Thyroid UK

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Hypothyroid with High RT3 & Defective DIO2 Gene. On T3 only treatment. No improvements.

Hey guys, I am new here..

I am suffering from constant Fatigue, Depression, Anxiety, Cold sensitivity & Brain fog for past 12 years. It all suddenly started after the episode of Jaundice earlier 2006. Over the time period I have been prescribed with more than 12 antidepressants without any improvements. I no longer take any antidepressants. I am 31 years now.

Earlier this year (2018) I discovered that I have Hypothyroid with High RT3. I also discovered that I have defective gene DIO1 (heterozygous variant) & DIO2 (homozygous variant). So I am unable to convert T4 to T3 at cellular level, although I have good Free T3, Free T4 & TSH blood levels.

Currently I am on 80mcg T3 only treatment to clear RT3. It’s been 6 weeks now and not seen any improvements so far with my symptoms. I gradually increased my dosage to 80mcg over the period of 4 weeks.

Before starting the treatment my RT3 was 31 (Range 9.2−24.1), RT3 levels after 4 weeks of starting the treatment was 17. It went down but I don’t see any improvements with my symptoms.

Please help me to understand if this is normal? How long did it take for you guys to see improvements with your symptoms?

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58 Replies

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Your basic problem lies in your past history. You've probably been in trouble for those 12 years and your body has adjusted to this as best it could. Now you are on therapy to correct this. It simply is not the case that your body is like a car waiting for the right fuel to power up. It has to get used to the new treatment regime, and it could take months to get there. The longer you have been under functioning, the harder it is to get back to something like normal.

I think this is very important point! I often want to remind people it is not that simple to just get the right treatment and expect recovery over night.

There are numerous other factors that can affect after being unwell for so long. T3 might do whatever it is supposed to do, but being unwell for so long increase the possibility of many things being wrong at the same time.

Hi and welcome I've followed your post as I'm interested in the replies you get as I'm in a similar although not identical boat.

I stopped taking levothryoxine as it made me feel a lot worse and diogenes commented that I was likely to be converting a lot of the T4 in it to RT3 (for which I had already had a relatively high figure - within range, but above the 'threshold' that is mentioned in this linke: restartmed.com/reverse-t3/#... (I found this quite a good article about RT3).

I last took any levo mid February. Initially I felt quite an improvement, enough to make me think I was on the right track. But since then I have rarely felt any improvement for gradually increasing my dose, and if I did it was a little hiccup of feeling a teeny difference, that might last a day or two, and then I'd revert to feeling just as bad Constant brain fog, zero motivation, feeling low and just bleah! So I was very encourage to read diogenes reply to you. I'm currently up to just over 60mcg of T3.

Apparently it can take a full twelve weeks for levo to leave your system, but your body may still be releasing its own supply of T4.

I've posted some articles recently about impaired sensitivity to thyroid hormone/thyroid hormone resistance. If you want to have a look on my profile you might find some useful reading there, particularly this thread where there are a number of articles posted by me and others: healthunlocked.com/thyroidu...

If you're on facebook, there is a page 'Recovering with T3' where the author of the book often answers questions.

Hope we both feel some improvements soon!

Take care x

I don't believe in the high RT3 issue as the reason why you cannot get well. The question is what is causing the higher RT3 ? This is often down to stress levels being out of sync.

I don't mean you have to be stressed emotionally as well, you could be stressed from a poor diet.

If you have good thyroid figures then the issue is with the absorption of the T3 into the cells. This is where the cortisol / DHEA balance comes into the equation. IF this is out (which it usually is) then the thyroid meds have a tough time working correctly.

The aim to try get well is to work out what balance your body needs between thyroid meds and the correct type and some type of adrenal support.

This is not an easy thing to do and it takes time, often a few years to really crack the nut. You have to monitor and record your reactions to different inputs and slowly understand what works for your body.

I cannot say what you actually need to feel fully well, but trying T4 and T3 in different ratios can be a good place to start. As can using thyroid meds at bedtime to help support the adrenal area a bit better.

Then you need to look at what adrenal support to use. Do you need to lower cortisol or raise it ? Licorice root is good at holding onto cortisol if too low. If you crack the cortisol you will naturally bring DHEA into a better balance. These two hormones are important, but much more so when in correct balance. You often get poor results if you just supplement cortisol or DHEA.

