Prior to July was on 50mcg Synthroid daily plus 2 extra. Labs RT3 34.5 T4F 1.76. T3F 2.69 TSH 1.42 ..Dr took away 2 extra 50 Synthroid added 5 mcg T3 ..Retesteted 6 weeks. RT3 27.2 T4F 1.27 T3F 2.7. TSH 2.69. She reduced Synthroid to 25 mcg day and added 10 mcg T3 I took this 3 days was so sick. Dr then upped Synthroid to 50 daily and 5 mcg T3. Retested Labs after 2 weeks Labs RT3 23.4. T4F 1.34. T3F 2.7 TSH 2.72.
She now has me on 50 mcg Synthroid and 7.25 T3 for last 9 days. I feel short term memory, cog fog, shakiness in hands etc. Should she have lowered my T4?
What do you think ? Im scared and having hard time thinking..Also on 15 mg Lexapro for 15 years. Any thoughts on what to do?
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Oberley
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Did you feel well on Synthroid only? If so, I would go back to doing what made you feel well, although it looks like you'd need a little more Synthroid judging by last blood tests.
I have not felt well for over 2 years. My Reverse T3 has been high since then. But Drs. Did not address it. It wasn’t until July that I researched high revese T3 and told Dr that something needed to be done to get the RT3 down to a ratio of 20.
Just not sure if what Dr is doing is going to help since she keeps changing meds so often.
I know T3 added is supposed to help somehow in reducing high RT3. Also that T3 can cause nervousness in some.
Oberley, the high rT3 is not the problem. It's just an indication that something else is wrong, somewhere. But, impossible to know where without the ranges for all those labs.
It sounds as if your doctor knows very little about thyroid. Keep jumping the dose around like that is not going to help - although you give no indication of the time scale. You need to give things time to work.
There are several possible reasons for high rT3, but the main one is that you are a poor converter, and have too much unconverted T4 in your system. Therefore, the T4 should be reduced and T3 added.
Your doctor was doing that, and it was good. But, it sounds as if she panicked and lost control at 10 mcg T3 because you were 'sick'. What sort of sick? Why do you think it was due to the T3? It could have just been a coincidence.
Anyway, now it would seem, you're back to square one, and under-medicated. But, difficult to make any suggestions without the ranges to your labs.
But, rest assured, there is no reason to panic about high rT3. It doesn't do anything much. Your main problem is likely to be low FT3.
Your on the MARK once again .The FT4 is high the FT3 is low and the TSH is high too . Most feel best at I or a bit lower . Nutrients are very important too . Selenium for conversion . Vitamin "D" B-12/folate , Iron helps with conversions too and can help lower RT3 . Magnesium is important too here .
Thanks for responding greygoose. She did reduce in July my T4 by taking away the 2 extra says.
TSH 2.69 Sept (In July was 1.42). uIU/ ml 0.450-4.5
FT4 1.27 September (In July was 1.76 ng/dL 0.82-1.77
FT3 2.7 September. ( in July 2.6) pg / ml 2.0-4.41
RT3 27.2 September (In July 34.5) ng/dL 9.2-24.1
When she reduced my Synthroid to 25 mcg and added the 10 mcg I took this for 3 days and was feeling very overstimulated almost hyper nervous anxiety. So the 4 th day I took 50 mcg S and 7.5 T3 called her she said go down to 50 mcg S and 2.5mcg T3 for the rest of week . Then she ran labs to see what was going on .
The last labs were from 3weeks ago... RT3 23.3 T4F 1.34. T3F 2.7
And TSH was 2.72. Same ranges as above.
With my T4 being high in July at 1.76 and my RT3 at 34.5 thats why she said I wasnt converting at a cellular level. So she took away the 2 extra days that I took 50 mcg..... I was on 50 mcg each day and had extra 50 on Sunday and Wednesday. And added 5 mcg of T3.. My RT3 came down a little then.
So right now Im on 50 mcg Synthroid and 7.5 Cytomel.
I just want to get my RT3 down to a ratio of 20 I believe you divide your RT3 bt T3 to get ratio. Plus I feel better when my TSH is close to 1.
And T3 upper range, T4 Upper 1/4 range. But not sure how to get this accomplished..?
