Hi everyone,
First off, thank you for being so helpful to me and others. This is such a great group of people with knowledge that surpasses most doctors. I posted 2 weeks ago that my reverse T3 is high and saw my dr yesterday. She wants to put me on an equivalent amount of Amour to see if my body will respond better to a non synthetic hormone. I would love to hear experiences good or bad from others that also switched. Thank you!
tsh .025 r .45-4.5
free t3 2.8 r 2-4.4
free 44 1.57 r .82-1.77
reverse t3 24.8 r 9.2-24.1
tpo ab 77 0-34
You are not a medical mystery, you have Hashi's and - like many Hashi's people - you are a poor converter, and not optimally medicated on 100 mg of Synthroid and 5 mcg of Cytomel. What you needed was a slight reduction of Synthroid and an increase in T3.
Your FT4 was high and had obviously reached the point where it converted into more rT3 than T3, so a reduction in dose would have done the trick.
How much Amour is she putting you on? Patients often lose out in these exchanges.
Hi and thanks for your response! She is putting me on 120 of Armor. She felt I needed more t3 and rather than up my Cytomel to 10 mcg and drop the Synthroid to 88 mcg she wanted to try the non synthetic approach
Well, it might help you feel better, anyway. Athough increasing T3 by 13 mcg in one go is not a good idea, it's too much at one time. And, NDT is not for everyone. Some people don't get on with it.
amburke1965,
I used to medicate synthetic T4 & T3 which I did fairly well on but switched to Armour to avoid the T3 ‘bump’ I was particularly sensitive to. NDT is bound to thyroglobulin which stomach enzymes have to release and this process happens slower, giving a much smoother ride.
Switching from a synthetics-combo means you can do a straight swop. However, I think you need a starting dose of 1 & quarter or 1 & half grains.
2 grains gives you 76mcg T4 + 18mcg T3 but manufacturers claim it to be bio-equivalent to 200mcg with a ratio of 4:1. I have found 1 grain to equate to around 88mcg, and the ratio too T3 rich so had to reduce Armour dose and add back some Levo. Hence I caution to start with a lower dose.
RT3 causes are multiple and varied with high T4 dosing being one of them but you are medicating a more ‘usual’ Levo dose and did not have over-range T4 labs indicating other causes of your elevated RT3 more likely. Armour is no more sympathetic to nutrient/iron deficiencies or chronic inflammation than synthetics, so unless the cause of your RT3 is removed, it may continue no matter what thyroid hormone replacements meds you take.
I can't comment on RT3 in the UK this is never tested. I can say though I went through the process of levothyroxine on its own, helped but wasn't well, levothyroxine plus Liothyronine was better but I hate the spikes and drops it gave me despite it being taken in 3 split doses.Armour Thyroid however was great. I was started on a lower does to the equivalent and then increased until I was optimal.
Armour gives me an even feeling, no spikes or drops. It has a slower uptake and drop. It did take time patience to get the right dose for me but once there Ive been stable for over 15yrs.
Some people find the T3 content too much and find a lower dose of Armour plus levothyroxine works best for them.
Make sure your vits are optimal not just in range for best uptake. In particular Vit D, B12, folate and ferritin.
Are you in the US or Australia? I know that some doctors in those countries test RT3 and treat it if high, but I have not heard of it in Europe.
The idea with high RT3 is to avoid T4 altogether and take T3 only for 8-12 weeks to flush out excessive RT3. So, Armour may not be ideal for you if your doctor wants to lower RT3 levels as it is mostly T4.
However, newer research seems to indicate that RT3 is not the problem it was once believed to be, that it cannot block T3 from entering cells and that it will not lower metabolism. Some doctors in the US and a couple in AUS claim that RT3 is a thyroid antagonist and better at blocking T3 than drugs used to treat hyperthyroidism, while others claim that RT3 only has the fraction of the activity of FT3. They cannot all be right.
But newer research seems to indicate that RT3 only stays in the body for a few hours before it is converted to T2.
Hi, thanks for your response. I am in the US so maybe the doctors here are not as up to date. I guess we will see what happens
This is a pretty interesting article:
However, it´s one thing to have a healthy thyroid or be hypothyroid and take levo only, on the one hand, and to take T3 on the other hand. I think there is general agreement that the body will increase T4 to rT3 production during illness or starvation, to preserve energy as an evolutionary survival mechanism. That can happen in a healthy person or someone on levo only. In those cases, more T4 becomes rT3 and less T4 becomes fT3. BTW, some doctors think this is the reason why yo-you dieting always fails in the end; after X number of diets, the body simply lowers metabolism by increasing T4 to rT3 production. However, what happens if that person also takes T3 (either Cytomel or NDT)? Doctors treating rt3 dominance will say that rT3 blocks ft3 from entering cells. Convenient. But, as pointed out in this article, there is no way of knowing what happens at cellular level. So, even if rt3 levels in blood are high, how do we really know that they are stopping ft3 from entering cells? We cannot know, as there is (currently) no way to measure thyroid hormone activity at cellular level.
Hi amburke, I am in the USA. After my thyroidectomy for papillary thyroid cancer, I used synthetic T4 for three years and had to lower the dose multiple times. My FT4 remained too high in the range and my FT3 was too low. My RT3 remained normal. My body was not adequately converting the T4 hormone into T3/FT3. I tried the addition of T3 hormone but that did not work for me as it did not increase my FT3 and gave me side effects.
I switched to NDT - NatureThroid and WP but no longer available so I use NP by Acella. I used four endos of which they either would not give me T3 or NDT or did not know how to test and dose it. When I first switched, the dose was too low.
I suggest (not recommend) that you start out with the dose recommended but remember, it is not the same and must be increased every few weeks until optimal results are achieved. Depending on the lab’s assay and reference range, (this is based on Labcorp and !Quest), we like the FT4 approximately 1.0-1.2 and FT3 approximately 3.7-4.0. Do not be concerned with a very low TSH as the T3 hormone usually will keep TSH low. As long as the Frees are optimal is what matters. I would retest ever 4 weeks until desired results are present.
Thank you everyone! You are all so educated and informative!
amburke, I sent you a direct/private message.
Thank you!
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