Its a big topic to go into but there is loads of info on sites like this to help guide you.

May I ask a question, marsaday? How would the suggestions you make for lowering or increasing cortisol work if you have both high and low results throughout the day?

I now have high waking cortisol and morning cortisol, with my afternoon and evening cortisol in range (Back in October I had low in range waking cortisol, high in range morning cortisol, afternoon in range and evening high above range.)

Post Awakening: 11.84nmol/L (2.68-9.30) HIGH

Morning: 3.50 H (0.75-2.93) HIGH

Afternoon: 1.49 (0.36-1.88) Night: 0.66 (<=0.94)

Sum of Cortisol 17.490.

DHEA am: 2.08 nmol/L (0.25 - 2.22).

DHEA : Cortisol Ratio 0.18 (0.05-0.32)

Results from 6 months ago using DUTCH test (dried urine)

Waking: Low end of range 17.2 ng/mg 12 - 55

Morning: High end of range 138.2 ng/mg 38 - 155

Afternoon: Within range 22.5 ng/mg 7.3 - 30

Night: Above range 28.6 ng/mg 0 - 14

I've tried searching for answers but the only suggestions I find don't specify this.

Thanks for any light you might be able to shed

Firstly you can only compare the same tests when doing cortisol. It seems you get very different results with one test compared to another. No one has done it, but it would be interesting to do two cortisol tests with different companies on the same day and then compare the results.

What have you done differently in the time between these two tests is my next question ?

Your latest result doesn't look that bad. The shape of the cortisol curve is as it should be. It is declining to a low in the evening which is good. DHEA is not low which seems very common in thyroid patients. So the two are in a good balance.

Cortisol is a little higher in the morning. This is also a little different to typical thyroid patients who have low morning cortisol quite often. Their systems try and make up for it in the daytime and they can often get evening spikes of cortisol. So this is a good result for me. Generally your profile is good. What does the company report say ?

I would say it is very common to have a few readings out of range, but the shape of the cortisol curve and the level of DHEA are just as important.

What thyroid meds do you take and at what time of the day do you take it. Is it multiple times or just once ?

Thanks marsaday The main key difference since taking the first test is that I started taking T3. When I did the second test I was on T3 only. That's encouraging that the shape of the curve is at least right!

The comments on the results were:

For the patient:

This profile measures the levels of cortisol and DHEA and provides an evaluation of how cortisol levels differ throughout the day. Cortisol levels typically peak shortly after rising and are at their lowest after the onset of sleep.

Cortisol is involved in many important functions in your body, including the metabolism and utilization of proteins, carbohydrates and fats, your body's response to physiological or psychological stress, and the control of inflammation and proper blood sugar levels. Cortisol also helps maintain proper blood pressure, normal nerve and brain activity and normal heart and immune function. DHEA also plays a role in the metabolism of protein, carbohydrates and fats, and works with cortisol to help maintain proper blood sugar levels. DHEA helps regulate body weight, blood pressure and immune function, and is used by the body to make the hormones, testosterone and estradiol. Too much or too little of cortisol or DHEA can lead to illness, and it is important that these two hormones be in balance with each other.

For the Physician:

In this profile, Sample 1 (Post awakening) cortisol level is significantly elevated. Because cortisol levels are typically at their peak shortly after awakening, morning cortisol may be a good indicator of peak adrenal gland function. High morning cortisol levels suggest a degree of adrenal hyperfunction in regard to peak circadian activity, stress being the most common inducer. High cortisol levels cannot be sustained and are often a precursor to adrenal fatigue. Other possible causes of high salivary cortisol include heavy exercise, pregnancy, hypoglycaemia, smoking, obesity, depression, alcoholism, and if significantly elevated, adrenal hyperplasia or Cushing's syndrome.

Sample 2 cortisol level is above the reference range. Mid-day cortisol levels may be a good indication of adaptive adrenal gland function since they represent the adrenal glands' response to the demands of the first few hours of the

day. High mid-day cortisol levels suggest a degree of adrenal hyperfunction with hyper-reactive adaptive response, most commonly to stress. Other possible causes of high salivary cortisol include heavy exercise, pregnancy, hypoglycaemia, smoking, obesity, depression, alcoholism, and if significantly elevated, adrenal hyperplasia or Cushing's syndrome.

