Having completely given up on my GP who unfortunately won't even refer me to a specialist I am going it alone. This is an excellent website !! But I'm still a little confused as to which path to take.
basic background
I have a range of symptoms e.g. always cold, difficult to lose weight etc and my bloods indicate that I have a high reverse T3 with a low ratio (see bloods of relevance below).
I do have leaky gut and a couple of autoimmune diseases which I control very well by diet. I know when I've eaten something I shouldn't because I have an instant flare up.
I have also had a scalp biopsy which shows I have 'female pattern hairloss' however, I have researched this and thyroid could mimic this also. My thinning whilst worse at front and crown has also become diffuse all over recently.
My bloods are as follows:
Thyroid function range
TSH 2.28 0.27-4.28
T4 Total 80.2 64.5-142.0
Free T4 14.64 12-22
Free T3 4.20 3.1-6.8
Reverse T3 21 10-24
Reverse T3 ratio 13.02 >20
Immunology
Ant-Thyroidperoxidase 8.8 <34
Anti-Thyroglobuli anbs 12.1 <115
Other Endoctrinology
FSH 12.3 3.5-12.5
LH 7.5 follicular 2.4 - 12.6
mid 14 - 95.6
luteal 1 - 11.4
I do have normal periods etc I'm unable to recall at which stage in the cycle I was tested.
17-beta oestradiol 77
Follicular 98-571
Mid 177-1153
Luteal 122-1094
Based on my RT3 ratio I believe I am hypo at the cellular level.
I'd love to know more, which T3 meds to take, how to source them (I couldn't afford £240 per month, so paying privately is not an option), whether you can use T3 to 'kick start' or if you need to take it forever.
Huge appreciation for any nugget of advice at all.
thank you
Written by
Bevyg
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Hi and welcome to the forum. Your test results show that you are under-medicated. The aim of t4 treated patients is to have tsh around 1 or even below, with ft4 in top quarter of range and ft3 in top third, or whatever level is required to relieve symptoms. It can take a few months after you reach good biochemistry to feel better. For effective use of thyroid hormones, it is important that vit b12, vit d, folate and ferritin are at fairly high levels, not just in range. Do you have any results for these?
Your rt3 is in range and the ratio is only low because your ft3 is low. RT3 is your body's braking system, the body produces it to slow you down to allow recovery time from illness, for instance, or to conserve energy if you are on restricted calories. I wouldn't worry about levels until you get to an optimum thyroid level. Hypo at cellular level is relatively rare and should be considered only after all levels - including nutrients - are optimum, you have had several months of this and you still feel bad. So too early for that.
It is possible to self-medicate with t3, many of us do, but I would recommend you sort everything else first as 85% do fine on t4 only and that really is the easiest path.
Thank you startagain, My GP says I am fine. I’m not even on any medication at all. BecuSe all the ‘usual’ Thhroid tests are within range. Maybe I should pay to go privately ?
I do have absorbtikn problems I was low on iron and very low on zinc. Now prescribed high doses of both and well within range now. On the higher end. B12 is fine calcium and vit d we’re low and I had cracking nails etc but I manage all this myself now. And that is all good. Nice string nails. I started taking a good quality vit e as I had really dry skin. I d been taking for about four months and my dry skin is so good now and it has resolved my lethargy. I still have many other symptoms but the ones I’d like to sort the most are my hair and my coldness. Even in the summer my hands and feet are painfully cold.
You are undermedicated. It's worth asking your GP to increase dose before you selfmedicate. A dose increase will raise FT4 which will also raise FT3 and will lower TSH.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
rT3 21 is within range so it is not high and high or low rT3 ratio is not an indicator of good health. tiredthyroid.com/rt3-3.html
Thanks clutter. my GP says I am fine. I’m not even on any medication at all. BecuSe all the ‘usual’ Thhroid tests are within range. Maybe I should pay to go privately ?
Sorry, Bevyg, I assumed you were taking Levothyroxine and were undermedicated. Your results are euthyroid (normal) for someone not on Levothyroxine replacement and don't indicate thyroid dysfunction. Some private doctors might diagnose hypothyroidism when TSH is >3.0 but I don't think they will when it is lower than that. Most, like NHS, will diagnose hypothyroidism when TSH is over range or FT4 under range.
Ask your GP to check ferritin, vitamin D, B12 and folate. Low/deficient vitamins and minerals can cause symptoms similar to hypothyroid symptoms.
Were bloods done early in the morning, fasting. Are you taking multivitamins, multi b vitamins and/ or biotin as these can give false low TSH and false high ft3 ft4. also get b12 folate ferritin and vitamin d checked you need them to be optimum not just 'in range'.
Thank you fibrolinda, I had a full vitamin check. Calcium and oleic acid were low out of range although I’ve sorted calcium out now as my shin splints have gone as have my flaking nails. Iron zinc b12 all very good. BecuSe I’m prescribed high doses. Other vitamins all pretty low but just within range
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