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  • Hypothyroidism, rT3 problem and other issues, please help

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    Old 04-01-2013, 05:42 AM   #1
    karmina
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    Question Hypothyroidism, rT3 problem and other issues, please help

    Hi all. I'm new to this site but have had many health problems over the years. I wanted to see if there's anyone who might be able to help out. Sorry for the long story but I think this is all more or less related so I want to tell the background properly.

    I'm 28 year old female. I was diagnosed with Crohn's disease six years ago and was then put on prednisone and immunosupressant (azathioprine). I've been on azathioprine ever sience and the prednisone treatment lasted for a little over a year. I've had no issues with Crohn's after I stopped taking prednisone but soon after I started to feel very tired and I was diagnosed with hypothyroidism. I kind of think the prednisone had something to do with this, but who knows.

    The original lab results were: TSH 5.6 (ref 0.5-3.6) and free T4 18 (ref 10-21). There was no sign of Hashimoto's.

    I got a prescription for thyroxine and started with a small dose. It made me feel better so I was put on thyroxine permanently. After about a year I started to feel that things weren't quite right and my doctor had me increase the dosage a few times. The maximum dosage I was on was about 85 Ķg. My free T4 was always a little bit over the reference but the symptoms never went away.

    In 2011 I started to feel even more tired. I also developed a chronic cough with thick green sputum and low fever that comes and goes. I think it may be mycoplasma but the tests came back negative. Iíve been well examined but no one seems to know whatís causing the cough and fever. Basically Iíve been told to just live with it.

    Six months ago I decided to had a comprehensive thyroid assessment done with Genova Diagnostics. It became clear that I had a problem with excessive reverse T3. The lab results came back as follows:

    TSH 0.78 (ref 0.4-2.5)
    free T4 1.6 (ref 0.9-1.8)
    free T3 2.13 (ref 1.8-4.2)
    reverse T3 52.9 (ref 9-35)

    The free T3 / reverse T3 ratio is about 4.

    I was also tested for the adrenaline fatigue syndrome. The salivary cortisol curve looked quite nice, although it wasnít ideal.
    DHEA 7 am Ė 9 am: 121 (ref 71-640 pg/mL)
    DHEA / cortisol ratio: 159 (ref 115-1188)

    I was able to find a doctor who would describe me Liothyronine so I stopped taking thyroxine. Iíve been on Liothyronine (20-30 Ķg) for four months and Iíve felt a little better lately. My most recent lab results were:
    TSH 1,49 (ref 0.5-4.5)
    free T4 10 (ref 10-21)
    free T3 4.2 (ref 3.6-6)

    The thing is that thereís no place where I could get proper treatment for this because I havenít been able to find a doctor who would understand anything about the rT3 problem. Iím just trying to guess what to do next. I still have many symptoms such as irregural periods, fatigue, the persistent cough, chronic headache, cognitive issues and so on. Iíve tried to take more Liothyronine and Iíve tried to take a small amount of thyroxine with it but my heart just goes crazy when I do that.

    Can anyone tell me what should I try next? Are there any more lab tests I should have? (I have my basic blood panel checked regularly and itís fine.) Should I be worried about my cortisol or DHEA levels? Is my DHEA level too low for a female of my age?

    Any help is so much appreciated.

     
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    Old 04-01-2013, 07:21 AM   #2
    Heckofagal
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    Re: Hypothyroidism, rT3 problem and other issues, please help

    I have also struggled with high RT3, and I gotta say it is hard to find a dr. to properly treat straight thyroid issues much less the more complicated cases. Perhaps look for a naturopathic dr in tour area.

    Did you test your RT3 with your last labs? I think the theory with straight T3 (liothyronine) method of clearing RT3 is supposed to clear the RT3 in 12 weeks, and then you can go back to regular treatment. So if you have cleared the RT3 you really should add some T4 to the treatment as you are in the very bottom of the range.

    Wish I could be more help with the DHEA -as that seems really low but its not something I am familiar with. Also, have they tested your Vit d or b12?

     
    Old 04-02-2013, 02:59 AM   #3
    karmina
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    Re: Hypothyroidism, rT3 problem and other issues, please help

    Hi, thanks for the reply.

    I can't get rT3 tested in any "normal" lab. I would need to send the blood sample to Genova Diagnostics and it costs a lot. So I'm not going to get rT3 tested at this time. I heard that getting rid of the excess rT3 requires high dosage Liothyronine treatment but I haven't been able to level up the dose so I don't really know if I should start taking thyroxine again.

    I've tried almost all easy tricks such as vitamin d and other vitamins, selene, iron, gluten free diet (I've been gluten free for a year now) but I don't think it's been much help and my vitamin levels are very good anyway.

    I'm so sick of being sick all the time

     
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