Sample 3 cortisol level is within the reference range. Afternoon cortisol levels may be a good indication of the adrenal glands' ability to help regulate blood sugar, since they represent a postprandial sample. Afternoon levels within the reference range suggest normal adrenal function, especially in the area of glycaemic control.

Sample 4 cortisol level is within the reference range. Late-night cortisol levels may be a good indication of baseline adrenal gland function since they typically represent the lowest level during the day. Normal late-night cortisol levels suggest normal adrenal function with regard to baseline circadian activity. DHEA is within the reference range. Proper levels contribute to the ideal metabolism of proteins, carbohydrates and fats, including efficient glycaemic control.

The ratio of DHEA to cortisol is normal. This ratio indicates a relative balance of the adrenal output of androgens and cortisol. Both of the hormones are released in response to ACTH from the pituitary and a normal ratio indicates a balanced function of the hypothalamic-pituitary-adrenal axis.

Well the T3 has certainly done a job on helping the adrenals work better.

All seems to be ok, but i assume you are not fully well.

Maybe worth experimenting with the T3 dosing and timing. I don't know what amount you take and how you take it, but you may need less T3.

Have you tried adding in 25mcg T4 to see what reaction you get. Certainly worth trying this at some point. Experimenting with the T3/T4 ratio is something to look at. It is unusual for people to not need any T4 or for it to cause them negatives, but Paul robinson is someone who cannot take it at all. So it can happen.

I think some patients would do better if they altered the T4/T3 ratio they artificially take. To do this you use T3 and then add in a baseline of T4 and do not change this and then mess around with the T3 level. The T4 level to use is 25mcg and then work with the T3 to see if you can fine tune things. Over time you may find more T4 can be used better and so the ratio changes.

That's interesting as I have been thinking recently of adding some levo back in. Initially it just made me feel far worse the more I took, and I reduced it and then stopped, and then felt a relative improvement. I figured it was to do with me converting it to RT3 instead of T3, so tried the T3 route to overcome it.

Paul suggested either reducing my T3 or using it more aggressively ie higher doses. I went for the latter approach but this is quite recently.

Thanks for your advice, I appreciate it

Where did u check your cortisol I mean what company and do they usually comment on it too?thank you

Hi Ari, purehealthshop.ecwid.com/Ad... I used this company, and the test itself was done by Genova. You pay for it when you send off your samples.

medichecks.com also do the test, I believe, but they don't include the DHEA test.

Just hang in there.

It took me exactly 6 months to get full effects of t3 monotherapy.

You may need to increase your dose to get good saturation in the meantime.

I swapped from t4 to t3 only last November after two years on high dose of t4 (up to 350mcg), been continuously on 150mcg of t3 for the last 6 months without hyper effects, just recently finally got to hyper stage and was able to lower my dose to 75mcg.

I finally got there and you will too.

I know it's long time but like diogenes said you've been on t4 for a very long time, your body needs time to heal now.

trelemorele ~ your reply is really interesting to me.....(sorry yogi for hijack) I was also on high dose T4 ~ I could only manage 300mcg, as it was poisonous at any level😝but I was on Levo for 25 years 😳. I am currently on 100mcg T3 (Tiromel), and like ShinyB, had initial improvements, and still have some, but not as dramatic as at first.

Can I just ask how much you increased by each time, and what did it feel like to be over medicated? That sounds crazy, I know, but I think I've always been hypo, and have read on the forum that being over medicated has similar symptoms?? I'm very knowledgeable about hypo😊but a little worried I may not recognise the hyper, and then miss the sweet spot. How did you manage to reduce your dose to 75mcg from the 150mcg ~ was it just trial and error going backwards too? Presumably no testing was involved. 😏 ooh! I hope this is me too! 🙏. x

Hey sorry for late reply. HU keeps kicking me out and I keep losing my replies.

I started T3 monotherapy on 2x25mcg (50 mcg) T3 for 10 days, moved to 1x50 + 2x25 (100mcg) for about 2 weeks and then moved to 3x50mcg (150 mcg) until mid May this year.

I don’t do tablet splitting, I only deal with multiplies of 25 mcg.

All was done on how I feel not on any special formula or other people experiences. I followed my body responses how I feel and I was increasing till I reached the point I felt great, didn’t have hypo symptoms but didn’t get hyper symptoms either. If 150 wouldn’t give me satisfactory “good energy and feeling levels” I’d increase to 200 and so on.

