I haven’t posted here in a while because since last year I have made HUGE progress with healing my thyroid and hashimotos. I got on NDT, and upped my LDN. I changed diet and lifestyle stuff and FEEL so much better than last year. I lost weight, my skin cleared up, but I have also been through an immense amount of stress the last 7 months. My supplements are dialed in and I’m feeling better as my symptoms have decreased. So why are my lab numbers so dangerous? Someone in the thyroid space told me my t4 is dangerously high, my reverse t3 is dangerously high as well. I was told to lower my NDT dose and add in t3. So that’s what I’m doing but I am wondering what you guys have to say about my labs and what you would do. I’m scared because the woman in the thyroid space told me high reverse t3 is indicative of poor health and heart issues.
I was on 130mg of nature throid NDT during these labs. but today I lowered it to 65mg and I added 5mcg of t3 , in hopes my t4 will go down and my RT3 will go down.
Written by
Queenofwands1212
To view profiles and participate in discussions please or .
With NDT you dose to the relief of symptoms and not a blood test :
Having said that all these results are all said to be normal :
What is this blood spot ?
Dropping 65 mg NDT - 1 grain of Nature Thyroid - half your daily dose -
which contains 9 mcg T3 + 38 mcg T4
and adding in just 5 mcg T3 doesn't seem to make much sense to me.
We all have reverse T3 - it is surplus T4 - and since you are liable to swings in your thyroid levels as your gland comes under attack this is the body's way of loosing surplus storage hormone.
I'm with Graves and post RAI thyroid ablation and my reverse T3 was way over range 6 years ago - I don't know where it is now, I would presume less as I now take just 1 + 1/2 grains with a T4 content around half that of when on T4 monotherapy.
So yes, I agree that I should manage meds based on symtoms not labs, but with that said, a reverse t3 of 30 is very high. It might say “normal” but it’s only 1 point off “normal” and it’s definitely not okay for me. And my t4 is high. So that is why I lowered my NDT and added t3 only. I did that today and actually feel a little better. I’m just mainly concerned about the reverse t3 because I was told this can be indicative of heart issues and poor health. Being reverse t3 hypothyroid is definitely a thing, I’ve listened to so many podcasts about it and read about it. So as I am not experiencing weight gain symtoms like last year, I am having sleep issues, and I am not eating enough but I am maintaining my weight so I know my metabolism is very hypo right now. I assumed even small doses of t3 would be helpful but I guess I’m an idiot and wrong lol
On NDT some people run with a low T4 - whilst others run with a high T4 :
i run with a low T4 and presume I'm better able to convert the T4 into T3 -
I run with a T3 at around 95/100% through the range and a T4 at around 25% after 10 hours and having fasted and I take all my NDT at around 2/3 am in the morning :
Currently your T3 is running at around 62% and your T4 at around 83% :
No thyroid hormone works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal levels so these might need looking into :
You say you feel so much better so why jeopardise what you have achieved for an unknown ?
yeah that makes sense. The only reason I was thinking about changing my NDT dose and lowering it is because high reverse t3 number scared me and can be an indicator of heart issues and health issues. That’s all
High reverse T3 can also be excess T4 and that's what mine has/had to be as I wasn't able to convert the T4 well when on T4 monotherapy.
Now I seem to convert very well so I needed that T3 to kick start my metabolism and with optimal vitamins and minerals my reading look and are good for me.
As for my reverse T3 that was 50% over the top of the range 6 years ago - who knows, and I'm not concerned as I'm more well now than than.
yeah that’s exactly what I was thinking my issue was. T4 isn’t being converted to t3 and it’s only going to reverse t3. So that’s why I was thinking adding in t3 would be helpful since my NDT is only 18mcg of t3 with the ratio. I just know too much t4 isn’t good. I guess I will continue what I’m doing and keep my 130NDT and add a little t3 and focus on stress releif and stress management becaude I think that has something to do with my rt3
Your results are all normal and there is nothing wrong with your results..
You said you felt so much better this year, and until you saw this print out you were in a happy place with yourself.
The first advice you got from some thyroid blog in the States was alarmist and wrong so it was a good idea to get our second opinion.
As you continue to improve your health your conversion may well improve and you may find you can drop a little NDT anyway as it takes time for the body to adjust and plateau and I found I was still seeing improvements in my overall health and well being for around 2 years.
There are no quick fixes with thyroid hormones and we need to go just go one step at a time and slowly.
So why are my lab numbers so dangerous? Someone in the thyroid space told me my t4 is dangerously high, my reverse t3 is dangerously high as well. I was told to lower my NDT dose and add in t3.
Goodness! Who is this "someone in the thyroid space"?
FT3: 3.1 (2.1-4.2) = 47.62% through range
FT4: 1.8 (0.8-2.0) = 83.33% through range
I wouldn't call your FT4 dangerously high, it's probably higher than most people who are on NDT, one might expect to see FT3 higher than FT4 when on NDT, but that result, in my opinion, is not dangerously high. What on earth are they expecting to happen - spontaneous combustion?
My supplements are dialed in and I’m feeling better as my symptoms have decreased.
Surely this is telling you something. You feel better, perhaps these levels are right for you. They may not be right for everyone but we are not clones, we need what we need and if you need your levels there then so be it, it's nothing to do with where anyone else needs their levels.
rT3: 30 (8-31)
my reverse t3 is dangerously high as well.
Top of range but not over range. Are you aware that reverse T3 can be high for many reasons and only one of those reasons is to do with thyroid and that is when there is an excess of unconverted T4.
