What's ur advice on this result please? X

[Holza]

Hi guys I finally have my endo appointment tomorrow and just wondered does this result mean I'm not converting to t3 and do you know what range it should be please xx

[jimh111]

Reverse T3 is of little use and certainly not just by itself. Do you have TSH, fT3, fT4 ?

[Holza in reply to jimh111]

Hi yes I do I can't seem to post list on this reply but if you look at my profile I think it's there thankyou x

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT3 and FT4, plus vitamins

[jimh111 in reply to SlowDragon]

Your TSH 3.05, fT3 3.9, fT4 15.2 indicates you need an increase in your medication. The reverse T3 figure tells you nothing, the companies marketing this test claim it tells you about T4 to T3 conversion so they can justify selling it.

Important! Your profile says you are pregnant, you need your levothyroxine increased straight away to bring your TSH below 2.5. If the above results are from before you became pregnant you need an increase of at least 50 mcg. Insist your levothyroxine is increased as you are pregnant. Don't take 'no' for an answer. Maybe take your partner along for support.

[Kell-E in reply to jimh111]

Not everyone agrees with you regarding rT3 Jim.

So then the statement this statement is attributable to Rudolf Hoermann? Is this his current thinking?

Reverse T3 is not an inactive metabolite as has long been thought, rather it acts as a T3 blocker. Our whole view on the non-classical hormones has dramatically changed in recent years and new roles are emerging (Hoermann et al. 2015).

diogenes

diogenesin reply to Kell-E

Yes I think so, but exactly how rT3 interferes is still up in the air. It isn't at the receptor level so must be in the biochemistry of T4-T3 conversion somewhere.

[jimh111 in reply to Kell-E]

rT3 is important, it blocks the action of T3 although we don't quite know the mechanism. However, the rT3 number is not much use, especially in isolation. We don't know how rT3 numbers relate to symptoms and what the interaction with fT3 is. So, rT3 is important but knowing the rT3 figure doesn't help much.

[Kell-E in reply to jimh111]

Um, you said, 'The reverse T3 figure tells you nothing, the companies marketing this test claim it tells you about T4 to T3 conversion so they can justify selling it.'

So, if someone had a TSH of 100, this would not be much use in isolation?

[jimh111 in reply to Kell-E]

Whether or not an rT3 figure is useful in isolation has no bearing on whether TSH in isolation is useful.

A TSH of 100 in insolation would tell you that you probably had primary hypothyroidism, but it could be a pituitary tumour causing hyperthyroidism or rarely a genetic mutaton of the thyroid hormone receptor beta gene. The free hormone levels, signs and symptoms would confirm the correct diagnosis.

Numbers from tests, including blood tests, having varying usefulness. it's then a matter of seeing how useful each parameter is and how it can be interpreted. I don't know of any study that has demonstrated a numerical link between rT3 and symptoms. In the case of conversion you have to define which deiodinase you are referring to D1, D2 or D3. Both D1 and D3 produce rT3. D1 and D2 produce T3.

rT3 is elevated in some thyroid conditions such as elevated fT4 as well in as non-thryoidal illnesses such as major burns, cardiac arrests and severe depression. It can be useful to know if rT3 is very high but noone knows how a specific rT3 level relates to hormone activity.

Just to clarify the role of rT3. It used to be thought it inhibited T3 action by 'dominant negative' binding to T3 receptors, that the rT3 bound to the receptor thus stopping T3 from doing so. Some research showed this not to be the case. It is thought (not known) that rT3 disrupts T3 binding to receptors by some other mechanism.

[Holza]

Thankyou this test was done since I'm pregnant I am taking 100mg Levo now iv just been trying to find out if my results showed that I needed to change my meds I feel so unwell can't understand it x

[greygoose in reply to Holza]

You feel unwell because your FT3 is too low. Could you possibly type in the ranges to those results? That will tell us how well you're converting.

[jimh111 in reply to greygoose]

Results are here healthunlocked.com/thyroidu... . I didn't have time to put in reference intervals.

[greygoose in reply to jimh111]

But, jim, I wasn't asking you, I was asking the OP.

Thanks for the link, anyway.

[jimh111 in reply to greygoose]

I know but I posted the figures without the reference intervals so I bear some of the guilt.

[greygoose in reply to jimh111]

Tish tosh! No guilt involved!

[greygoose in reply to Holza]

OK, so I've looked at those results, and your TSH is too high to tell if you convert well. It needs to come down to a 1, and then we can compare your FT4 with your FT3. But, at the moment, they are both too low, and you need an increase in dose. Have you had a test since the increase in levo? How long have you been on 100 mcg?

[Holza in reply to greygoose]

Hi grey goose thankyou so much for your reply that was the results with my increase dose I seem to be in a desperate way to try and find out if this has been my problem I am seeing an endo for the first time tomorrow they have asked to see me so just wanted to be ready for appointment means so much to me xx

[greygoose in reply to Holza]

Well, you need another increase in dose. Your TSH is too high and your Frees are too low. You are under-medicated. That's your main problem at the moment. Why didn't your doctor give you another increase when he saw those results?

Plus you have Hashi's, so your TSH should be kept low. Plus your B12 and folate are a bit too low. Are they doing anything about that?

This endo you're going to see, does he specialise in pregnancy? Because you really need to see someone who does.

[Holza in reply to greygoose]

Sorry forgot to say been on 100 mg since start of pregnency so since November 😊

[Holza]

No the docs have said they don't know enough about my resukts which I hope is why endo is wanting to see me hopefully they will help but my sister ended up going to see doc toft to get help she is on t3 only now helped her a lot maybe I should take a trip to see him. The docs have said for years my tsh levels are fun although I have been suffering with things for years. Until I got this medicheck test done I had no idea about all the other things need checked xxx I started taking vitamin b 12 , selenium and a probiotic tablet x

[greygoose in reply to Holza]

When you are on thyroid hormone replacement, the TSH should be 1 or under. Over 3 is hypo. Although UK doctors refuse to believe you can be hypo until your TSH is 10, it is actually 3.

Doctors, in general, know nothing about thyroid. And it never seems to occur to them that they ought to learn in order to be able to treat their patients, who entrust them with their lives! In my opinion, they are all negligent! That is why we all have to learn about our disease and take responsibility for our own health, and refuse to have it messed about by doctors. I have never allowed a doctor to reduce my dose, I have just said no! And when I considered I needed an increase, I have fought for it. Eventually, that all became too exhausting and I started self-treating.

But, you are pregnant, and you have a right to a doctor that knows what he's doing. I don't know if Dr Toft knows anything about the thyroid in pregnancy, but it's a pretty sure bet that no doctor would allow you to be on T3 only during pregnancy. It's a question of T3 not passing the blood/placenta barrier, or something, I don't know the details. But one thing I do know for sure is that you need an increase in dose, and you have got to insist on it until you are blue in the face, and not let any doctor fob you off. For the baby's sake, you need that increase in dose. And soon.

Take care.

[Holza in reply to greygoose]

I can't thankyou enough grey goose I will let you know how I get on I hope I get some decent help xx u takecare 2

[greygoose in reply to Holza]

I hope you do, too. xx

[jimh111 in reply to greygoose]

greygoose is right, your levothyroxine needs to be increased now. TSH should be below 2.5 for the first six months of pregnancy and then below 3.0 until delivery.