T3 t4 rt3 advice please

[muci]

Hi, looking for feedback on my thyroid issues.

Diagnosed in 2011

On t4 only, have always had ft4 in high mid to high range, ft3 in low range and TSH in low range.

Never felt completely good but better than when diagnosed.

In 2018 my ft3 started to go below range despite ft4 being high. Numerous hypo symptoms

Since february of this year my dr has been adjusting my doses of t4 and adding t3. Lowered t4 initially (at 75 mcg) and increased t3 a few times (at 6 mcg)

Latest test results are:

TSH .36 (.32-4)

Ft4 15 (9-19)

Ft3 3.9 (2.6-5.8)

B12 561 (138-652)

Ferritin 70 (5-272)

Vit d 141 (75-250)

Note that prior to adding t3 my b12, ferritin and vit d were all quite low I had increased with supplements as well as adding selenium, zinc and magnesium, none brought up my ft3 until adding t3 medication

Thyroglobulin antibody 74 (<40)

Tpo antibody 23 (<35)

Dr believes rt3 may be high with these test results (was tested high in past) and is lowering t4 and increasing t3. Please let me know if this can bring me to where I should be and that I’m on the right track. Slow process waiting to adjust and tweaking doses!!

[muci]

RT3 was 19 (8-25) when tested

[greygoose in reply to muci]

That rT3 is fine. And your FT4 is not high enough to be causing excess rT3. If it is high - and he really should test it before taking action - then it could be due to your low ferritin - or to a host of other things. Your levo does not need lowering - although, if it were me, I would want an increase in T3, because your FT3 is not even mid-range. But, you don't have to reduce the levo every time you increase your T3. That could just make things worse.

[muci in reply to greygoose]

Thank you, so many factors in trying to get optimal levels and feel good. Gets frustrating.

[greygoose in reply to muci]

I think part of the problem here is that doctors just don't understand nutrition, and the part it plays in optimal health. But, even if it is the low ferritin causing high-ish rT3, the symptoms will be caused by the low ferritin, not by the rT3 itself.

[Aurealis]

You’re on a tiny dose of T3. I think I’d try increasing T4 first if it was me. Your conversion might be better now you’ve increased other things ... but you may need to increase T3 later too, or replace T4 with T3. It is trial and error. Your dr may well be right, I think there will be lots of posts supporting his decision. You have a good one there!