PLEASE HELP ME UNDERSTAND BETTER.....

[rap16992]

Hello all. I have finally decided to write as I need some help from others. I am taking NDT....1 (60) grain in the morning and 1.25 (75) in the afternoon. My latest lab results as follows:

TSH (mcIU/mL 0.4 - 4.0) - 0.629

FT3 (pg/mL 1.8 - 4.2) - 3.24

FT4 (ng/dL 0.8 - 1.9) - 0.76

RT3 (pg/mL 90 - 215) - 63

ATPO (<35) - 459

Not sure how to proceed further as I do not feel as good as I did several months ago when only on T4 at 88 per day. Sure hope someone can point me in the right direction with my next step.....DR informs me add some T4, is this right? Please help me understand better. Thank you!

[Mary-intussuception]

You T4 result is LOW isn't it - below range.

What do you think?

[Mary-intussuception in reply to Mary-intussuception]

Sorry -

FT4

[rap16992 in reply to Mary-intussuception]

I have seen online where low FT4 is of no concern when on NDT, but I also ran across a website that leads me to believe that I need to increase T4 input to further expand the ratio of T4:T3. I hope that I am explaining myself accurately. The premise being that NDT alone is 4:1 ratio and since I felt better on T4 alone and always thought I needed more T4, before switching to NDT, I am thinking about changing my NDT dosing down from 2.25 grains per day as identified in my OP to only 1 grain daily, but re-adding back 44 mcg of T4.....half of my original 88. This would even out my T4:T3 ratio to about 9:1. My next step being, if necessary, to add in a bit more T4 to expand the ratio even further.....next step to 12:1. Does this make any sense to anyone out there?

[Clutter]

Rap16992,

You could increase dose by 30mg to see whether symptoms improve. Most people taking NDT feel better with FT3 higher in range which will usually mean TSH is below range. FT4 is often low when taking NDT so nothing to worry about there.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

[rap16992 in reply to Clutter]

Yes, this was actually going to be my next step.....increasing my NDT up. However, I believe that I am feeling worse as I increase and that I felt best when on T4 alone. I thought I needed to increase my T4 previously and then found out about NDT and went that route instead.....wondering now if I should have stayed on T4 and increased instead. Now I am thinking of staying on NDT but also adding more T4 to expand the T4:T3 ratio.......see my reply above. Does it make any sense at all?

[Clutter in reply to rap16992]

Rap16992,

It doesn't matter what you take, if you're not taking enough you won't feel well. You can either increase your NDT dose as I suggested or add in some T4. It's entirely up to you.

rT3 is within range so there's scope to increase either NDT or T4 without pushing it too high.

[rap16992 in reply to Clutter]

Not understanding how my RT3 is in range when bottom of range is 90 and my result is 63. This is where I need help as my FT3:RT3 ratio is only 5.1 when I have seen online it state that it should be higher than 20....maybe I am not reading this correctly online and I would appreciate any learning you might provide on this specifically. This is why I am thinking I need to expand my T4:T3 input ratio from current 4:1 to at least 9:1 for starts.

[Clutter in reply to rap16992]

Rap16992,

Sorry I misread. rT3 is below range but it doesn't matter. It is high rT3 which can be problematic, not low rT3. I really don't know much about rT3 but according to this link rT3 ratio is no more an indicator of good health than TSH is. tiredthyroid.com/rt3-3.html

[rap16992 in reply to Clutter]

Yup, already read this and another reason I am leaning more towards expanding my T4:T3 ratio from current 4:1 with NDT straight to decreasing NDT and adding T4 to expand the ratio to 9:1. "Lowering the desiccated thyroid dose and adding T4 has lowered rT3 levels in some patients. These people report improved reverse T3 ratios on higher levels of T4 and say they feel more “balanced” with the additional T4." Just so much info out there and some contradicting others.....looking for support in my next decision and you have stated above either way, it is up to me. I take that as either way is OK.....not going to really screw myself up.....I hope not.

[Clutter in reply to rap16992]

Rap16992,

No, I really mean either way is okay. You will have to try both ways to know which is best for you. If I thought you were doing something that would screw you up I would have said.

[rap16992 in reply to Clutter]

Yes I believe you would have. That is why I decided to comment here looking for input and I really appreciate it. I will be starting my new dosage this week and will post back later as it goes.......just like this "special" journey I am on.

[rap16992]

Any comments/input regarding the RT3???