Hi - well reducing the t4 helped as your ft4 went down and ft3 up, however t3 comes with its own challenges. It is a hard taskmaster and will magnify the effect of any nutritional deficiencies. I haven't looked back through your earlier posts - do you have recent results for vit d, vit b12, folate and ferritin? Important to have all these optimum.
Generally the way to accomplish raising the freeT3 is to take additional T3 tablets.
When you had your first dose change it was a slight increase overall in medicine. You reduced 100mcg of Synthroid per week, and added 35mcg of T3. The relative potency of these is quite fuzzy, but it's often said to be 3x or 4x as potent. I find my TSH very closely correlates with dose increases, so it seems like your body has found this to be a bit of a decrease.
The second dose change reduced you by 25mcg a day of Synthroid (this is 175mcg per week - almost double your previous change), and an identical increase of T3, 5mcg per day, or 35mcg per week. So this time you had a substantial dose decrease. You're already undermedicated, so you will have been even more undermedicated after this change! No wonder you felt sick.
The restart after two weeks doesn't add anything - there's no point testing when you've been chopping and changing doses, your body will be in a surprised state and showing strange results.
I think the reasonyou're feeling strange is that this is the first time in the process you've had a real dose increase. This is what you need, and it will be good to see the blood test in 5 weeks as you may start to get good changes.
This is a process that takes a long time, and you can feel worse before you feel better. This increase is supported very much by your blood tests and your previous experience trying to change dose. So this is partly a judgement call, if you're able to hold on for 6 weeks that's the right thing to do. Things will likely settle down and it will become easier and easier.
The other possibility is that you have the problem of being unable to tolerate the amount of hormone replacement you need. This is something that sometimes comes up on the forums, and can be treated. The first step is to make sure your vitamins and minerals are in excellent shape. Folate, ferritin, Vit B12 and Vit D are the first to look at. Post these in a new thread of you have results and members will advise. The rule of thumb is they need to be about halfway up their ranges, although doctors will often fob you off of they're just inside the range. You can also try daily increases that are absolutely tiny, half what you're currently doing.
Just to give you some comparison with my own experience, I have been raising my dose for 2 years. I increase by half a grain of NDT each time, this is 4.5mcg of T3 plus 19mcg. So your increase is actually pretty small. I've found I sometimes feel a little overmedicated a few weeks after an increase, I'm not sure if that's what you're feeling, but if so I have found increasing my activity a little gets me over it. For me this means going for a walk for about a km or less.
I can add little to the information given above, but I would like to say that taking T3 alone does no harm. Cytomel (pure T3) is often given straight after a thyroidectomy and I have to say that I never felt better than during those first 3 months after my total thyroidectomy. I imagined I was going to be ill and have a slow recovery, but no, I felt great within a couple of days. I tell you this because one of the ways to bring down reverse T3 is to go on T3 only. I think your doc is reading the right books and research papers, I think she is a little nervous though, like greygoose said.
It is also essential to bring your nutrition up to par, especially the catalyst Selenium which stimulates the conversion of T4 to T3. One other small detail, you say that you are on Lexapro. This is given for anxiety and depression. T3 is often prescribed for problems of this nature and other mental type illnesses and it has proven itself very effective. So, stick with the doc in increasing T3. (Keep an eye on your blood pressure though - that's it's only drawback but not everyone is affected in that way - (I am!))
Lahs thanks for taking time to reply. Im a little anxious as to these changes, adding the T3. I really thought I would be finding some relief by now. I don’t quite understand why I reacted so bad when Dr reduced T4 from 50 to 25 (Synthroid) and added 10 mcg of T3.
Perhaps Im sensitive to adding T3 so quickly. After 2 weeks now of 50 Synthroid and 7.5 Im still feeling no relief.
My Dr said she doesn’t believe going to T3 alone is safe that it can cause an aray of problems. I have to wait 3more weeks before labs will be rechecked. Do you think I may see any improvement?
I don’t know if she will reduce Synthroid a little or if she will add more T3.
I worry about being on the Lexapro for 15 years now I feel it should never have been on it this long and Im in tolerance to it.
I want off it, but everything about getting off it is so scary on the internet. I probably never needed it years ago had the first Dr never checked thyroid.
Im glad you are doing good with the T3. Youve been through a lot! Just wish I could figure out all this and getting off Lexapro safely . And getting my Thyroid in sinc. I have a feeling that SSRI AD can mess with Thyroid levels. .?
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