Revised postResults showing high rt3: Due to... - Thyroid UK

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Revised postResults showing high rt3

130396 profile image
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Due to these results with the rt3 and advice given, I reduced t3 dose from 25mcgs a day to 20mcgs a day.

So I have been taking 100mcgs levo plus 15mcgs on waking.

Then 5mcgs t3 at 2pm.

I've now seen my gp and he had said to help reduce RT3 to cut my levo dose to 75mcgs instead of 100mcgs but keep t3 at 20mcgs

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130396
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Clutter profile image
Clutter

130396,

Your rT3 isn't high, it appears to be mid-range.  If you felt well on your previous doses I see no reason to have reduced T4 or T3.

galathea profile image
galathea

 rt3 is made when unused t4 is broken down.

Reducing the t3 would have no effect on rt3....    T3 cannot become rt3, it can only become t2 and t1.   You can remove an iodine atom but you cannot move it

So your Gp is almost right, but i think he should have increased your t3 and reduced your t4 by more.

.

G x

HIFL profile image
HIFL in reply to galathea

"Reducing the t3 would have no effect on rt3.... "  Not true.  If T3 is too high, the body converts available T4 to rT3.  There's a graphic here that explains it better: tiredthyroid.com/blog/2015/...  

Interestingly, her lab results graph shows her FT3 at the top of the range, and it's the only value that high.  So lowering her T3 dose could possibly reduce her rT3.  

Of course, how she feels is what matters most.  If she felt well on that dose, I wouldn't have changed anything, as Clutter said.  

130396 profile image
130396 in reply to HIFL

Thank you so much for this. I've read it and it makes a lot of sense.

As I told Clutter my remaining symptoms are hard heartbeat. Not fast but hard and breathlessness on exertion.

Thank you so much.

HIFL profile image
HIFL in reply to 130396

You're welcome.  Hope you feel better!

galathea profile image
galathea in reply to HIFL

Ok... Point taken.... I phrased my answer badly.      A lot of people who have high   Rt3 dont appear to be making rt3 because their free t3 is replete.....  They appear to make it because they get stuck in some sort of loop.     It seems that any t4 they injest becomes rt3.     Stopping t3 doesnt help, the only aswer appears to be stopping t4.

HIFL profile image
HIFL in reply to galathea

Agreed.  There are different reasons for HIGH rT3.  But note, this person's rT3 is well within the reference range.  What IS high, is her FT3!  

130396 profile image
130396 in reply to HIFL

Hi

My ft3 is 5.7 so within range and top 1/4.

Could this be the reason for high rt3 then? Am I taking too much T3?

I say my rt3 is high at 0.31 as I went to another fb forum and they worked it out that it should be 0.17 according to lab values 

HIFL profile image
HIFL in reply to 130396

Because T3 spikes and falls within hours in the bloodstream, it's so hard to tell whether someone is taking too much T3.  If your result was after waiting 24 hours, then your levels 4 hours after a dose could have been above the reference range.  I purposely started testing after 6 hours just to see, and my FT3 was then over the range, although at 24 hours, it was more like top 1/4.  

You might find this page helpful: tiredthyroid.com/rt3-3.html  You look more like Profile I.  If that's the case, then maybe your original move, dropping just 5 mcg T3, may have been the right one all along!

130396 profile image
130396 in reply to HIFL

Hi 

Thank you.

My blood test was 18hrs after last dose t3 and 25hrs after t4 dose.

Does that tell you anything 

radd profile image
radd

130396,

Your results are ok . ...  FT4 mid range, FT3 high range and RT3 mid range.

You may require RT3 a little lower but this could be achieved with making thyroid meds work better with optimal cortisol, iron & nutrients.

Messing with med doses could be counterproductive, especially if you are now feeling well ? ? ..  I also agree (with galathea) that only reducing T4 & increasing T3 will reduce RT3. 

130396 profile image
130396 in reply to radd

Hi radd 

I was told my rt3 was high at 0.31 as it should be 0.17. My rt3/ft3 ratio is 18.4 and apparently optimal is 20.

I reduced t3 as the Thyroid Advocates site told me to do so.

They were the ones who also said my rt3 was high.

They said although it is in range it needs to be much lower in the range.

I saw my gp today and told him about the RT3 and he said reduce t4 to 75mcgs. I didn't tell him I'd already reduced t3.

Unfortunately I cannot get iron optimal as I have a serious blood disorder that prevents new from getting iron levels up. My saturation is 26% and that's the highest it's allowed t P go.

I have now got my high cortisol under control. I have been using holy basil and I now have stable DATS.

My average daily temp us now 37C 

My Dr does think my hard heartbeat is possibly due to RT3 but sending me to cardiologist just to be sure

radd profile image
radd in reply to 130396

130396,

Your RT3 is a little high but still within range and could be caused by any number of things such as low iron. The body needs iron for carrying oxygen throughout the body and to assist in digestion (enzymes). When iron levels are low it slows down the conversion of T4 to T3 (deiodinase activity) as requires iron containing enzyme thyroid peroxidase to produce the thyroid hormones.

 A proportion of unconverted T4 (sometimes together with other factors) will convert to RT3. Reducing T3 will not lower RT3 levels as RT3 only comes from unused T4.

Reducing high levels of RT3 is only successful long term if the underlining cause is addressed otherwise it will just return. 

I also have an iron condition and have to keep my thyroid hormones very low. In order to feel well I have very little margin but it is achievable with adequate cortisol, optimal nutrients and low thyroid antibodies. 

My heart jumped and bumped for four years before adding T3. Optimal thyroid hormone levels (suitable to myself) has stopped any previous palpitations.

Reading "Your Thyroid & How To Keep It Healthy" by Dr Barry Durrant Peatfield will educate and allow the making of informed choices. GP's & endos aren't always worth listening to.

130396 profile image
130396 in reply to radd

I don't have an iron problem as such. I have blood cancer which means my iron is not allowed to go any higher than it already us. If it goes any higher they will increase my chemo in order to reduce my iron. Iron level is critical with my condition as too much will increase the cancer.

It was because of my blood condition and the fact that my t4 wasn't converting that I was also put on t3.

So now what do I do?

Do I reduce the t4 like my gp said to do?

Apart from my gard heartbeat I feel a lot better than I did.

Along with the hard heartbeat I do get breathless on exertion such as hanging washing out and just walking

radd profile image
radd in reply to 130396

Sorry to hear about your blood cancer. On top if everything else it hardly seems fair. Your breathlessness could be down to low thyroid hormone or low iron as is required to carry oxygen around the body.

Yes, I agree with your doctor in needing to reduce T4 but keep T3 at 20 or 25 mcg.

If you reduce T3 you may risk impairing T4 conversion further resulting in even higher RT3. 

You have your iron & cortisol sorted so ensure all nutrients are optimal, gut issues are addressed & thyroid antibodies are kept low.

130396 profile image
130396 in reply to radd

Well that's what I thought too but was told to first reduce t3 and if no better after a week to reduce t4!!!!

If still no improvement then raise t3 again.

Roadrunnergreg profile image
Roadrunnergreg

High RT3 implies one of the following like low iron, or adrenal issues... 

130396 profile image
130396 in reply to Roadrunnergreg

My iron is at 26% saturation. Adrenal issue has been dealt with now and DATS are very stable.

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