Should I add T3 to NDT

[Geminichica]

Started NDT 6 weeks ago 1/2 grain morning/afternoon, and after about 10 days increased to 1.5 grains per day then 2. Defo felt more motivated (if not less tired), but soon after went downhill, now am on 2 grains per day and feel dizzy all the time and even more exhausted than usual, extremely irritable and snappy, swollen ankles, blood pressure is low (checking it several times per day), I also had perfect 120/80 blood pressure. I was thinking to add T3 to help flush out RT3 which showed on blood results. In the meantime as I suspect weak adrenals I have ordered the saliva cortisol test but I need to act now, I seriously can't function like this, I was so nervous driving earlier with my kids in the car. Any advice for me?

[SlowDragon Administrator]

Just looked at your old test results. Your vitamin D was low. Do you supplement? If so do you also take magnesium (recommended)

How's your vitamin B12, still supplementing. Also recommended to take good Vitamin B complex if taking B12

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Was your high ferritin ever investigated?

Selenium supplements can help improve conversion

Vitamin C daily to support adrenals.

Don't want to increase dose to much or too frequently, it can make adrenals worse

Definitely avoid kelp

[greygoose]

I think you've increased rather quickly, don't you? What were you taking before NDT? Adding in T3 if you don't need it is not going to 'flush out' rT3, it's just going to make your FT3 too high. Is your FT4 over-range?

[Savysofa in reply to greygoose]

restartmed.com/reverse-t3/

[greygoose in reply to Savysofa]

Yes, I know that article, and Dr Westin Childs is wrong. Since he wrote that article, there have been new discoveries made in that field. The problem with these medical bloggers is that they don't go back and correct or delete when science advances.

[threenme86 in reply to greygoose]

What's the updated science? I'm curious and I'm suffering terrible from Reverse T3 issues. What should be done instead?

[greygoose in reply to threenme86]

No, you're not suffering from 'Reverse T3 issues' because rT3 is inert. It doesn't cause symptoms. It only stays in the body for about 2 hours before it is converted into T2. And, it doesn't block T3 receptors, it has its own receptors.

But, I really can't say anymore without seeing your blood test results for FT4 and FT3.

[threenme86 in reply to greygoose]

Thank you for your reply I. Free T3 is 2.2 and free T4 is 1.30

[greygoose in reply to threenme86]

Sorry, but results are meaningless without ranges.

[threenme86 in reply to greygoose]

May I ask why you don’t agree with the RT3 issue? I get sicker the higher it goes and i feel better when it’s lower. My RT3 is 20

[greygoose in reply to threenme86]

Well, if your FT4 is high, and you're not converting it to T3 - which I cannot tell without the ranges - it's not the rT3 that's causing you to be sick, it's the lack of T3. As I said above, rT3 is inert. It doesn't do anything. So, it cannot be the cause of you getting sicker. It's whatever is causing your rT3 to be high - and there are many, many causes - that is also causing you to be sick. So, the two factors would rise in tandem.

[threenme86 in reply to greygoose]

I’ll give you the ranges but I’m not a fan of ranges. Doctors tell me I’m within range yet I can’t walk or talk most days .... I believe in symptoms more than I do ranges. The FT3 Range is 2.0-4.4 free t4 range is .82-1.77

[greygoose in reply to threenme86]

FT3 2.2 (2.0-4.4) 8.33%

free t4 1.3 (0.82-1.77)

50.53%

You may not be a fan of ranges, but I can't feel your symptoms, can I? And, the trouble with symptoms is that so many of them can be caused by both under-medication and over-medication, so you do need labs to back them up. And, the only way to tell if the result is high or low is to look at the ranges.

What doctors don't understand is that just being 'in-range' is not a recommendation in or of itself. And, you really don't need to go to med school for 7+ years to see if a result is in-range or not! That's obvious. But, it's where in the range that result falls that is important.

So, what do those labs tell me? First of all, that your FT3 is much too low, so not surprising you're sick. It should be more like 60 - 75% (depending on the person).

Your FT4 is just a fraction over mid-range, which is still too low for the majority of hypos. So, you're under-medicated, but also a poor converter.

And, it tells me that that your high rT3 is not caused by your thyroid problems. Your FT4 is too low for that. It would need to be up the top of the range to be resposible for high rT3.

As I said, there are many, many causes of high rT3, and only one of them has anything to do with thyroid. Other conditions that contribute to increased Reverse T3 levels include:

* Chronic fatigue

* Acute illness and injury

* Chronic disease

* Increased cortisol (stress)

* Low cortisol (adrenal fatigue)

* Low iron

* Lyme disease

* Chronic inflammation

* Selenium deficiency

* Excess physical, mental and environmental stresses

* Beta-blocker long-term use such as propranolol, metoprolol, etc.

* Physical injury is a common cause of increased RT3

* Viruses, such as flu

* Starvation/severe calorie restriction

* Mistreated diabetes

* Cirrhosis of the liver

* Fatty liver disease

* Renal Failure.

* Fever of unknown cause

* Detoxing high heavy metals levels

* Etc. etc. etc.

So, maybe one of those rings a bell, and it would be that you'd need to work on to reduce your high rT3.

[threenme86 in reply to greygoose]

Thank you! I needed good advice. I ordered Cytomel actually Mexican version because doctors refuse to help me. They say my labs are within range and I just have anxiety.... it’s been hell. I’m on 60mg of NP thyroid a day and have low cortisol issues (I take hydrocortisone cream because I have severe gi issues) ... so I’m buying Mexican drugs and praying. I plan on adding T3 to my NDT dose I just don’t know how much. I also found out I have severe Mold Toxicity so I believe that to be the underlying cause of the RT3. I appreciate you responding. It means the world to me. I’ve been in and out of the Emergency room for months and through 12 doctors and even had an endo tell me my labs are fine and refused to see me. I’m slowly dying and nobody helps

[greygoose in reply to threenme86]

Glad to be of service.

