Like everyone, I'm trying desperately to get my antibodies at an optimal range.
I currently take 75 mcg of Tirosint and also something called T-150 by Xymogen, which my functional doc prescribed. (It's basically a bovine, multi-glandular, mineral, and herbal formula to support healthy thyroid function).
I did not take biotin for 2 weeks prior nor did I take thyroid meds for 24 hours prior. Could I possibly be overmedicated now? Previously my TSH was 6 and now it's super low! Plus my Reverse T3 has risen from 11 to 28!
Also, I've heard that over-medicating can cause Reverse T3 to rise. Does anyone know if this is true?
However, my T-3 and T4 seem to be converting better than my last labs. 🤷♀️
Side note: Because my Iodine was low I started taking 1 mg of iodine supplementation. Prolamine Iodine by Standard Process. I don't feel like Im having any side effects, I actually I feel like I have more energy. Any help is much appreciated!
TSH 0.204 ref range 0.450-4.500
Reverse T3 -28 - ref range 9.2-24.1
Free T3 -2.4 ref range 2.0-4.4
Free T4-1.57 ref range 0.82-1.77
TPO -18 - ref range 0-34
C- Reactive protein Cardiac - 2.25 ref range 0.00-3.00
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JannSimpson
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That's a lot of Iodine .. about 40mcg from the T4 in tirosint + 40 mcg per capsule of xymogen + 1000mcg + plus whatever you consume in food ...........the recommended daily requirement is only about 150mcg .
if fT4 is 'too high' then yes, that is one cause of high ReverseT3 , but to be honest your fT4 doesn't seem particularly high ...there are lots of other reasons for high reverse T3.. if you wanted to see if a lower dose of tirosint lowers the rT3 you could always try it .. but the fT3 is already pretty low, so if too much T4 is not the cause of yor High rT3 then reducing tirosint will just reduce your fT3 even further.
That TPOab level wouldn't concern me personally ,as they are well within range .
And that is with you entirely ignoring the iodine content of 150 milligrams of thyroid powder (T4, T3, DIT, MIT, etc.) and the 15 milligrams of bladderwrack and 400 milligrams of dulse. All of which are not properly declared.
All such products should have to declare TOTAL iodine content.
helvella I agree! Ive been taking it for a while now and my Iodine levels still have not come up. Ive tried additional kelp, seaweed ect.. and nothing. Not sure why my levels are still so low. I don;'t eat table salt, only Celtic Sea Salt.
tattybogle I will definitely revisit the Iodine dosage. It was my decision to try it.
I follow a FMD names Carrie Vitt who recommended that we can start with this dosage, if Iodine levels are low. Ive also read Dr. Brownstein's book on how important Iodine is, (as controversial as it is regarding thyroid issues). If we don’t have enough iodine in the body, we cannot make enough thyroid hormones, in particular, T4, which can lead to hypothyroidism.
I've since seen where 150 mcg is the best dosage for females. And even though I totally trust Standard process products, I must admit, Im confused because these start at 600 mcg per pill.🤷♀️
And yes we will be looking into lowering my Tirosint to see if that helps lower the RT3. Ive been told that TPO over 20 is considered positive by many FMD's so I like to see it at least that low or closer to 0 if possible. ( at least I can try 😎)
After watching this video I have decided to stop the Iodine and get tested for deficiency. I will also revisit whether I need it in supplementation or not.
Regenallotment The thing is I actually feel better than I did. My previous Free T3 Level was even lower at 1.9!! So it looks to have come up a tad.
I will definitely revisit the dosage of Iodine. It was my decision to start it as my levels were extremely low. I have read Dr. Browinsteins book on how important it is and I follow Carrie Vitt FMD and she reiterates If you don’t have enough iodine in the body, you cannot make enough thyroid hormones, in particular T4, which can lead to hypothyroidism.
I may be grasping at straws, but when my Vitamin D was super low, I supplemented to get it back where it should be. Why wouldn't we with Iodine? Sincerely asking 🤷♀️
As far as Reverse T3 goes, I'm told by Health counselors on Hashoimotos 411 and from other functional health care blogs and articles that It’s an inactive thyroid hormone and eventually lowers our free T3, the active hormone. And if RT3 is made in EXCESS, we end up having a problem. Our metabolism is lowered, and we experience more hypo symptoms.
Plus TPO can ( and has in my experience) be lowered. I know some think remission is a pipe dream, but I'm still trying 😊
hey Jan, only you know what is right for you and if FT3 is increasing then that’s what you want. Can only be a good thing.
Yep my D was low too, among othe vitamins and yes I supplemented and benefited. I see your point.
