Latest thyroid labs -NDT/T3

[FunkyC]

Hi

Can anyone please help with are my latest lab results of which endo things are ok ? I’m uncertain if my levels are what they should be -my T3 has never been over range previously ?

I’m on 2 1/2 grains of NDT and 40mcg of T3 per day.

Many thanks

[SeasideSusie Remembering]

FunkyC

Your endo doesn't know much does he?

You appear to be overmedicated with T3 to have such a high FT3.

How do you feel, did your endo discuss that with you?

[FunkyC in reply to SeasideSusie]

Hi

Thanks so much for your reply.

I did discuss that was I over medicated and he said well you can decrease it if you want but we’ve taken 2 years to get to this point of feeling ok. He’s ok with me playing abut with dose, but I wanted some guidence.

I mentioned RT3 so T3 not being in the cells and possible adrenal issues

“Well we did the short synth test in 2016 and ruled out Addisons and I don’t see why the T3 wouldnt be in the cells ! “

I’m not that confident in him but getting my T3 prescribed by him...

[SeasideSusie Remembering in reply to FunkyC]

You won't have rT3 with such a low FT4 and such a high FT3. When there is high FT4 and low FT3, that suggests that the T4 is being converted into rT3 instead of FT3.

[FunkyC in reply to SeasideSusie]

Ahh ok thank you for explaining that.

Would you have any suggestions of how to tweek my dosges ?

Many thanks

[MaisieGray]

It would seem that you are currently over-medicated. If your Endo has checked all your vitals and symptoms and found that you've not had any adverse reactions from your over-range T3, I'd imagine that's why he's fine with your results, which is okay as long as he continues to monitor you. But if he hasn't done the other checks and is unaware whether things are or aren't going askew with too high a dose, then that's not good. How do you feel, are you experiencing palpitations, tremor etc? If it were me, I would in any case, reduce the NDT by half a grain ie 4.5 mcg T3, and monitor symptoms/re-test in 6 weeks.

[FunkyC in reply to MaisieGray]

Hi

Thanks so much for your reply.

I did discuss that was I over medicated and he said well you can decrease it if you want but we’ve taken 2 years to get to this point of feeling ok. He’s ok with me playing abut with dose, but I wanted some guidence.

I mentioned RT3 so T3 not being in the cells and possible adrenal issues

“Well we did the short synth test in 2016 and ruled out Addisons and I don’t see why the T3 wouldnt be in the cells ! “

I’m not that confident in him but getting my T3 prescribed by him

I did discuss how I felt , which wasnt feeling too good , but as I’ve just started HRT sand also have B12 issues I said it’s hard to know what’s out of sync.

I get heart palps early hours of morning which wakes me up

Thanks for you guidnede of how to reduce. As my T4 is low end of range would it still be best to reduce by half grain NDT or would I be best to reduce the T3 by 4.5 mcg ?

Really appreciate your comments

[MaisieGray in reply to FunkyC]

I think on balance ie he prescribes T3, isn't freaked out by lab results, and is wanting you to do well, so he's a keeper lol. Him not being on board with cellular resistance/poor cellular take up, is perhaps the price to be paid for that, and thankfully you aren't brand new to this so can judge the accuracy of what he says to you ...... However, and by the way, not everyone agrees with RT3 being a blocker of T3 receptors: "It is frequently claimed in articles published on the internet, but not in peer-reviewed papers, that rT3 blocks or “gets in the way of” the nuclear thyroid receptors. The nuclear thyroid receptors are the sites of action where the primary active thyroid hormone, T3, exerts its effects to drive cellular metabolism and maintain body temperature. There is no credible scientific evidence that rT3 enters the nucleus of the cell at all, and the bulk of the scientific literature states clearly that rT3 does not bind to, and has no known transcriptional activity at, the thyroid receptor. It is, however, known to have potent activity in the cytoplasm as an initiator of actin polymerization in astrocytes in the brain. This is mediated in a non-genomic manner by its binding to a very specific thyroid receptor that exists only in the extranuclear compartment. Actin polymerization is important to cell structure and motility, and particularly important to normal brain development. " (Margaret N. Groves, M.Phil., ELS - a scientific and technical writer for ZRT Laboratory) My suggestion to reduce NDT rather than your T3 is more about practicalities tbh: unless you are taking your T3 in 5mcg multiples it's easier to not take the 1/2 grain NDT than divide 20 mcg T3 tablets into quarters, but it's obviously your choice. Given that you would always expect T4 to be very low when taking either/both NDT/T3 I doubt the T4 loss would be significant or noticeable - unless of course, you are a person that needs at least some T4 to feel well (remember that the view is beginning to change, that T4 is solely an inert pro-hormone). So do what feels comfortable to you, as we're all individuals in this

[FunkyC in reply to MaisieGray]

Thanks so much for taking the time to write such a detailed reply, really appreciated.

I’ll work on reducing my T3 by one or the other

[SeasideSusie Remembering in reply to FunkyC]

Funky

If those were my results I'd want the FT3 back into range, and I would be reducing my T3 gradually, 5mcg each time, to achieve that. But I'm not medically trained, and I know that I need a good amount of FT4 as well as FT3. So really, no-one can tell you what's best for you, looks like you'll have to experiment and see what suits you best.

[FunkyC in reply to SeasideSusie]

Thank you very much for your time and comments, appreciated

[Hidden]

It sounds like too much medication. When I was taking 3 grains of NDT only per day last year my results were similar to yours. I did notice that I was losing weight as well so I cut back to 2.5 grains per day which is fine.

[FunkyC in reply to Hidden]

Thank you for taking the time to respond, very helpful.

I’m going to cut down my T3 by 0.5 mg and see how that bodes before reducing my NDT x

[Hidden in reply to FunkyC]

Yes a good idea you can only try it's frustrating sometimes getting just the right dosage