If not caused by an excess of unconverted T4, the other conditions that contribute to increased Reverse T3 levels include:
· Chronic fatigue
· Acute illness and injury
· Chronic disease
· Increased cortisol (stress)
· Low cortisol (adrenal fatigue)
· Low iron
· Lyme disease
· Chronic inflammation
Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.
Is your top of range rT3 caused by excess unconverted T4? Who knows but rather than half your dose of NDT it might have been better to do things slowly and gradually reduce if that's what you want to do (but you shouldn't be frightened into it by anyone scaremongering like that), starting say with half a grain reduction (30mg) and see what happens. We should never change two things at the same time, when we do how do we know which is making a difference?
If NDT is giving you too much T4 and not enough T3, maybe it's not right for you. Maybe you'd be better with synthetic T4 and T3 which gives you the flexibility to tailor the doses to exactly what you need. Many here on the forum find that the synthetic combination is better for them than NDT.
thanks for all the info! Synthetics do not work for me at all. I was on them for many years and synthroid kept me sick and full of symptoms. Will never go on that again. NDT works wonders for me! I think I just need to tweak dosaging. I truly do believe 130 mg of NDT is too high of a dose. But yeah that makes sense maybe I will lower my NDT 30mg down . It’s just very challenging to cut my capsules.
You actually do not know that, that synthetics do not work for you Why? I will try to make this short and will fail. I did horrid on Synthroid. Was up to 225 mcg, could hardly function through a day.
I sourced NDT. Wonderful changes. Almost instantly.
My next batch is sitting Lord knows where, maybe customs and no one can find it. Maybe a customs agent took it home.
Coincidentally a new endocrinologist offered me prescription NDT or Cytomel plus back on Synthroid, at the very same time as this mail fiasco.
I just wanted my package to arrive but with no thyroid I had to do something.
I chose the latter, seemed crazy to go back anywhere near Synthroid. But I chose it, with the Cytomel added.
I am only a week or so in & it feels nothing like Synthroid only. Nothing .
So maybe synthetics are not good for you. But if you have only done levothyroxine by itself, you simply do not know that fact 100% as yet.
And who are these thyroid space people? Are they related to the Facebook b12 group? Insert big smile. Because we are continually doing damage control with them over on the PAS section here. Those ones are cuckoo for cocoa pops at times.It is crazy late here so excuse my fun! Smiling.
All.the best to you. So very happy you found a good change for you That is wonderful. And like Pennyannie said you dose by symptoms for NDT, not labs. And that is going well for you, which is fantastic news.
Don't know who you've been talking to , but really ... i can't see that there is anything at all dangerous those labs . I cant see any risk , or any cause for concern ..... at all .
If you feel well on your current dose of NDT , then dropping your NDT dose in half (by 1 whole grain ? ) and replacing it with just 5mcg T3 is probably not a good idea ... and would seem entirely unnecessary as far as i can see, based on those labs .
1 grain ? ( 60/ 65mg ish ) NDT usually contains about 38mcg T4 and 9 mcg T3.
5mcg T3 is not remotely 'equivalent' to that and will not make up for the loss of T4 and T3 . So what you propose is a fairly significant Decrease in your total thyroid hormone dose .
The "95% population reference ranges" are there for a reason , to show the outer limits of what is usual / to be expected in healthy people.. and all your results are comfortably with those ranges , so what's the problem ?
Your TSH of 2 is showing that you may not be on quite enough thyroid hormone in total unless you currently feel well with TSH at 2 ,in which case its fine .... so a decrease (and especially such a large one) seem unwise to me.
( TSH is usually around 1 or2 in healthy people who are not taking any thyroid hormone .. but in people who are taking thyroid hormone it sometimes end up a bit lower than that once they are on the righ dose to make them feel well)
High Reverse T3 has a MULTITUDE of potential causes ( only one of which is 'too high T4 levels' )
There's nothing wrong with your FT4 levels. For years my FT4 level were 1.94 and even then my TSH was still 1.5. If you tested your Total T4 and Total T3 you'd most likely find those under the top of the range. This is why my Dr ran all Frees and Totals. My FT4 levels were high but my Total T4 was only about 50-70% in range so I was never overdosed feeling. It takes high FT4 levels to bring my TSH down but that doesn't necessarily equal more T3 which is why we're all here on T4/T3, T3, and NDT!! My Dr always said my FT4 was too high and my response was I don't have a functioning thyroid gland so what are you going to replace it with? Make sure you keep your calories and carbs up to keep up your T4/T3 conversion. Poor appetite really did a number on my conversion!
I have been instructed by functional doctors to Not take your thyroid medicine till after you do your bloodwork.
In the US functional doctors recommend TSH to be in the range of 0-1. My doctor has advised an ideal range for Free T3 should be between 4-5 and Free T4 to be close to 1.6. RT3 is only slightly higher. It seems that you are doing ok. As someone who’s thyroid has improved over the years, but has adrenal issues, Stress management is something always to work on.
I'm one of those people on ndt who needs her thyroid hormones to be high in range. Your results are fine. You feel much better you say. Seems to me you are on to a bulls eye! I'd leave well alone. Focus on ensuring you vits a d minerals are optimised.....all helps with uptake and feeling well.
When taking ndt blood tests are a guide. Keep in mind that TSH, Ft4 & Ft3 were designed to be used with synthetic thyroid hormones. I always keep my thyroid hormones in range but as important, if not more so, is how you are feeling, what symptoms & signs do you have - if any. You can cross check this by taking your temperature & pulse first thing in the morning before rising.
I'd mentally kick into the bin what that person said online..... they clearly don't know what they're talking about!!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
T3 Only - 5 Weeks in
GP review - low TSH on NDT
What should I do with tirosint and cytomel? 
High TSH causes?
