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Masta 02-17-2009 03:51 PM

RT3 and my other labs i dont understand
I have read up that the lab ranges changed in 2002 so I have been seeking out doctors that will help me. I finally found a doctor who would help me then my insurance dropped him. He placed me on Armour 90mg after my 01/08/09 labs were done and I haven’t been able to see him since. My periods are 3 weeks late. My previous 24hr urine showed I had low cortisol. I have not had an ACTH test or a saliva test done to get my adrenals checked. I’m finding it so hard to get tested for anything, doctors thinks I’m a hypochondriac because they gave me a prescription so I should feel ok.. I have an appointment for a new Endo specialist end of March 09 that’s over 1hr away since my current endo thinks I need to exercise to feel better. That doctor was the one who put me on the Synthroid and she only tests my TSH and FT4.

Can any of you help me understand these labs and give me some insight on the RT3 and or the IGF issues?

[B]01/08/09[/B] These labs are based on me being on Synthyroid for the 1st month (didn’t take it the morning of the test):
[B]IGF-1 =[/B] 103 ng/mL (range 109-284 ng/mL) [B]Low[/B]. (I don’t know if I have insufficient growth hormone, it could explain why I feel so crabby as well as RT3 issues) (I have read random testing could show a low score).
[B]DHEA-Sulfate =[/B] 167 ug/dL (range: 45-270 ug/dL)
[B]Vitamin D, 1, 25 Dihydroxy =[/B] 18.6 pg/mL [B]Low [/B](range: 15.9-55.6 pg/mL) (Should be 35+)
[B]Insulin Free =[/B] 7.3 uIU/mL (range 0.0-22.0 uIU/mL)
[B]Insulin Total =[/B] 7.3 uIU/mL (range 0.0-22.0 uIU/mL) My doctors notes say he wanted to put me back on Metformin to give me some energy and that he wanted to discuss the RT3.
[B]TSH[/B] = 2.21
[B]Free T4[/B] = 1.01 (lab range 0.71-1.85 ng/dL)
[B]Free T3[/B] = 3.2 pg/mL (range 2.3-4.2 pg/mL)
[B]RT3 =[/B] 367 pg/mL (range 90-350 pg/mL) [B]High [/B](from what I’ve read this means I’m not getting T3 from the Armour because of the RT3 being high)

[B]11/10/08: [/B]
[B]TSH = [/B]3.40
[B]Free T4 =[/B] 0.94 (lab range 0.71-1.85 ng/dL)

[B]10/14/08: [/B]
[B]Free T3 =[/B] 2.4 (lab range 2.4-4.2 pg/mL),
[B]Free T4 = [/B] 0.82 (lab range 0.71-1.85 ng/dL),
[B]TPO Ab = [/B]0.3 (range 0-3.9 uIU/mL), TgAb = 0.0

[B]10/07/08: [/B]
[B]TSH =[/B] 2.83
[B]Total T3 =[/B] 96 (lab range 58-159 ng/dL),
[B]Free T4 = [/B]0.87 (lab range 0.71-1.85 ng/dL)
[B]Vitamin D, 1, 25 Dihydroxy =[/B] 29 pg/mL [B]Low[/B]

[B]09/10/08: TSH = 4.58 [/B]
2007: TSH = 3.23
2006: TSH = 3.38
2003: TSH = 2.87
2002: TSH = 2.60
2000: TSH = 2.73

I’m wondering since my TPO Ab did show some antibody of 0.3 if my thyroid is slowly pooping out.

I don’t know what tests I should ask for when it comes to my adrenals. I feel tired all the time. More awake at night. Cannot get up in the morning etc etc. I sure wish my doctor would do a TSH, FT4, FT4, Reverse T3 all on the same day so I could get a better picture of what’s going on. I had a ultrasound done on my thyroid and it shows my thyroid glands are very small.

I have read that my dose of thyroid meds needs readjusted till I get to the optimal number/or feel better. I’m in the process of getting that done.

mkgb 02-18-2009 09:50 AM

Re: RT3 and my other labs i dont understand..
Let me go in order:

Blood suger results and tests:
The low IGF and lower insulin levels indicate a trend toward a diabetic state. this needs to be monitored closely. Has your MD checked to see if you have anti-Gad present. The AI that attacks your insulin production capabilities?