My understanding with iodine is that there are two camps some who say we all need more and some that say you will make yourself sicker, I’m no specialist but tried it and felt awful so stopped. Your experience sounds different.
rT3 there is a whole lot of stuff out there on this and I’m not sure I buy it, I listened to Dr Eric Balcavage interview Proff. Bianco, they discussed this and emphatically said rT3 cannot reduce FT3, here is the link podcasts.apple.com/gb/podca... again different schools of thought so we can make our own minds up.
TPO I’m a massive fan of Izabella Wentz, her books and diet brought me back to life, but one thing I disagree on is this concept of remission and reducing antibodies. but that’s me, others disagree with me. 😊
Like everyone, I'm trying desperately to get my antibodies at an optimal range.
As far as I'm aware, everyone is not trying to get their antibodies at an optimal range. There's no such thing as an optimal range for antibodies, anyway, only positive or negative. And, besides, why would they want to do that? And, how would they do it?
The antibodies are not doing you any harm. They are not the cause of the disease they are the result of it. So, even if you got rid of them completely you'd still have Hashi's - I take it you do have Hashi's? In any case, on the above test, they are negative for Hashi's. But antibodies do fluctuate all the time.
Same goes for rT3, it's not doing you any harm, so forget it. Waste of time and money testing it.
Because my Iodine was low I started taking 1 mg of iodine supplementation. Prolamine Iodine by Standard Process. I don't feel like Im having any side effects, I actually I feel like I have more energy.
Possibly you do have more energy because, in the beginning, iodine stimulates the thyroid to make more hormone. And, more T3 could only do you good, as yours is so very low. But, that won't last. Stimulating a sick gland only hastens its demise. And, in any case, high doses like you're taking are anti-thyroid. Iodine used to be used to treat Graves' before antithyroid drugs were invented.
Best to avoid all things that call themselves 'thyroid support'. In the first place, they will not 'support' your thyroid - whatever that even means! They won't do it any good at all, and could do a lot of harm. Secondly, all functional doctors are best avoided, in my opinion, because they don't know any more about thyroid than any other type of doctor - they sometimes appear to know less! - but they do have some very weird ideas and theories. Yours appears to be hell-bent on destroying your thyroid as fast as possible. What he should be doing is prescribing you some T3 or NDT to bring your FT3 level up. It is very low. And given that you're only over-medicated if your FT3 is well over-range, no, you can't possibly be over-medicated. You are under-medicated, regardless of the TSH.
I agree with Regenallotment . Forget the rT3 and the iodine, and all forms of so-called thyroid 'support', but also forget the TSH. It is a very bad indicator of thyroid status.
greygoose Im sure you know what I mean by trying to get levels optimal and to feel better. We all strive to feel better right? And to achieve remission if possible. It's a daily struggle that all of us here encounter.
When I first started this journey some of my antibodies and vitamin/ mineral levels were off the charts. My TPO level was above 600! And others like Vitamin D, TSI, Reverse T3, Trab, etc...were wonky as well. This has all has been a huge learning curve.
However, Through diet, and lifestyle changes I have been able to get the TPO level as low as 13 and my Reverse T3 as low as 11. My Free T's are another story. I must admit I have resisted medication. I wanted to try and do this naturally. However, I know medication has its place, so I'm coming around to that.
The decision to take Iodine was my own. I've read Dr. Browenstein's book on how important it is and when my levels came back so low ( 36.8) I decided to supplement, as most high-iodine foods are high in histamine as well. I will review the dosage with my FMD this week.
That's a pretty broad statement about functional doctors. I'm sorry, I can't agree.
I trust my functional doctor 100%. She has helped to uncover parasites, candida, histamine intolerance, and adrenal dysfunction to name a few. Therefore my insomnia and internal tremors and anxiety have ceased. So I'm forever grateful for that. I'm taking the Thyroid support for T3 to see if it brings it up.
We are looking into adding a T3 medication if it doesn't. Unfortunately ( as you may know) sometimes It's trial and error to see what dosages work for different people.
I've tried NDT before and feel like it made me go hyper and now Im dealing with Thyroid Eye disease. Hopefully, my FMD is not " hell-bent on destroying my thyroid as fast as possible" That's a very negative and defeated statement as well.
As far as Reverse T3 goes, I'm told by Health counselors on Hashoimotos 411 and from other functional health care blogs and articles that It’s an inactive thyroid hormone and eventually lowers our free T3, the active hormone. And if RT3 is made in EXCESS, we end up having a problem. Our metabolism is lowered, and we experience more hypo symptoms.
