Test Results.. problem due to rt3?

[theriverman]

Looking to get some feedback / advice. I've been struggling on thyroid medication for a few months since being diagnosed in August with a tsh of 36. I originally thought it was all related to my hernatied disc / back injury, but I've realized hashimotos is playing a big role in my issues.

Main symptoms: muscle soreness/fatigue in hips and legs, lack of stamina, overactive nerves, aches/pains in hips, general fatigue, muscle twitching, feeling cold

I felt pretty good like my symptoms were all improving for a short period of time on synthroid 100, but after switching brands and then trying NDT, things went down hill again, and when I try to raise my dose my symptoms seem to get worse. My ft3 and ft4 were both higher when I felt better, but I'm guessing that's where the RT3 comes in? Based on my labs, does it appear to be iron/adrenals causing rt3 to rise? Any thing else stand out?

[greygoose]

It could very well be your low ferritin causing the high rT3. Although there could be many other causes. But, the high rT3 isn't causing any problems with your FT4 or FT3. You are simply under-medicated.

Your vit d should be higher, too.

[theriverman in reply to greygoose]

But wouldn't my ft3 be higher if the t4 wasn't converting to rt3? Also, I've felt worse trying to go up on NDT and also on synthroid.

I recently started iron supplements, but it including synthetic B vitamins and folic acid and since I found out I have mthfr I realized that may be making me feel worse. Just switched to iron without extras in it, and getting some methylated b complex.

[greygoose in reply to theriverman]

Even your FT4 isn't high enough, it's not even mid-range. But, yes, your FT3 would be higher.

All nutrients need to be optimal for NDT to 'work'. So, yes, you do need those irons tablets. Your B12 isn't too bad, but I didn't see a result for folate.

And, of course, you really do need to supplement that vit D, together with the co-factors: vit K2 - MK7 and magnesium.

[theriverman in reply to greygoose]

Yes I'm taking 5000 IU for vitamin D, and 150mg IRON just started. I think I want to get my b12 up too.. and am going to try to introduce a tiny amount of t3.

I also have pretty bad sciatica/back pain, do you recommend CBD oil? Bought some yesterday bc I'm tired of taking tylenol/morphine/diclophenac.

[greygoose in reply to theriverman]

Yes, I do recommend CBD oil. I wouldn't be without it for back pain.

If i were you, I would leave the T3 until you've got your FT4 optimal. But, in any case, only make one change to your regime at a time, or you won't know what is helping and what isn't.

[radd]

theriverman,

Great comprehensive testing. 👍

Cortisol levels are still good but DHEA looking low. Testosterone low as is common in men with (low) thyroid hormone issues.

Both FT3 & FT4 are too low.

TPO is massively elevated and likely causing inflammation which will not only decrease T4-T3 conversion but decrease both the number and sensitivity of thyroid hormone receptors. If there aren’t enough thyroid hormone receptors or they aren’t sensitive enough, it doesn’t matter how much thyroid hormone replacement we medicate because our cells won’t be able to use it.

Iron is too low and could be exacerbating low T3 levels further by decreasing deiodinase activity that results in conversion to RT3. Toxic heavy metal levels are good, indicating good clearance abilities, which are usually at odds with elevated RT3.

You need to optimise thyroid hormones, iron levels and reduce antibody levels, and supplement something like milk thistle to aid any liver clearance issues re RT3.

NDT appears commonly difficult to introduce with low iron. Also, have you had folate tested as this will be influencing how your body is using Vit B12 ? ? If you have the MTHFR mutation, you may need to supplement methylfolate with the methylocobalamin together with a B Complex. Also, supplementing Vit C will not only support hard working adrenal glands but help with iron absorption.

What thyroid meds and how much are you medicating at present ? ? ..

[theriverman in reply to radd]

Folate16.2 ( >5.4)

My TPO did come down a bit from 620 when I tested a couple months ago. Maybe because I added selenium?

Right now I'm at 100 synthroid.. I tried upping to 112 but felt worse.. I'm thinking about adding a small amount of of t3. When I tested though, I was on about 1.5 grains of NDT. My results on 100 synthroid were about 70% of the range on t4 and 50% on t3. I realize I'm still under medicated, but want to raise medication without more problems popping up.

[radd in reply to theriverman]

theriverman,

As I said ...optimising iron levels, reducing antibody levels and supplementing something like milk thistle to aid any liver clearance issues re RT3 will help your body tolerate higher thyroid hormone replacement increments.

Selenium is good as not only helps T3-T4 conversion but there is research showing it helps in reducing antibody levels. Have you researched a gluten-free diet ?

[theriverman in reply to radd]

Yes I'm gluten free. Working on iron, will look into milk thistle.

[radd in reply to theriverman]

theriverman,

Oops ... nearly forgot. I actually take milk thistle for iron overload ! ! 😳

But ..... plentiful Hashi page recommends it, and there are more Hashi peeps who have an iron deficiency than an iron overload.

.

hashimotoshealing.com/hashi...

[Hidden]

Do you understand that range for RT3? Mine was, umm 500-and-something. Maybe a different range?

I’ve worked for years on iron but have got my ferretin good now. Is your dietary intake good?

[theriverman in reply to Hidden]

Lol oops range is 8-25 I think

[Hidden in reply to theriverman]

So you’re just a little out of range, though I’ve read suggestions that it should be low in range. I don’t know enough about it, I’m afraid.

[theriverman in reply to Hidden]

Yeah I’ve read 15 or less is ideal

[Hidden in reply to theriverman]

My 500+ was well out of range but I think the range started at 50. I wonder if there’s a percentage to use.

[theriverman in reply to Hidden]

How did you get it under control

[crw2ddd]

I realize this is an older thread but I've been scouring this site looking for someone like me. I was diagnosed with Hashimotos a couple years ago and I tried 50 Synthroid and felt no difference in my muscle aches at all. I added 2.25 t3 and I felt better for a while then upped it to 5 mg t3, but had energy crashes. Then it was over range for a short time and I ditched the t3 and was just on Synthroid again but just 5 days a week. Still hardly anything has touched the leg aches and pain ..and now I'm having nerve twitches and a little face pain and stuff like what you describe in your posts. All my vitamins levels were similar to yours as well. I now take armour 3/4 grain with 50 Synthroid and sometimes I'm okay for just part of the day and sometimes I feel sick all day long still. I'm curious if you've ever gotten any relief?

[theriverman in reply to crw2ddd]

It's been a long journey but most of my symptoms are under control now. I'm on synthroid 88 and .1mg of fludrocortisone. Adding in the steroid for adrenals made a big difference. I also realized I have a major stressor on my body, degenerative disc disease with large annular tear that's leaking out chemicals onto my nerves. That can cause an immune reaction and major inflammation. Getting surgery to get this addressed in a couple months.

[crw2ddd in reply to theriverman]

Hmm, I wonder if getting a spinal epidural when in labor could do something similar to this? I've been sick both times postpartum, the second pregnancy resulted in an extreme hashimotos reaction and the body aches and now nerve pain and twitches. I suppose I should visit a neurologist.

[theriverman in reply to crw2ddd]

Not sure if the epidural would have that effect, but nerve pain could be a sign of back problems. Might want to consider an MRI and xrays. I'm convinced that the stress of my back injury triggered my hashimotos in my case. I think the twitching in my case came from adrenal issues or possibly related to one of my back symptoms, muscle fatigue. But it all seems related in some way.