High Reverse T3 and Free T3

[Morgan2478]

Hello!

I was hoping to get your opinions on my recent thyroid test results. I was on 40mcg of Cytomel prior to switching to 2 grains of Nature-throid. I have been on Nature-throid for about a month now (adding 5 mcg of cytomel as needed). My reverse T3 and Free T3 are both high. This is the first time that my FT3 has been above 2.4! Wondering what I should do about my medication. I was thinking of decreasing my Nature-throid dose to 1.5 grains. I would really appreciate any thoughts or opinions. Thank you so much!

Reverse T3: High 27.6 (range 9.2-24.1)

Free T4: 1.54 (range 0.82-1.77)

Free T3: High 4.7 (range 2.0-4.4)

TSH: <0.006

(Took my Nature-throid 7-8 hours before the test)

Thank you!!!

[greygoose]

adding 5 mcg of cytomel as needed

What does that mean? That you don't take the same dose every day? That's a bad way of dosing.

If you were on 40 mcg Cytomel, and you changed to 2 grains of NatureThroid, you gave yourself one hell of a reduction in dose! How did you feel on 40 mcg T3? What was your FT3 level?

Your FT3 is only slightly over-range, and perhaps if you'd left longer between your last dose and the blood draw, it would have been within the range. The minimum gap should be 8 hours.

As to the high rT3, that can be caused by so many things. It can be caused by high FT3 - more T4 is converted to rT3 to stop you reaching hyper levels - but I don't think your FT3 is that high. And it can be caused by high FT4, for the same reasons. But, your FT4 isn't that high, either. It's more likely to be due to 'something else'. Low calorie diet, infection, high cortisol, low ferritin… there's a long list of things that can cause high rT3. High rT3 isn't a problem in itself, but you do need to find out which problem is causing it.

[Morgan2478 in reply to greygoose]

Thank you so much for your reply!

I thought that 25mcg of T3 is equivalent to about 1 grain of Nature-throid. If that's right then it's not too much of a drop?

I actually felt so much better on the Nature-throid than on the T3 only. I probably shouldn't have been adding the 5mcg of cytomel as needed but I was trying to experiment to see if I needed more T3 or if the Nature-throid was a good mixture.

I tested my thyroid levels the morning before taking my cytomel (last dose was probably about 15 hours before) and my FT3 levels were about 2.6 I believe.

I wonder if it takes some time to normalize the RT3 - maybe it was caused by the high T3 from the Cytomel? It also could easily be caused by my chronic infections (Bartonella, EBV), overexercise and intermittent fasting.

What do you think I should do about dosing? I have been having some trouble sleeping so think maybe I should drop to 1.5 grains? Do you suggest splitting the dose and taking some in the morning and some in the afternoon which may help staying in the range?

I really appreciate your help!!

[greygoose in reply to Morgan2478]

I thought that 25mcg of T3 is equivalent to about 1 grain of Nature-throid. If that's right then it's not too much of a drop?

It's very difficult - if not impossible - to say that so much T3 or so much T4 is equivalent to so much something else. It all depends how well you convert. I grain of NDT contains 9 mcg T3, that's all you can depend on. How much of the 38 mcg T4 gets converted to T3 is anybody's guess, so you really can't base your dose on that. I think I would have started with at least 1.5 grains, and titrated from there.

I probably shouldn't have been adding the 5mcg of cytomel as needed but I was trying to experiment to see if I needed more T3 or if the Nature-throid was a good mixture.

Depends what you mean by 'as needed'. If it was just from time to time, it wouldn't tell you anything.

(last dose was probably about 15 hours before) and my FT3 levels were about 2.6 I believe.

15 hours is a bit too long. Should be maximum 12 hours. But, I don't know what 2.6 means, without the range.

I wonder if it takes some time to normalize the RT3

Given that rT3 only stays in the blood for about two hours, I should think it normalises pretty quickly. And high rt3 could be caused by any of the things you mention, or all of them.

I have been having some trouble sleeping so think maybe I should drop to 1.5 grains?

If you're going to drop, only drop by 1/4 grain every two weeks. It's so easy to miss your sweet spot.

I wouldn't suggest splitting your dose, I would suggest you try splitting your dose and see if it helps. Some feel better that way, some don't. And, others don't notice any difference. It's all trial and error, and we have to experiment to find what is best for us as an individual.