RT3 30 TSH 6.8 Advice please on latest bloodwork.

[nagasakih2o]

Hi Folks, First post so hello, great community

Could anyone please cast their eyes over my latest lab work and recommend where I go from here. Do I need more T4? If so, will that not increase RT3? Do I introduce T3?

I'm on 75mcg levo eod then 50mcg levo eod

Many thanks

TSH: 6.88 mIU/L (0.27- 4.20)

FREE THYROXINE: 17.6 pmol/L (12.00 - 22.00)

TOTAL THYROXINE (T4): 83.3 nmol/L (59.00 - 154.00)

FREE T3: 4.08 pmol/L (3.10 - 6.80)

REVERSE T3: 30 ng/dL (10.00 - 24.00)

REVERSE T3 RATIO: 8.85 (15.01 - 75.00)

THYROGLOBULIN ANTIBODY *373.000 IU/mL (0.00 - 115.00)

THYROID PEROXIDASE ANTIBODIES*152 IU/mL (0.00 - 34.00)

VITAMIN B12 396 pmol/L (140.00 - 724.00)

FOLATE (SERUM) 14.26 ug/L (2.91 - 50.00)

25 OH VITAMIN D 65.9 nmol/L (50.00 - 200.00)

Inflammation Marker

CRP - HIGH SENSITIVITY 0.1 mg/l (0.00 - 5.00)

FERRITIN 80.6 ug/L (30.00 - 400.00)

[ITYFIALMCTT]

Can you edit your post to include the ranges for each test, please (typically given in brackets). Ranges vary from one lab to another, depending on their equipment and the assays that they use so ranges are necessary for interpretation.

[nagasakih2o in reply to ITYFIALMCTT]

Will do thanks

[Nanaedake]

Hello Nagasaki, please could you add the laboratory ranges which you'll find are the numbers in brackets next to the blood test result. Labs vary so we need the ranges to make sense of the results. We'll be able to make better suggestions then.

[nagasakih2o in reply to Nanaedake]

Done

[Nanaedake]

I would say in my non-expert opinion, judging by the mid range FT3 that you need a dose increase and if it were me I wouldn't worry about the RT3, it shouldn't rise unduly if T4 is converting to T3 which you'll only know when you're optimally dosed although someone more knowledeable on T3 levels might be able to give a more definitive answer.

Most people don't feel well until their TSH is 1.0 or a little lower. Do you have thyroid antibodies? If so, then post the results here too. In addition, you need to have vitamin D, folate, ferritin and B12 levels tested as all can be low in people with thryoid conditions. Ask the GP to test those and give the GP a list of symptoms as the reason why they need testing. There is a lot of good scientific research on vitamin D deficiency evidencing it's more prevalent in people with thyroid conditions

[nagasakih2o in reply to Nanaedake]

Have you confused my post with someone's dad lol?

Thanks for the input anyway

[Nanaedake in reply to nagasakih2o]

Haha, you're right, I'm going thyroid gaga!!! And old age combined!! I'll amend now but the advice is the same...

[nagasakih2o in reply to Nanaedake]

Haa many thanks. I've added in more information you suggested.

[Nanaedake in reply to nagasakih2o]

Ok, so you have autoimmune thyroid condition which means you have Hashimotos thyroiditis. There is good information about it on the Thyroid UK website which you might already have read.

I don't know whether you've been taking vitamin supplements or not but vitamin D is still on the low side and could be increased to mid range, especially now we're coming into winter unless you're in a hot sunny country.

B12 is best top of range and folate should be mid range so there is still room for improvement. Have you got a ferritin result or an iron panel?

[nagasakih2o in reply to Nanaedake]

Yes I'm in the UK so aware of upping Vit D for the winter. I have to be careful as I get headaches if I increase too much. I take a spray 1000IU per day, if I up to the 3000 that's when tension and headaches kick in. Other than that, no other vitamin pills. Just try and eat as healthy as possible.

[Nanaedake in reply to nagasakih2o]

It's good that you eat a healthy diet, however, with Hashimotos sometimes the gut doesn't function terribly well and it causes absorption problems for getting vitamins out of food and into your blood and also low stomach acid which can seem like high stomach acid because of acid reflux can cause problems. So it might be worth looking into probiotics if you have any gut problems. Some people take a desert spoon of organic apple cider vinegar with a glass of water before their main meal.

[nagasakih2o in reply to Nanaedake]

Added in Ferritin

[Nanaedake in reply to nagasakih2o]

Ferritin is better mid range so with the range you've given you could increase to 150. You do have to be cautious not to overdose on iron as your body stores it but some reserve is good. Take iron at least 4 hours apart from levvothyroxine and take it with vitamin C to help prevent stomach discomfort. I take 1000mcg of vit C with it.

[nagasakih2o in reply to Nanaedake]

Thanks for your help, much appreciated.

[Nanaedake in reply to nagasakih2o]

Oddly, the advice on the NICE website is not to take vitamin C with iron supplements so read it and make up your own mind.

cks.nice.org.uk/anaemia-iro...

[Roadrunnergreg]

Your B12 and folate are Low even though in range. RT3 being high is T4 being diverted. I'd say you've a critter in there that needs dealing with wether it be Candida EBV H Pylori etc. Plus check on Zinc and copper levels too, odds are zinc is low and copper high. Get rid of the critter and balance copper and zinc and the thyroid should function normally again.

Here's why you need Zinc and copper levels checked, generally if you/We have low thyroid levels Zinc is low, because low zinc suppresses Thyroid hormones, and copper feeds the critter/s plus copper overload suppresses Zinc. Theseare where I'd start it seems a common scenario with Hashimotos or graves, the critter creating havoc on the thyroid is why people can and do yoyo from Hashimotos to Graves etc good news the body hasn't just decided to attack itself, it's just something that needs identifying and sorted. Hope that helps...