Help interpreting labs please

A little over six weeks ago I had labs done to see where my levels were and T4 was high 13.8 (4.5-12.0), FT4 high 1.90 (.82-1.77), RT3 high 51.6 (9.2-24.1) FT3 2.5 (2.0-4.4) and six weeks earlier the high numbers were a bit higher. To rid myself of the excess RT3 I stopped taking T4 during this past 6 weeks but slowly upped my dose of T3 to 30 mcg per day. I just got my labs back and now am wondering what the heck! T4 1.4 (4.5-12.0) very low, FT4 .32 (.82-1.77), RT3 6.2 (9.2-24.1), FT3 3.2 (2.0-4.4). Fasting and no meds before test as always. The day I had my labs done I started taking .56mcg T4 and dropped the T3 to 20 mcg a day. I do plan to increase the T4 eventually getting to the dose my endo has prescribed which is .112 mcg and then changing my T3 to 10 mcg per day as originally prescribed. I am wondering what the latest labs are really telling me can anyone chime in on this please? I am going to schedule another lab for 6 weeks out to see what has transpired during that time. Thanks for input, I so appreciate all the knowledge this group has.

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  • guysgrams I'm no expert on this particular thing ie rT3, so I am happy for someone to put me right, but my thoughts are that surely you've done exactly what you set out to do, which is clear your rT3.

    You took T3 only. No T4, so your total T4 and FT4 reflect that by being low. Your rT3 has reduced considerably - which was your aim. You have some FT3 which I would have thought to expect as your rT3 has now resolved.

    How are you feeling? I imagine the aim is now to gradually reintroduce whatever thyroid replacement hormone is needed for you to be optimally medicated and feel well.

    As I say, I'm happy to be educated on this as it's something I'm only just learning about.

  • Yes, my aim was to reduce RT3 substantially. What I am not sure of is how quickly to go from the .56 mcg T4 to the dose prescribed of .112 mcg T4 and reduce the T3 to the 10 mcg per day originally prescribed also. Don't want to screw things up.

    Thanks for your input.

  • Guysgrams,

    You were over medicated on 112mcg so why not try 100mcg + 10mcg T3.

  • Endo had been changing my dose for about a year. I took it upon myself to have RT3 tests done last Fall because I was feeling so hypo again. My last visit with her she stated there was no issues with the RT3...........I knew the RT3 needed to come down. I plan on slowly changing so that I can see how I feel. Interesting that during this last 6 week period my hair is softer, my head didn't itch and the areas around my eyes weren't red and scaly and my eyes didn't itch. I actually didn't feel as hypo as I thought I would during this last 6 week time period. I still had energy just not all day long and only things I found different was waking up around 3/4 a.m. hot and my hands hurt. That was about it. I have written all down to discuss the next time I see my Endo but there is quite a bit of time between now and May 2.

  • Guysgrams,

    There is no need to titrate slowly just resume slightly less Synthroid than 112mcg so you aren't over medicated.

  • Ok thanks

  • She has some T3 because she's been taking T3. But, obviously, 30 mcg isn't quite enough. So, going back down to 10 mcg T3, is going to mean she really doesn't have enough. And, her conversion really isn't very good, so raising the T4 will probably mean the rT3 will rise again, because the root problem hasn't been addressed - i.e. taking too much T4 and not being able to convert it for whatever reason. History is more than likely bound to repeat itself.

    guysgrams, how are your nutrients? Cortisol? Do you have Hashi's?

  • Brilliant answer GG ,you are sooo well informed ,another gold star haha!!

  • Thank you, sunny. :)

  • Yes, I have hashi. Nutrients are good and am getting ready to verify again. Cortisol hasn't been tested in about a year. At that time my levels at night were low at dinner and then high at bedtime. Levels in morning were ok but noon time started going down. I was wondering if I should be staying on the T3 only and raising the dose but I would have to acquire elsewhere as my script does not allow for that kind of dose per day. When using only T3 does T4 go real low like it did on my test?

  • Yes, it does go low, because if you're taking T3 'ready-made', you don't need so much T4 and the body doesn't hang on to so much. But, if you keep trying to raise it, when you can't convert it, then the body uses plan B, so to speak, and converts it into rT3.

    rT3 is, basically, a safety valve for the body, when conditions are dire - sickness, famine, etc - so that you are forced to rest. But, if you have too much unconverted T4 sloshing around, and the body doesn't want to waste it, it will convert it to rT3. The rT3 will eventually be converted to T2, so the hormone isn't wasted, but, in the meantime, it might clog up the T3 receptors. It can't pass through them, because it's the wrong shape, so it gets stuck, meaning that the FT3 can't get into the cell, which will make you more hypo temporarily. So, it's not good to have an excess of T4.

  • Am I correct in thinking we do need some RT3 in our system it is just not good to be over loaded with it? Thanks for the advice. I do not want to get back to that overload point again. Baby steps, right?

  • It's not that we need it, as such. We just need to be able to produce it if necessary. But there usually is some in the system.

    Yes, baby steps all the way, I'm afraid!

  • Thanks so much Greygoose

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