Reverse T3 issue or overmedicated?

Please can I have some advice on recent blood tests before I go to see the g.p?

I have taken for some years 200mcg levo from g.p. plus 4.5 grains ndt which i source separately (g.p. knows about it but usually ignores) and felt well. I appreciate this is a hefty dose but b.p. ok and palpitations, anxiety, temp, head aches all none existent since on ndt. I also take b12 and use serenity cream, no iron.

However, couple months ago g.p. reduced levo down to 175mcg and will probs want it to go down further. Since reducing I have started to have resurgence of aches and pains and weariness.

Should I be continuing to reduce my dose given the test results below or not given the resurgence of hypo effects? Not sure how to interpret?

Thanks

Biochemistry

CRP 2.60 range <5.0mg/L

Ferritin 166.5 range 20 - 150ug/L

Thyroid Function

TSH<0.005 range 0.27 - 4.20IU/L

T4 Total 151.5 range 64.5 - 142.0nmol/L

Free T4 40.82 range 12 - 22pmol/L

Free T3 11.90 range 3.1 - 6.8pmol/L

Reverse T3 55.0 range 10 - 24ng/dL

Reverse T3 ratio 14.09 range Normal >15, Borderline 12-15, Low <12

Immunology

Anti-Thyroidperoxidase abs 574.2 range <34kIU/L

Anti-Thyroglobulin Abs115.6 range <115kU/L

Vitamins

Vitamin D (25 OH) 91 range Deficient <25nmol/L, Insufficient 25 - 50, Consider reducing dose >175

Vitamin B12H>1476 range Deficient <140pmol/L, Insufficient 140 - 250, Consider reducing dose >725

Serum Folate 12.14 range 10.4 - 42.4

7 Replies

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  • AKatieD,

    Your reverse T3 is high because you are over medicated with FT4 and FT3 considerably over range. FT4 should be <22 and FT3 should be <6.8. You need to substantially reduce dose.

    Being over medicated can cause fatigue and musculoskeletal pain and make you feel very unwell.

    thyroid.about.com/library/a...

    Thyroid antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism. 100% gluten-free diet may improve symptoms and reduce antibodies.

    chriskresser.com/the-gluten...

    thyroiduk.org.uk/tuk/about_...

    Vitd is optimal.

    B12 is high which is fine if you are supplementing. Adding a B Complex vitamin will boost folate.

    _______________________________________________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Ok thanks. Just confused as felt fine before started reducing and now don't!

  • AKatieD,

    I think it's likely your T4 and T3 levels built up and reached a tipping point and it is that, rather than the 25mcg dose reduction, which has made you feel unwell.

  • Understood thanks

  • If you get your dose of levo reduced until your Free T4 and Free T3 are in range, but testing shows you still have high levels of reverse T3, then I would suggest you get a full blood count and an iron panel done. There is a condition called Anaemia of Chronic Disease (or Anaemia of Chronic Inflammation) which may fit you, but it is a long shot on the basis of just the results you've listed and you need to know more.

    irondisorders.org/anemia-of...

    irondisorders.org/Websites/...

    en.wikipedia.org/wiki/Anemi...

    The reason I'm mentioning this is because I had iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) together. My IDA lowered my ferritin, and the ACD increased it. It looked normal to a doctor's eyes. And yet my serum iron was in my boots and my TIBC was also well below range and my GP didn't know, because she never did an iron panel. Despite this my CRP (an inflammation indicator) was not high (nor is yours). But my reverse T3 was way over range. (Like yours.)

    I realise I'm going out on a limb with the above. Don't take it too seriously. I'm not a doctor.

  • Thanks for the interesting information. Will work on lowering the t3&4 and then see where I am.

  • Thank you

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