reverse t3 tests

[Emuflea]

Where do you get your RT3 home tests from?

[greygoose]

Why do you want an rT3 test? It's long, expensive, and won't give you any useful information that you can't get from TSH/FT4/FT3. Really not worth testing.

[Emuflea in reply to greygoose]

My t3 is consistently high with t4 consistently low. Was told this can be due to the ratio of rt3 and that I should test. Was also told it was pooling which this site said doesn’t exist. Am going to stick with SlowDragon advice as much as possible. I’ve been trying to get well for 5yrs. The array of advice is bewildering. Meanwhile I’m still fat, tired and sad.

[greygoose in reply to Emuflea]

Yes, well, I'm afraid you'll get told all sorts of things that aren't true, by doctors and on other forums. But, stick with this one because we have a real scientist to guide us: diogenes.

Pooling doesn't exist. The half-life of T3 is only about 24 hours, it doesn't have time to 'pool'. But, I thing that what some people mean by 'pooking - although they don't realise it - is thyroid hormone resisitance, where it has trouble getting into the cells. But, that has nothing to do with rT3.

If your FT3 is always high, but you are still hypo, that is a sign that it's not getting into the cells - for whatever reason. Are you taking T3? Or do you just have exceptionally good conversion?

Having high T3 can cause T4 to convert to excess rT3, it's true. That's a safety measure the body has put in place to try and avoid you having too much T3. But, if you have resistance to thyroid hormone, you need even higher levels of T3 flood the resceptors and try and get some hormone into the cell.

But, whatever rT3 you have, it's not doing you any harm. It's not blocking the receptors, as used to be thought, it has its own receptors. It is inert - doesn't cause symptoms - and only stays in the body for a couple of hours before it is converted to T2. So, there's really not much point in worrying about the rT3 isefl, just the causes of it.

Oh, and forget ratios. They are totally irrelevant when hypo.

[Emuflea in reply to greygoose]

Thank you. V helpful. Yes conversion seems to be great but not using the t3. If I increase t4 the t3 goes up even more. So do I increase t3? My doctor is good but I think I’ve gone beyond his abilities because he’s made me stop t3. However I FEEL better with t3. Even if it’s just 12.5mcg am (I did this for 5 days to get through a festival with my kids). One of the many pieces of advice I’ve had is to lower the t4 and reintro t3.

[Lalatoot]

Rt3 is a red herring. Testing it is a waste of money There are many reasons for high rt3 and only one of them is thyroid. Testing will tell you if rt3 is high but not what is causing it.

Rt3 does not stop t3 getting into the cells. It has its own roll to play.

I wouldn't waste your money.

[SlowDragon Administrator]

Previous post

healthunlocked.com/thyroidu...

shows

High CPR

Ft3 too high

Ft4 too low

absolutely dire ferritin at 16

High TPO confirms autoimmune thyroid disease

Since this, have you reduced T3 dose by 5mcg and increased dose levothyroxine by 12.5mcg or even by 25mcg

Suggest you retest see where levels are now

Last dose levothyroxine 24 hours before test

Day before test split T3 into 3 smaller doses spread through the day

Last 1/3rd of daily T3 dose approx 8-12 hours before test

[Emuflea in reply to SlowDragon]

My doctor told me to drop the t3 completely. It’s all such a mess.

[SlowDragon Administrator in reply to Emuflea]

Which was ridiculous

Adjust everything SLOWLY

I would have reduced T3 by 5mcg initially

Retested after 6-8 weeks

Then, assuming Ft4 was low, increased levothyroxine by 12.5mcg or 25mcg …..then retested again after 6-8 weeks

But now ….you are where you are

On just 150mcg levothyroxine

Essential to get all four vitamins optimal

Retest thyroid levels after 6-8 weeks on constant unchanging dose and brand of levothyroxine

[Emuflea in reply to SlowDragon]

Is it possible to buy t4 without prescription? I’d like to follow your advice but need my doctor for the t4. I’m now just on 150mcg of levo am.