Here is an excerpt on STOP THE THYROID MADNESS by Janie Bowthorp:
Thyroid patients have noted rising RT3 (reverse t3) due to inadequate levels of iron (due to absorption problems), having high cortisol (due to stress from still being hypothyroid or other conditions), having inflammation (such as from the autoimmune attack on the thyroid), and etc. Even a stressed liver can do it. THUS, you need to do all four iron labs if you want to follow all these years of solid patient experiences. Then compare the results. You’ll find out if low iron is your cause, and the ferritin will tell you if inflammation is the cause. Many endocrinologists believe that reverse T3 (3,3’,5-triodothyronine) is only an inactive metabolite with no physiologic effect. This is an erroneous belief as this and other studies demonstrate that reverse T3 (rT3) is a more potent inhibitor of T4 to T3 conversion than propylthiouracil (PTU) which is a medication used to decrease thyroid function in hyperthyroidism. In fact, rT3 is 100 times more potent than PTU at reducing T4 to T3 conversion. Clearly demonstrating that rT3 is not just an inactive metabolite, but rather a potent inhibitor of tissue thyroid levels.
I truly do want to hear the truth, but I hope to get more encouraging help on this forum.
I'm curious, Are you a healthcare professional? Or have any training in the area?
Thanks so much for your input and I hope you have a wonderful day! 🥰
Please don't patronise me. Obviously you want to get well, but the point is, it's not the antibodies, nor the rT3 that are causing you to be unwell. Doesn't matter how low you get them - and doubt that anything you did actually brought them down, they do sometimes just drop on their own - but no matter how low they are, you will still have Hashi's, and it's the immune sysem attacks on the thyroid, and the subsequent descruction of the gland that is making you feel unwell. And there is nothing you can do about it 'naturally'. If the thyroid is damaged, it cannot regenerate, so even if it were possible to reverse the Hashi's, your thyroid will never be able to make enough hormone to keep you well.
And taking iodine is not going to help your thyroid. It is just one ingredient of thyroid hormone, not some magic elixir to make the thyroid work better. It doesn't matter how many eggs you put in the batter, if your oven is on the blink, you still aren't going to get a cake out of it.
As for functional doctors, I'm sure they have their place, and are very useful for a lot of things. But not for thyroid.
rT3 does not lower T3. It's poor conversion that causes low T3 and high rT3. When you can't convert well, and your FT4 level gets to a certain point, it will convert to more rT3 than T3. But, what these people are telling you is not logical. If it is inert, how can it cause problems? It just sits in the system for a couple of hours and is then converted to T2.
There are many, many causes of high rT3, even in people with no thyroid problems, and they don't even know they have it. So, it can't be causing that much trouble, or everyone would be testing it!
And, please don't quote Janie Bowthorp at me! She does not keep up with the latest research of she would have scraped that article years ago.
I am telling you the truth. Your problem is not high antibodies - they have a job to do but it is a useful one, not destruction - nor rT3 - which is just a safety valve the body uses in certain situations and equally necessary. Your problem is that you're a poor converter and your FT3 is too low. It's low T3 that causes symptoms, not the other things.
I am not any sort of health professional - thank the lord, or I would know less than I do! I'm just a patient that has educated herself to save her own life because all the doctors I've seen have been slowly killing me. I'm still alive at 78 but if I'd listened to any sort of doctor - and I've seen many, many of them - I would either be dead by now, or a dribbling vegetable in a corner.
We know you have Graves antibodies (definitely some 'stimulating' and potentially some 'blocking' TRab) .. and when levels of these antibodies fluctuate they will affect both your thyroid hormone levels independent of your dose , and also your TSH result.
(plus there is the issue you had previously with getting high TSH results from some tests (15/ 12) but then only (3) when endo repeated using different method so bear this in mind view your TSH results with a degree of suspicion)
But as your current T4 / T3 levels are higher than they were before, it does make sense that your TSH is lower.
You increased to 25mcg at end of august (no labs for 25mcg )..... then increased to 75mcg at some point .... these labs seem to be on 75mcg but you were not sure how long you had been on 75mcg at the time these were done . if you had not been on 75 mcg for at least 6 - 8 weeks then ignore this TSH result .
on 75mcg Levo (Feb 2023) :
TSH 5.5
FT4 1.1 (0.82-1.77) 29% (bit lower than previous)
FT3 1.9 (2.0-4.4) below range ( bit lower than previous)
fT4 1.57 [0.82-1.77] 79% (significant increase from previous)
fT3 2.4 [2.0-4.4] 17% ( significant increase from previous)
RT3 28 [9.2-24.1[
TPO 18 [<34]
It would be interesting to see if TSI antibodies are higher again , this would be one explanation for the significantly higher T4 /T3 levels on same dose
Thank you so much for this in-depth analysis. It really helps me to see the bigger picture! ❤️
No. I haven't had TSI or TrAb checked since February, but now I'm curious as well! I think my FMD just wanted to see where the basics were right now.