Mid May this year my HR shoot up from 80 to 120. This increase wasn’t instant, it happened over few days. I noticed my HR watch reading was higher than usual and also it was physically noticeable and uncomfortable.

I then dropped from 150 to 50 for a couple of days but I got hypo symptoms on 2nd night, in my case it is pretty much instant carpal tunnel swelling in both hands. That is also usually preceded by extreme fatigue in early evening.

I increased then to 75 and I’m on it since then. I do have days I take additional 25 making it total 100 mcg/day once a week and it’s usually when I feel like I need it around mid day or early evening.

You’ll know when you get to hyper stage. It’s not life altering, it’s not as dangerous as people make it out to be. If you’re on T3 it’s pretty easy and quick to correct it.

Also, don’t forget 100mcg may be your IDEAL daily requirement and you’ll never get to hyper stage. Some people need it like it.

Thank you so much for your informative reply. I too am having problems with forum 😳. This is very reassuring because I thought I had started too low, and was being over cautious, but as my body had never had T3 before I thought it wise.

As things have gone on though, I think it may be better to follow your protocol of larger increases, as I'm certain I'm on the right track. I tend to get a hard heartbeat when the dose is wearing off, or after I've eaten, whereas it was pretty constant before.

I also have lots of other symptom checks that I've been taking note of, and found it odd that things I thought had resolved, have started to return before an increase ~ I imagine this is the body becoming accustomed to that dose, but it seems to be happening at an ever increasing rate, which is a bit unnerving😊.

I have wondered actually if I needed to flood my cells before finding an optimal amount, so it's interesting what you say about that, and it has given me confidence to follow that path ~ obviously we're all different, but it's something that I also 'felt'. Thyroid blood tests have proved useless to me, so I am also going purely by how I feel, so your input is very helpful and much appreciated👍 Many thanks 🌟 x

Thanks for tagging me, Mamapea How interesting! xx

That is so interesting, thank you

Did you take your T3 in single or divided doses, trelemorele?

I've been increasing in tiny 6.25mcg doses. Very refreshing to read a different approach!

May I ask, did you feel improvements with each dose, or did you have to reach a certain doseage before you felt an improvement?

Good points shiny👍if my brain was functioning, I would have asked them myself lol! 💭 x

I had a brief moment of clarity Maybe the T3 is kicking in lol x

Your aim is to get out of hypo state and feel good if not great.

So no matter what dose you're on if you have hypo symptoms you need increase.

That's how I increased my dosing.

I was looking for no more:

1 tired at lunch time or early evening

2 ability to stay up till 10 - 11 pm

3 waking up alert and refreshed

4 no swelling, especially carpal tunnel

5 prolonged digestion

6 muscle and bone pain muscles stiffness

7 feeling cold at 24C degrees

8 good energy level from waking up till time for bed

So until I eliminated all bothering symptoms I kept increasing t3.

Yes I do split dosing. Up to 4 times a day. Mostly 3 times a day.

My routine:

5:30 (later weekends) - time I wake up

12 pm

6 pm

If I feel I need additional dose I take it when I feel and adjust following dose timing to when I feel.I need it next

There were times I took last dose at 8pm.

You need to follow how you feel and what your body needs.

I don't believe doses lower than 10mcg have any impact. But that's my personal opinion.

That's so helpful, thank you

I like the idea of listing the symptoms like that; it's a simple way of checking progress.

Talking of progress, I had a huge poo today without any straining! Sorry if too much information lol but severe constipation was my first noticeable symptoms from when i was 13. So I was very chuffed with that

That's exactly another one of the symptoms you're looking for! To be able to have regular, not aided by laxatives or other laxative supplements BO daily.

I'm thinking about issuing a press release about it, it's such big news

Yes, and I leave off the magnesium citrate and see how I'm doing without it, in order to more accurately assess the situation ~ things are slowly improving though.....that's one my life long problems that I thought was fixed earlier on....x

There you go again shiny! lol! Actually, so did I😊but that happens when I have an increase, and then fades out again.....waiting to see what happens this time....interesting idea to increase according to symptoms daily or when feeling them..... I expect this may be what happens in the body via the feedback system if one is lucky enough to have a fully functioning thyroid and receptors??