[SlowDragon Administrator in reply to Emuflea]

For levothyroxine or T3 to work you need optimal vitamin levels

Vitamin D at least around 80nmol minimum

Serum B12 at least over 500

Folate and ferritin at least half way through range

Ferritin at least over 70 minimum

We need good vitamin levels for good conversion of Ft4 to ft3

Try splitting your levothyroxine into 2 doses - half waking and half at bedtime

This might improve conversion as well

GP should investigate cause of high CRP

Are you on absolutely strictly gluten free diet

[Emuflea in reply to SlowDragon]

I’m gluten free already. And I’ve got Lyme hence the CRP.

[Emuflea in reply to SlowDragon]

Here’s the latest blood test. What do you make of it? I’m tired, gained more weight, and squirting out stress hormones with the slightest challenge (washing, dressing, warm weather).

Blood test results

[SlowDragon Administrator in reply to Emuflea]

Folate is too low

Ferritin is terrible, and deficient

You need full iron panel test for anaemia

May need iron supplements

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Also See page 7 on here

rcn.org.uk/-/media/royal-co...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked

preventmiscarriage.com/iron...

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

NEVER supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron

Medichecks iron panel test

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Good explanations of iron

theironclinic.com/iron-defi...

theironclinic.com/ironc/wp/...

[SlowDragon Administrator in reply to Emuflea]

What vitamin supplements are you currently taking

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement

If taking separate B12 suggest you stop this….just take vitamin B complex

[Emuflea in reply to SlowDragon]

These are the supplements I was taking

Supplements

[SlowDragon Administrator in reply to Emuflea]

Wouldn’t recommend that at allRidiculously high dose vitamin supplements

[Emuflea in reply to SlowDragon]

That's why I stopped. Felt no difference stopping.

[SlowDragon Administrator in reply to Emuflea]

Was test done early morning and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you currently taking

Are you lactose intolerant or tried dairy free diet

[Emuflea in reply to SlowDragon]

I currently take no supplements as it had gotten silly the amount I was taking. So this is me with diet only. I do eat liver and red meat but could probably do with more. I don’t eat gluten and have reintroduced dairy. The test was done straight after waking and 24hrs after last dose. The brand is mercury pharma. Hope that helps. Shall I reintro t3?

[SlowDragon Administrator in reply to Emuflea]

At the moment your results show you need dose increase in levothyroxine

FT4: 13.7 pmol/l (Range 12 - 22)

Ft4 only 17.00% through range

FT3: 5.35 pmol/l (Range 3.1 - 6.8)

Ft3 is way higher at 60.81%

How long after stopping T3 was this test done?

Shows incredible conversion

Suggest you increase levothyroxine by 12.5mcg daily and retest in 6-8 weeks

May need to increase again after next test

Looking for Ft4 at least 50-60% through range

[Emuflea in reply to SlowDragon]

Stopped t3 6 weeks ago. Will do the t4 increase but only have 50mcg tabs so 12.5 will be hard to achieve.

[Emuflea in reply to SlowDragon]

Hi

Latest test results: TSH 4.09, Free T3 5.1, Free Thyroxine 10.

This is on 100mcg levo am, t3 11am 6.25mcg and 4pm 6.25mcg.

Would love to know your thoughts.

Not sure what these results tell you but I can say that I feel awful until I take that first dose of T3 but it feels like I need more.

(Ferritin still dire and I’m still working on it)

Thanks

Emily

[SlowDragon Administrator in reply to Emuflea]

please add ranges on results

Was test done early morning around 9am and last dose Levothyroxine 24 hours before test

And last dose T3 approx 8-12 hours before test

What vitamin supplements are you currently taking

[Emuflea in reply to SlowDragon]

TSH 4.09 (0.27-4.2)

Free T3 5.1 (3.1-6.8)

Free Thyroxine 10 (12-22)

Yes.

An ADEK supplement.

[SlowDragon Administrator in reply to Emuflea]

Was last dose levothyroxine 24 hours before test

How much levothyroxine are you currently taking

Do you never forget a dose?

Got a weekly pill dispenser

Do you always get same brand levothyroxine at each prescription

approx how much do you weigh in kilo

[Emuflea in reply to SlowDragon]

yes was 24hrs. Always same brand. Don’t forget as do it when I wake. Weigh…a lot. Never used to.

