High reverse t3 on T4 only

[Daisybellerose]

I’ve been feeling a lot more hypothyroid recently and just constantly told my doctor that my results are in range.

Just paid for a full thyroid panel and results are as follows:

TSH 0.247 (0.27-4.2)

Free T4 21.8 (12-22)

Free T3 3.61 (3.1 -6.8)

Rt3 30 (10-24)

FT3:RT3 7.83 (>15)

I realise I’m over medicated on T4 which I need to address but I’m concerned about the high reverse t3. Has anyone else had a reading like this? Is it just likely not converting to the T3 any more or can it be another issue? Thanks.

[greygoose]

The high rT3 is almost certainly due to the high FT4. You can see, obviously that you are not converting at all well, which is why the T4 has got so high.

Why you're not converting is uncertain. Have you had nutrients tested: vit D, vit B12, folate, ferritin? And selenium. How about cortisol? Are you on a low calorie diet? Have you had an injury or infection recently? Do you have Hashi's?

Correcting conversion, if possible, is a long-term project. In the immediate, the only thing you can do is reduce your levo and add in some T3.

High rT3 is not, in and of itself, a problem. But, with such a low FT3, it's hardly surprising that you don't feel well.

[Daisybellerose in reply to greygoose]

Hi thanks for your quick reply.

I’ve checked all my nutrients - my vitamin d was a tad low -I’ve got it up to 60 now and trying to get it higher. Everything else is ok. I have got hashis and have been gluten free/grain free for last six months and although I’m not counting calories I realise the effect of lowering my carbs has probably actually made my conversion worse somewhat 😞 it’s so hard knowing what to do for the best.

I did a saliva test for cortisol and that showed all normal apart from the evening which was raised. I might repeat that again just to check.

[greygoose in reply to Daisybellerose]

Low carb can indeed affect conversion. You need carbs to convert. Perhaps you could try increasing your carbs a little, see what happens?

[Daisybellerose in reply to greygoose]

Yes I’m going to get back on my gluten free oats and see what happens. I’ve also made an appointment to see a private doctor to discuss t3. Shall I lower my T4 dose tonight? Or shall I see if that rectifies itself with the carbs?

Thanks

[greygoose in reply to Daisybellerose]

Try reducing your T4 a little, see if that improves conversion. It might. But, I doubt it would be enough on its own to raise your FT3 enough to make you well without the addition of some T3. Or, try the carbs. But that won't be a quick fix. But, don't do both at the same time, or you won't know what is helping - if either of them.

Interesting article:

unboundwellness.com/im-not-...

[Daisybellerose in reply to greygoose]

Thanks for the article. It’s actually reassured me that my diet has actually been ok -I’ve been eating lots of fruit/veggies/sweet potato etc just not bread/potatoes/grains

Maybe it’s not that afterall🤔

I’ll try reducing my dose while I wait to see the doctor.

Thanks so much for your time.

[greygoose in reply to Daisybellerose]

You're welcome.

[Hidden in reply to greygoose]

GG, do you have a link to a source? I'd be interested as I have tried low-carb diets in the past, felt horrible and almost zombie-like after a few days, only to be told by others that it was the "carb detoxification process" that I had to get through in order to come out on the other side of the tunnel and see the light...however, LC does not work for me, and I feel sluggish even on high doses of NDT. The symptoms go away within 24 hours after adding more carbs.

[greygoose in reply to Hidden]

Depends what you mean by 'a source'. I gave a link to an article on the subject, above. And, here's another:

eastwesthealing.com/hypothy...

But, I don't have any links to actual research.

[Hidden in reply to greygoose]

Thanks!

[Luna1390 in reply to Hidden]

I don't have a link but I read an article by Chris Kresser's nutritionist that said some people just need more carbs. I did AIP for 6 months & had horrible insomnia after awhile and just felt awful. The article said that low carb/paleo can lower glycogen stores in some people to the point that it causes insomnia and low energy. For me, once I added carbs back in, I started sleeping well again (it took a few months to slowly resolve). I didn't gain any weight & feel much better. People are all so different. So many websites preach Paleo for Hashimoto's, but I don't think it's a one-size-fits-all type of thing.

[greygoose in reply to Luna1390]

It certainly is not! We're all very different.

[Luna1390 in reply to greygoose]

This is such a good point. I have recently added more carbs back into my diet and have been shocked by how much better I feel.

[jgelliss in reply to greygoose]

greygoose your suggestions are *Spot On* as usual . I would also suggest to check liver enzymes . Since most of the conversion goes through the liver it might be time to check out the liver .