However, I'll be doing more labs with my regular doc at the end of this month including Iodine, and excluding Vitamin D for now, as my Insurance only covers it taken every 6 months.
Question for you: I've been having my Iodine levels taken by blood, but I've read and been told that the 24 Hour Urine Iodine Loading Test is best to determine levels. Apparently, it is a long and drawn-out test that not many doctors do. Also, I've heard of the Iodine patch test where you paint Iodine on your forearm at night and if it's totally absorbed by morning you are deficient.
What do you feel is the best test to indicate Iodine levels?
i've never looked into iodine testing for myself , so i don't know if i'd prefer blood or urine . but the patch test has always sounded dubious to me , helvella thinks so too ,and i tend to trust his opinion.
Re your quote from Janie about rT3 being more potent than PTU;
I'm sure i've read a properly referenced rebuttal of that idea on thyroidpatientsca.. might have been this page , but not certian
... just noticed that post still needs updating with links to the best explanations from ThyroidPatientsCanada which i haven't got round to doing yet., so if interested you'll have to use the search facility on that site but it's pretty good ( unlike the one here on HU)
tattybogle Ok Thank so much. I will definitely look into it. I appreciate your knowledge!
I know different camps beleive different things, but I try to open my mind and heart to listen to anyone (as long as they are kind and respectful. Which you are! so thank you for that 🥰)
I personally ABSOLUTELY believe that RT3 is a thing- and it has only been by addressing this that i'm getting well. Although RT3 seems to be so divisive, and I ignored it for many months thinking it was only a metabolite of FT4 as some people on this forum think, addressing it has been vital for me. Have you read the work of Paul Robinson? He explains that RT3 can absolutely lower FT3. The deoidinase3 enzymes that are activated in the conversion of FT4 to RT3 lock on to the cell nuclei and prevent T3 from properly getting into the cells. Although my FT4 was only 38% through the range on NDT, I couldn't increase my dosage higher than 1.75 grains (having addressed cortisol, iron, core vits), because the T4 in my opinion was getting converted in RT3. Many things can cause this to happen- fasting, illness, stress ... and autoimmunity! By introducing some synthetic T3 to my NDT im finally getting well. I don't think we can dismiss RT3 in such a dogmatic way, nor functional medicine practitioners!!
Good luck with your journey and do check out Paul Robinson if you haven't already.
JannSimpson Yes I absolutely agree with Lucy, I also think rT3 is potentially an issue 🙋♀️
Paul Robinson, p.26 thyroid patient’s manual.
“RT3 can only bind to receptors in cell walls - not in the cell nuclei, but it can still slow down metabolism in two ways. It acts as a brake on T3 by reducing the level of D2 deiodinasr enzymes produced. RT3 is converted from T4 by the D3 deiodinase enzyme. D3 does block T3 access to the cell nuclei. So, if too much rT3 is present, the person can feel hypothyroid.”
I think you need some direct T3 in your treatment because your conversion is clearly very poor.
Yes Im talking with my FMD about T3 once again next week 😑 I may have to force her hand as she beleive the T-150 is the best course over time but It has not helped at all.
Shes been great in every other aspect except this. Now I just need to find the best course of dosage and when to take it.
LucyYoga Thanks for that. I appreciate your experience and insight. I will check his book out for sure.
I beleive the way that we " feel" is a better indication of our health than numbers anyway.
And...It is a very confusing topic ( as well as Iodine!) I'm researching so much that I feel like I should be a doctor! LOL Praying I just get to the bottom of MY issues and feel my best. Whether I'm in ( or can be in) remission or not. If I feel good I'm happy 😁😎
but it's important to be precise with language .. it is not the rT3 itself which lowers T3 , or stops T3 from reaching the receptors at the nucleus , it is the deiodinase D3 which reduces the amount of T3 that is available to reach the receptors.
D3 does this by catching T4 on the way in to the cell and turning more of it into rT3 (instead of T3) . So there is then less T3 in the cell to reach the receptors on the nucleus ..and since this rT3 can then exit the cell again , and so the rT3 level in the blood goes up .
but rT3 didn't do it, and rT3 is not what is stopping T3 getting to the receptors .... rT3 is not the guilty party here ..".it's the D3 wot did it "
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