[Emuflea in reply to SlowDragon]

100mcg (down from 150mcg last time because t4 was high) levo 6.30am. T3 6.25mcg 11am, and again 4pm.

[SlowDragon Administrator in reply to Emuflea]

How long since you reduced dose levothyroxine

Reducing even by 25mcg a day is frequently far too much

Reducing by 50mcg catastrophic

Clearly woefully under medicated

Ft4 is below range

Increase dose to 125mcg every day and retest in 6-8 weeks

Meanwhile test iron, ferritin, folate, B12 and vitamin D

[Emuflea in reply to SlowDragon]

ferritin is still low, in fact lower than ever

[SlowDragon Administrator in reply to Emuflea]

Hardly surprising as you’re even more under medicated now

Approx how much do you weigh in kilo

Guidelines on dose levothyroxine by weight is 1.6mcg per kilo per day

Improving low vitamin levels essential

Eating red meat everyday, with glass of orange juice. Liver or liver pate once week. Black pudding. Etc etc

Aim for ferritin minimum 70 and nearer 100 likely better

Are you taking Daily Thorne Basic B vitamin complex (as detailed in previous reply above)

[Emuflea in reply to SlowDragon]

well according to that I should be on 200mcg

[SlowDragon Administrator in reply to Emuflea]

well your previous results on 150mcg (6 weeks after stopping T3) showed you needed dose INCREASE in levothyroxine

I suggested 3 months ago that you increase levothyroxine to 162.5mcg daily

Instead you reduced levothyroxine to 100mcg

Results show you are now very under medicated

Don’t go straight back to 150mcg too big a shock to the system…….Increase dose levothyroxine back initially to 125mcg daily

Wait 6-8 weeks, then increase dose to 150mcg and hold at that dose 6-8 weeks minimum before testing thyroid and vitamin levels

Meanwhile working on improving terrible ferritin

Likely to need to increase levothyroxine SLOWLY upwards after being on 150mcg 3-4 months. But only by 12.5mcg daily

[Emuflea in reply to SlowDragon]

hi I definitely didn’t gather I needed to increase, but I’m dyslexic and adhd so these replies all over the place are overwhelming…on top of how overwhelming sorting your own health is. I appreciate your input very much.

I reduced because my Polish doctor told me to and he’s who I get the prescription from. That’s why I was looking for other ways to get the prescription so I could have more independence.

[SlowDragon Administrator in reply to Emuflea]

Suggest you write new post asking members for source of non prescription levothyroxine by private messages only

Which brand of levothyroxine are you currently taking?

It’s unlikely that you will get same brand

Some EU countries you can buy levothyroxine over the counter

[SlowDragon Administrator in reply to Emuflea]

On just 150mcg levothyroxine 

3 months ago you said (earlier in this post) you were taking 150mcg having stopped T3

FT4: 13.7 pmol/l (Range 12 - 22)

Ft4 only 17.00% through range

FT3: 5.35 pmol/l (Range 3.1 - 6.8)

Ft3 is way higher at 60.81%

Results showed then that you needed dose INCREASE in levothyroxine

And working on improving terrible vitamin levels

[SlowDragon Administrator in reply to Emuflea]

What exactly is this ADEK supplement

[Emuflea in reply to SlowDragon]

a supplement with vits a, d, e and k.

[SlowDragon Administrator in reply to Emuflea]

yes obviously….but which make

We never ever recommend multivitamins

Most are cheap poorly absorbed ingredients. Too little content for any deficiencies

Come back with new post once you get FULL thyroid and vitamin results 6-8 weeks after increasing to 125mcg daily

We frequently need to fine tune dose levothyroxine

Eg might eventually need 125mcg 4 days week and 150mcg 3 days …or 125mcg 6 days week and 150mcg one day

It can take months slow steady fine changes in dose to find sweet spot

All four vitamins need to be tested annually and at optimal levels

[Emuflea in reply to SlowDragon]

the are mitocare drops.

I did get a full thyroid panel done. Ferritin still awful so didn’t include it. Whatever I’m doing isn’t working.

Thanks for the info re levo. Will do 125mcg. Can I take some t3 in the morning? Feel so awful til 11 when I take the first t3 dose.

[Jazzw]

Nowhere, it isn’t a useful test.