I'm constantly monitoring my symptoms and I'm finding this info kindly provided by trelemorele very helpful. I'm sure it's much more complex than we can possibly imagine, but we just have to give it a go using all the information available, and hope for the best. Glad we've both had a productive day! lol! 😄 xx

Whoa hold your horses ladies

I didn't say increase daily.

Have a look at my 2nd reply where I said I increased after 10 days and then after two weeks....

I do take additional dose if I'm hit with the fatigue but I keep to one dose I found sufficient.

Originally it was 150 now it's 75.

I wouldn't advise increasing daily especially not with 25 mcg. You need to give your body some sufficient time to adjust and heal

I read it as an increase in any given day based on symptoms/activity level.

Maybe I read it incorrectly?

If that's how it came across, I didn't mean it like that.

I'm brave and impatient but even I wouldn't increase from 0 - to 150 in just one week by 25 a a day.

Main reason being you can quickly overmedicate without resolving more difficult hypo symptoms.

Some more debilitating symptoms take much longer to resolve and no matter what dose, they won't budge quicker even on higher or quicker administer dose.

I.e my leg swelling took slightly over a week to resolve, my facial and preorbital swelling took much couple of months.

Sorry, I meant that I read Mamapea1 's comment that way, not yours.

I knew I'd written that in a way that would be misconstrued, but I was too lazy to correct it, also iPad is still being weird. I was referring to your taking of an additional amount on days when you feel you need it, or adjusting the timing of the dose depending on how you feel, not increasing daily ad infinitum 😳 sorry to freak you out with my poor use of language 😊

I've been taking mine all in one dose, but now wondering if I felt better when I had split the doses originally ~ and also if it offers scope for slight flexibility ~ it makes sense that more T3 would be used up on different days, depending on activities. I was hoping not to have to permanently take more than 100mcg, and that further increases would be for flooding purposes, but who knows? As ShinyB would say....Aarrrgggg!!! x

But how do you feel.on 100?

If you feel good till the time you go to bed I wouldn't change it.

My best indicator I'm sufficiently medicated day before is when I wake up for work at 5:30 am and I'm refreshed and well rested right after I sit on the side of my bed. My mind is clear and I have energy to be up and get ready. By the time I go to toilet I'm fully awakened and can think very clear.

If I wake up with migraine I know something was off and usually I'm rather groggy 1st half an hour till new dose if t3 kicked in.

This is my first week on 100mcg, so maybe too early to tell, and I still feel hypo, but not as bad as I was before, obviously. If I ever feel good until I go to bed, I would consider it a miracle!🙏. Ditto waking up with a headache/hangover feeling/migraine, which has happened for at least the last 10 years😔.

It takes at least 4 hours for me to even think about doing anything, and I only sleep about 2 hours at a time ~ the longer I sleep, the worse the 'hangover'. However, ALL these symptoms, and others are improving, but in the little 'jumps'.

Initially, the T3 really perked me up, but now I find it also knocks me out😳 it's probably helping me get some much needed sleep, but I want to get up and go! I'm not rushing though, I've been on the dreaded Levo for 25 years, getting nowhere! I'm so envious of you being refreshed and ready for work.....I've forgotten what that's like!😨. x

You'll get there.

Give it time, increase dose if you need.

The changes won't happen over night but you'll get there.

Have you checked you other hormones?

My thyroid or Hashi messed up my sex hormones and I ended up with premature menopause. That didn't help and until I got my estrogen levels up, t3 on it's own didn't make me feel 100%.

I'm totally confused by my sex hormones. I tested and both my oestrogen and my progesterone were very low, even taking menopause into account. But I was still oestrogen dominant. I tried supplementing with bioidentical oestrogen and progesterone - I went straight into quite bad oestrogen symptoms, so cut the oestrogen and carried on with the progesterone. When I retested, i was way way over on progesterone. So I had a gap for a week and now am taking a dose every other day.

Even though my oestrogen level was so low, I really did not react well to taking it. I can only surmise that I have hidden stores of it my cells but it's not showing up in my blood tests!

But you can't be estrogen dominant if your estrogen level is/was low. 🤔

Well there are two schools 're HRT.

I'm a firm believer in one because I'm the type of person who'll eat, drink, smear, inject anything modern medicine has to offer to make me feel normal/good/healthy and I don't mind synthetics and hardly get side effects.

There's other schools which doesn't like anything"unnatural". And I respect that.

It's really up to you how you want to approach that issue for yourself.

I'd corrected my estrogen and progesterone and recently testosterone.