With hormones, it's always best to start low and incrase slowly until you reach your sweet-spot. You will know when you do. So, if I were you, I'd start with a quarter tablet - I imagine they are 25 mcg, yes? - stay on that for a couple of weeks and see how you feel. If you feel you need more, add in another quarter. And, proceed like that until you feel well.

[threenme86 in reply to greygoose]

Yes. I ordered the 25mcg and I will be starting out on a quarter of that to see how it works. I can't tell you enough how nice it was to hear from someone that actually knows what they're talking about. Thank you.

[greygoose in reply to threenme86]

You're very welcome.

[threenme86 in reply to greygoose]

Will the addition of T3 to my NDT help my heart rate? I'm sitting here and my heart rate is around 53 beats per minute.... my blood pressure is low... I feel so bad. I'm praying the T3 will help whenever I get that.

[greygoose in reply to threenme86]

Well, it should help, because low blood pressure is a hypo symptom. But, there are never any guarantees.

[helvella Administrator Thyroid UK in reply to threenme86]

Being a slave to ranges is poor medicine, but you need some way of discussing results as, without any form of range, they are just numbers.

You just might find the article below (and the full paper which you can access) interesting and/or useful.

The normal range: it is not normal and it is not a range

1. Martin Brunel Whyte

2. Philip Kelly

Abstract

The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.

dx.doi.org/10.1136/postgrad...

pmj.bmj.com/content/94/1117...

[threenme86 in reply to helvella]

Great article! Thank you.

[jamesal0]

Hi Gem

Couple of points - as per gray goose you increased a little quickly. NDT is great stuff but it needs a healthy body to take large doses, hypo's and people who have been on Levo for long periods are often quit run down. So when you start NDT you need to ease into it slowly and let your liver, kidneys and other organs repair. Once they get better you will be able to increase NDT dose. I would do an experiment, for 2-3 days just take 1 grain per day, do you feel better ? Then for 2 or 3 days take 1/2 grain more than you are currently on. Do you feel worse. Choose a dose where you are border line ok. With NDT (you) don't worry too much about blood tests in the first 6-12 months (your GP may/will) , go on how you are feeling, just try and increase 1/4 or 1/2 a grain extra per day every 3-4 weeks. Decide if you can stay on that or need to fall back. As time goes of you will slowly increase. Example - I'm on between 3 and 3,5 grains per day depending on what I'm up to and how cold it is (after 2 years on NDT). I slit dose 4 ways, if I don't I feel dizzy and fluey . Some people can take it all at once but not me.

Regards

J

[NatChap]

As others have said I think you've increased a bit too fast. I increased 1/4 grain per week until I got to about 2 grains and then I held for about 8 weeks as Trying to increase further was causing hyper symptoms which I discovered was due to high cortisol. I addressed that and then began increasing 1/4 per month until I got to where I am now (4grains). It's a slow process and things like vit d, b12, ferritin, cortisol all need to be addressed in order to get the most out of NDT.

[NatChap]

Also, I recommend keeping a diary, it makes it much easier to track dose raises, symptoms etc..and see what may be causing what.

[Rapunzel]

thyrophoenix.com/adjusting_...

Way too soon for you to be thinking of adding T3. Give NDT a chance and don't increase so quickly. Patience, Gem.

[Geminichica in reply to Rapunzel]

Wow what a brilliant explanation, what would you recommend to do, cut it out for awhile and then start over or stay back at 1 grain per day?

[Geminichica]

Thanks for all your comments.

@ SlowDragon, yes take B12 (Solgar sublingual liquid B12 with complex) & Vit D. Ferratin am told nothing wrong, have pushed her and being referred for more testing on it, have appt on Monday. Its clear now that I increased too fast. Back to 1 a day to try feel better.

Magnesium I dont take, can you recommend a good supplement? also same for selenium & vit C. Had been taking kelp previously but not for a few months now.

greygoose thats what advice I have read on several articles so thought it was the way to go. FT4 is low 1.17ng/dl (0.89-1.76). Was not on anything before as they have always told me I was fine within range.

[greygoose in reply to Geminichica]

As your FT4 is low, I doubt your rT3 is very high. It's perfectly normal to have some rT3, everyone does.

It used to be thought that rT3 blocked T3 receptors so that T3 couldn't get into the cells. But, latest research has found that that is not so. RT3 has its own receptors and doesn't block the T3 receptors.

If you weren't on anything at all before the NDT, then you really did increase too fast, and by too much at a time. Which is probably the root of your problems.

[Geminichica in reply to greygoose]

My RT3 is 14 and optimal at 11 or under. Ok so do you think I should cut it out for awhile completely or stick back to 1 grain per day?

[greygoose in reply to Geminichica]

I don't think your high rT3 has anything to do with your NDT, because your FT4 isn't that high. Perhaps you have some sort of virus, or something. Go back to one grain and stick with that for a couple of weeks, then see how you feel.

[Geminichica in reply to greygoose]

Ok will do, thanks for your advise x

[greygoose in reply to Geminichica]

You're welcome.

[SlowDragon Administrator]

Calm vitality magnesium powder is cheap and easy to use and widely available

Vitamin C - personally I prefer Solgar Ester C as it's gentle on digestive system

Selenium - I like a Solgar vitamin E with yeast free selenium.

I am sure others will have different suggestions

[Geminichica in reply to SlowDragon]

Thank you very much, always prefer to go on a recommendation x