a normal thyroid only produces about 6 mcg of T3 in a day, then 25 is a lot. Plus you get more T3 from the conversion of your T4.

From your labs, I think it is possible that you may be on an adequate dose at 100 + 25, but you have to give it more time to work thru your system and make sure everything else (like adrenals) are also working properly...

 
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Old 01-05-2013, 12:13 PM   #6
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Re: I'm still trying to figure out this RT3.

Thank you so much!
Quote:
Originally Posted by mkgbrook View Post
Quick question because great is relative at your levels I still felt like a dish rag. My optimal is bumping the 80% of normal in both FTs.

I am of childbearing age, premenopausal. Are you?
Nope, all done with that lovely phase. Just stopped at the age of 38, and that was about a decade-ish ago.

Quote:
If so you are barely in the recommended 60-80% of normal recommended range. You could probably push for another increase. Baby steps now you are on the edge of the optimal range.

You have 18% more T3 than T4. This is trending towards adrenal support needed possibly. The main reason for over conversion of t4 to t3 is low cortisol production out of the adrenals.

If your cortisol levels are 75-100% of normal range.. Then it can simply be a need to boost your t4 intake... Not your t3. This will tell you a lot if your md and you want to try it actually. My md did this with me as a confirmation of hypoadrenalism test.
Ahhhh, so it's the range that also makes a difference, cool! My PA actually checked my "cortisol total serum" back in August, the result (at 8am) was 10.1 (range: 4.6 - 20.6) She didn't seem concerned, so no further adrenal tests were done. Perhaps another type of check?

Quote:
They increased my t4 from 50mcgs to 100mcgs. The result? My ft4 levels stayed at 30% no change and my ft3 levels jumped from 65% to 105% of normal range. All the addedt4 was converted to t3 when I didn't really need it. Solution 20 MG of hydrocortisone tablets spread out before 5pm. Now my ft3 and ft4 levels stay with in 10% of each other. Balanced.
That's exactly what happened to me. In August, while on 88mcg my FT4 was 50%, so she bumped me to 100mcg in September. The FT4 didn't budge, still at 50%. (which is why she then bumped me to 125mcg - just had the blood draw to check that a few days ago)

Quote:
Now I am not an MD, but reverse t3 levels are the humm.. Splenda version of t3. It is a chiral isomer of t3... Uh... Sorry chemistry geek just took over there..reverse t3 is a mirror image version of the usable t3. It uses up valuable t4 starting material and generates a component that doesn't fit in any of your metabolic gloves.

Think of it as trying to use two right handed gloves or shoes. Only one will actual work so you have lost half of what you need. The end result is normally higher levels of t4 and lower levels of t3 no matter how much t4 you take.

Make sense?
Got it! I guess I was confused (who me?) because I didn't know if the RT3, was some how blocking the effect of my FT3. As if it could get into my cells, but I couldn't feel the benefit... canceling each other out.

Quote:
I truly do not think that you have to worry about your reverse t3. Did you have an abnormally high result of rt3? If so your t3 supplementation regime is compensating well for it.

Now if you are post menopausal: optimal is 40-60% of normal range. You are right in at range.. But not balanced. You may need to balance your levels to get rid of lingering symptoms.

Well I am not sure if this will help, but I hope so. Just my chemically biased opinion.

MG
As always MG, you are amazingly helpful! I have my next appointment with my PA on the 15th, so I was trying to figure out if I needed to have her order the RT3 for my next blood draw. Thanks to you, I won't have to. {{{big hugs}}}

Thank you!
Lin

p.s. Edited to add: MG, do you have an opinion on Leptin Resistance?

Last edited by LPD; 01-06-2013 at 02:02 PM. Reason: another ?

 
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Old 01-05-2013, 12:40 PM   #7
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Re: I'm still trying to figure out this RT3.

Hi telus, thank you so much for your input!
Quote:
Originally Posted by telus View Post
LPD January 4, 2013

A question and some comments.

LPD - you say you are on 100 T4 + 25 T3 now, since October. But it is not clear what dose you were on for your October labs - was it 100+25 or 88+25? Also, it would be useful if you posted the actual numbers for your TSH, FT3 and FT4.
Ha, sorry about that. So much for my mensa membership, eh? I should have phrased it something along the lines of: Currently, I only have results from October, where my values were:
TSH 0.01
FT4 1.3 (0.8 - 1.8) 50%
FT3 3.6 (2.3 - 4.2) 68%
(was trying to save you the math!)



Quote:
Reverse T3:
It is good that you are aware of RT3, because it can turn into a real problem. I would agree that it is unlikely that you have high RT3, because 100 T4 is not a very high dose. However if you keep increasing your T4 intake, RT3 could become a problem. My RT3 went very high when I was on 150 T4. Of course the easy way to find out for sure is get a RT3 test done when you get your next labs.

Your High FT3:
It is my opinion that your FT3 is high relative to your FT4 simply because you are taking 25 mcg T3. That`s quite a bit of T3. I know lots of people take more. But if you consider that a normal thyroid only produces about 6 mcg of T3 in a day, then 25 is a lot. Plus you get more T3 from the conversion of your T4.

From your labs, I think it is possible that you may be on an adequate dose at 100 + 25, but you have to give it more time to work thru your system and make sure everything else (like adrenals) are also working properly...
Thank you so much. Back in July, I started out taking 12.5 of T3. I was at 1% of the range, so my Doc bumped me up to 25mcg. I really don't feel any different, and no where near hyper. (which is why I was digging into RT3)

Also, back in October, when my PA noticed my FT4 wasn't budging (sticking at 50%) she up'd me to 125mcg. I just had a blood draw a few days ago, in my prep for my next appointment on the 15th. (I'll hopefully have those results soon) May I ask if you think I should request a RT3 test?

Thank you so much telus. I truly appreciate your help!
Lin

 
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