Here was my most recent wail about it: healthunlocked.com/thyroidu.... If you have time and don't mind taking a quick look, I'm open to and grateful for any advice!

Test results further back to this are here healthunlocked.com/thyroidu... but they were very longwinded and confusing - key ones seemed to be that my oestrogen was very low and my testosterone high.

The reason I went with bioidentical was the apparent reduced risk of side effects but I'm not averse to synthetic. Tiromel is synthetic afterall!

From.last results

Your progesterone is way too high

Estrogen too low

Testosterone on lower side

Shbg high but that's expected as you were on Levo. And high shbg dampens testosterone as well.

I take you're post menopause

You're not estrogen dominant, if anything you're progesterone dominant by supplementing. your sex hormones are out of whack. They have to be in synch. Anything outside - progesterone or estrogen not balancing each other out is no good. But someone already told you that there on your post.

Normally if you're in menopause and not bleeding you should do good on continuous 2/1mg estrogen progesterone respectively HRT and this would bring both levels to mid range. You wouldn't go over it's just perfect dose. You can start .lower.if unsure or older like 1/1mg. But if not enough you could go higher.

If I was you (I assume you have uterus) I'd ask for combined continuous HRT if you're not against it. Judging by your estrogen levels you're not bleeding anymore so don't need cyclical unless you want to.

All estrogens sold in UK are chemically similar to natural estrogen (some call.It bio). If you want to avoid hepatic route go for a gel. And you can also get "bio" identical progesterone in a pill.

Bio identical progesterone pill will.make you sleepy so it's advised to take it at night.

I personally would not take progesterone on it's own. Too much progesterone will give you side effects too. Google progesterone dominance symptoms.

Women without uterus are given only estrogen as progesterone is thought not to be needed. Progesterone is used to induce bleeding in women with uterus so there's no build-up caused and in effect fibroids or uterine cancers

For reference, my estrogen level on 2mg estrogen BC is 234 pmol and I want to increase it to 367 pmol which is apparently ideal to be when on replacement for menopausal woman.

Ideal progesterone levels are 20, mine not measurable because I'm.on synthetic progesterone and this doesn't show up on bloods

Ideal testosterone levels are top.of the range for women so around 2 some even say 3 but you can ignore this one for now as yours still.in range and I seriously doubt UK GP will.prescribe (from experience)

Thank you, trelemorele. Brain fog is at large but I will come back to this and read it when my brain is feeling a bit clearer! Appreciate the detail

Wow! I could have written the first 4 and last 4 lines of what you've written here😳except I haven't had a test for ages....I need to get one, I have a complicated history re sex hormones....ugh! Testosterone maybe worth a look methinks....??? xx

Thank you for your reply... late response due to me and iPad both being below par😕. My sex hormones are probably out, and need testing, and if you don't mind, I would appreciate your advice when I obtain some results, when finances allow🙏. (I'll start another post yogi, sorry about all this💐).

I'm a vaccine damaged, pill damaged mess😳so it's a big ask lol! I did try HRT ~ various NHS stuff, despite being told years ago to never take oestrogen due to pill damage, but it made me worse😔. However, I'm sure there's an answer to it all, and I probably just didn't hit on the right combination ~ I'm thinking progesterone, but also have wondered about testosterone, and find it interesting that you have recently sorted yours.....really appreciate your input on all this by the way, very grateful, and it's inspiring to read your story👍 x

Don't go into supplementing one without balancing the other.

I really don't get fixation of some women with progesterone as single supplement. This is not the answer to menopause.

Progesterone has it's place but just like with estrogen dominance it is not good, the same apply to progesterone.

And if a woman in fact estrogen dominant, progesterone is not the answer to lower it.

Thank you for your reply. No, I wouldn't embark on any replacements without testing first, especially after the last time! HRT from GP nearly finished me off ~ I tried varying dosages and 4 different types, for years, but it just made me worse 😕 I'm a glutton for punishment lol!

I expect I just hadn't hit on the right combination ~ GP said I probably needed more progesterone, but couldn't prescribe it. That was a long time ago, so I need to test anyway, can't really second guess it, hopefully I'll be able to afford some tests soon. x

That actually took my breath away. I haven't felt like that since I was pre teens!

trelemorele, I could kiss you! LOL. Your replies have given me a real lift today - thank you thank you

Argggggh! lol. I've played about with my dosing, taking it as one single dose and as divided doses. I'm clearly not feeling massively better yet, but I think I've noticed I feel a bit better for taking it in one dose.....