Metformin will allow for a more effcient use of what insulin you are making, BUT it is only a patch if your immune system is killing off your insulin manufacturing capabilities. Metformin XR has been wonderful for me.

Thyroid results:
No HIGH RT3 doesn't mean you do not absorb T3 when it is supplemented. The high RT3 means that you need Armour to get T3. Your liver doesn't convert your T4 to T3 efficiently on its own. Without the T3 in your Armour.. you would have insufficient T3 levels. Right now your FT3 levels are near optimal 47.36% you can go up a smidge (50-80% of normal range) but might drive your self hyperT in T3 if you push too much. You may need to add some pure T4 to the Armour to get the right ratio for you. Currently your T4 levels are too low IMO. You are at 26.3 %. I think you may need to hold on your current Armour dosage and start adding T4. You can probably add 25 mcgs safely. You need to ask your MD though.

Your high RT3 should prove to any SENSIBLE MD that you need T3 supplementation.. be it Armour or cytomel or one of the variants. Having that positive test is a good thing for proper care.

Your low vit D will effect your adrenals and thyroid conversion processes. you need to add vit D to your supplement regime. This will require adding D, K, and Ca in the proper ratios. your MD or a nutritionist would be best to consult on this. Just getting sun may not do it. I have to take 2000 x the daily limit in addition to 15 minutes outside a day.

It is possible that you have Hashimoto's and it is in a low active state. The presence of antibodies should make you suspicious, but only a biopsy will give you 100% identification of Hashimoto's. Antibody levels flux.. but if Hashimoto's is in full out destruction mode 80% of sufferers have Positive antibody results.

Getting the right MD and keeping them is one of the hardest things about having a thyroid issue. I wish you the best of luck.


tygwyn 02-18-2009 10:16 PM

Re: RT3 and my other labs i dont understand
Having high RT3 basically means that you're not converting your T4 into 'usable' Free T3... it is being converted to Reverse T3 instead. Reverse T3 will block the cells and will not enable to the FT3 you do have in your system to enter those cells. Whatever FT3 is in your system at the moment is totally irrelevant because it isnt able to do its work... RT3 is blocking it.

With high RT3 it is very often recommended that you stop all T4 medication and move onto solely T3 medication for a period of either a few weeks or few months. If you continue to take T4 medication (of which Armour is 80%) then there is a very good chance you will not clear your RT3. Once the RT3 has been cleared you can then move back onto T4 meds (be that synthetic or natural).

Good luck with it :)

sparkie 02-19-2009 02:35 PM

Re: RT3 and my other labs i dont understand
Tygwyn, that is so interesting about RT3. I have read some on it but good luck getting an MD here to order the test. It seems to be a rare MD who will do that.

mkgb 02-20-2009 06:22 AM

Re: RT3 and my other labs i dont understand
DEFINITELY keep up the Armour. The sooner you get to optimal thyroid hormone replacement the sooner the RT3 production goes away. The theory behind only taking T3 to kill off the RT3 stems from attempting to reboot your thyroid conversion process. Going on pure T3 supplementation will completely suppress the TSH and thus tell the liver there is no need to convert T4 into T3. The suppressed TSH also tell the thyroid you have no need to make T4... so this tactic tends to drive one hypoT in T4.. however studies have shown if you suppress your TSH with a block and replace T4/T3 combination the RT3 will cease to be produced as well. In many cases going on pure T3 will temporarily fix the high RT3, but when you go off of it and the demand for T4 and T3 production reboots the poor conversion of T4 to RT3 resumes.

So Masta, in my personal non-MD opinion, you are under medicated and need an increase in your T4 medication. You may also need a small nudge in the Armour level as well. Many need a tailored T4:T3 ratio to meet their optimal thyroid hormone levels.


Masta 02-21-2009 01:06 PM

Re: RT3 and my other labs i dont understand
thanks mgkbrook. im gonna stay on the armour and try and find a good doctor.

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