I think one off dose is really good alternative.

I was considering to swap to one day dosing too, this would make my life so much easier.

I believe whatever works for you stick to it. Everyone is different. 👍

I got you

Yes i had improvements in that area early on and was very excited, but then it went back to its same old stubborn obstinate self!

I'll really know I'm 'good' when I have them daily without the additional magnesium, Vitamin C, senna, dulcolax etc etc lol.

Yay to productivity! xx

Sorry yogibeartogo that we've taken over your post, but hope you find some of the discussions useful too

No Problem Shiny, all your discussions are useful, I am getting better in site on my issue. Sorry I am not that active in replaying you all bcoz of my condition. By the way how are your iron panels (Total Iron, Ferritin) ?

Ah good to see your reply. I was a bit worried we'd put you off by jumping all over your post! I'm really grateful for your original post as the responses have given me so much information and reassurance, so big thanks from me

My ferritin levels were ok, but I'd had been taking various supplements for quite a while for general health purposes, so most of my nutrient levels were ok. I know I have been very low on iron in the past. I think I've read on here that it can be a hypothyroid problem - hypothyroids often don't produce enough stomach acid so we can be low on various key nutrients.

Have you got any test results for your ferritin, folate, B12, Vit D levels? These all need to be optimal for thyroid function.

In a couple of books I'm reading on impaired sensitivity to thyroid hormone, there is mention of some people needing to take as much as 500mcg of T3! Apparently it can typically take a big dose and getting to a certain threshold (typically 100 to 150 mcg) before you feel any benefit. I'm still waiting myself!

I definitely recommend a book called, 'Impaired Sensitivity to Thyroid Hormone' by Hugh Hamilton. It's straightforward and written in an easily understood style. You can get it very inexpensively from Amazon.

Thanks for the recommendation, I will surly go through it. My Ferritin was very low around 30 (20-360 range), folate, B12 & Vit D are good.

Gosh that is low. Can you cope with eating liver? I don't know enough about iron levels but if you make a new post with your test results and range, someone else will be able to help

Thanks for the hope Trelemorele, by any chance was your Ferritin low before starting your T3 course ?

1st time round when I started on t3/t4 combo therapy in 2009 my iron was low, below reference range but I didn't know about it then as my GP failed to act on it.

This time round my iron is about 50 which is within the range. I seem to have difficulties absorbing iron and folate. But at least is within the ranges.

If iam on ndt treatment can I bring up my cortisol levels or help my low cortisol by taking medication very early morning like 6am? Every morning? Could this help too?

T3 only to clear rT3 is a myth. As marsaday says, it depends what causes it. If your FT4 wasn't excessively high, then it wasn't anything to do with T4. So, cutting out T4 isn't going to help it - you only needed to lower your dose, anyway.

But, rT3 only stays around for a couple of hours, and is then converted to T2. So the rT3 that was around when your level was 31, is long gone. So, if it continues to stay high, then you need to look for other problems.

According to STTM, these are among the causes of elevated rT3

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

*Chronic inflammation, whatever the cause, has risen RT3 in patients.

*Physical injury, a common cause of increased RT3

*Illnesses like the flu, a common cause of increased RT3

*Starvation/severe calorie restriction is known to raise RT3. See this study.

*Diabetes when poorly treated is known to increase RT3. See this study.

*Lyme disease

*Cirrhosis of the liver (page 38 here)

*Renal Failure (page 38 here)

*A fever of unknown cause (page 38 here)

*Detoxing of high heavy metals

stopthethyroidmadness.com/r...

(Don't take too much notice of the rest of the article, it's not up to date.)

So, what you need to do is find out if you have one of these other problems causing it.

Do you have copies of your results? Both when you were taking T4 and now you're on T3 only?

Regardless of the cause of your high rT3, adding T3 will reduce it because is drops your TSH and your body makes less T4, the raw material for rT3. In lowering your TSH your conversion percentages also worsen, but only to a point. Once you max that out, you should see improvements by adding enough T3. Also, it takes 8 weeks to rid you body of the T4 that was produced prior to adding T3.

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Hypothyroid with High RT3 & Defective DIO2 Gene. On T3 only treatment. No improvements.

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