New vitamin levels- is this possible??

[Jackie419]

I have been on vitamins for 2 months now. I had very low Vit D and Folate, as well as B12. At that time my main thyroid levels were fine, with the exception of a high reverse T3. Still no doc, and luckily had an order for these tests below. I was starting to feel better but then moved almost a month ago, and feeling very very depressed, aggravated- don't handle stress well at all. I was very surprised to see these numbers today. (posting here as I know many of you have vitamin deficiencies as well) Thanks!

Vit D 25 OH     72.5     (30.00- 100.00)      WAS at 8.0
B12                  670       (180-914)               WAS around 230
Folate              24.8       (5.9-24.8)               WAS at 5.0

(the new test states that a new low of 4.0 is now in place for the folate)

[Jackie419]

Thanks, it IS a consolation....it would further console me to see these doctors, educated as they are, have a CLUE about any of this at all....ANY!! I have spent the last 6 months (this time around) calling dr. after dr. asking what they test, etc....that or they won't even see you if you don't have insurance...who goes by TSH only??? Apparently, most of them still do. Thanks though, I somtimes forget what I know when someone is telling me I'M an idiot...oh, I'm not mad...lol. Thanks for the support :)

[Barb135]

If it's any consolation to you, my TSH has been at < 0.01 for nearly 5 yrs and has never been a problem.

In order to find out what the endo "knows", you can call ahead and interview a nurse to find out what tests the doctor does, whether s/he goes only by TSH or looks at FT3/FT4, symptoms, etc.  Waiting 4 months to get in, then finding out it's a "TSH doctor" would be a real bummer.

[Jackie419]

the doctor never said who exactly he was refering me to and I will probably have no way of knowing what the endo knows until I get there. After waiting so long to get into anyone, that was a bitter disappointment...been all weepy the last few days, and I am not a weepy person. It's maddening that I have what should be a simple problem to deal with. Not so simple to find the doctor. I quit for now, I think. Thanks for the kind words.

[goolarra]

Sorry to hear you're not getting anywhere.  Odd that Canadian Cytomel is so expensive...it's pretty cheap here.

You might ask if you can get on a wait list for cancellations.  That might speed up the process a little.  

[Jackie419]

...also made calls to endos today, the one who was suggested to me has retired, the rest have up to 4 months wait, and then you don't even know if they know their stuff. Canadian Cytomel is beyond expensive and I am in the foulest of moods as you can imagine.

[Jackie419]

...I had tried repeatedly to start that as a new thread, and couldn't. About to go into the back alleys to get some Cytomel and take care of this myself....

btw, 2 years ago my tsh was .049 with an ft3 of 2.8 etc etc- this doctor suggested a pituitary problem, but to my knowledge, a lot of people have suppressed tsh from med. the search continues. so tired

[Jackie419]

Finally got into a doctor, only to find out he goes by TSH alone, so when he saw mine...well, you can imagine. He didn't even know anything about the RT3 and wants me to go to an endo of his choosing. Someone had suggested an endo in Ohio here to me but couldn't afford to go to her and 6 months into all of this and I am still nowhere. I told this doc that my TSH had been suppressed for years and in my understanding is quite common on medicated people. I had some major vitamin deficiencies, but they have almost all come up to good places but as of 9/4/12 my RT3 was higher than the last tests. I am about ready to go out and find my own T3...I have continually waited for a "doctor" to get to the bottom of my problem, to no avail--I am at the end of my rope!!

9/4/12
TSH     .02               .34- 5.60
FT3     3.9                2.0- 4.4
FT4     1.53              .82-1.77
RT3     52.8              13.5- 34.2

[Jackie419]

You are too funny!! Due to more stress and drama, and legal action (against someone- not me!!) I had to reschedule those Dr. appts I had finally gotten. More stress in the last month than I can even tell you. I am seeing a gyno and an MD and hoping between the two, one of them will know how to handle this, but they will probably pass me off to a "specialist"---until they do, I will have hope, but so angry I had to postpone those appts!! I am representing myself in court today, and while I am usually eloquent, it's going to be a challenge sounding reasonably intelligent when I can't think of even simple words at times.

I think you were right last spring when I was worried about being over range---you said we all have our different spots in the ranges that we feel best. I believed you then, I believe you now. I will say that I need to go to whatever forum and tout the benefits of Evening Primrose Oil though, that is my one positive I have to say. Been taking it for over a month and it has made all the difference in another certain misery I had been dealing with and helps many conditions and I am now a believer!! Will update all of this in a couple of weeks, thanks for the laugh!!

[goolarra]

Well, I'm sure Picasso ruined a few canvasses...nothing ventured, nothing gained.  You are now perfectly primed for your future reincarnatation as a guinea pig!  

Seriously,...sorry it didn't work out better.  What's next?

[Jackie419]

Quick update...had 2 dr. appts I had to miss, rescheduled for Oct 10 & 11- I have NO luck...anyway, I lowered my med dose by only a 1/4 grain 3 weeks ago and noticed I was losing words, simple words, again- my outer eyelashes are going away again and I feel berned out all the time. Those are my classic symptoms of hypo-even with the high Rt3 all this time, I still had my vocabulary and my eyelashes prior to lowering my dose this much. Go figure.

[Jackie419]

I thought thats what it meant, but thanks for clarifying! I just meant the NP Thyroid made by Acella- been on it for just over 6 months, although I never had me RT3 checked until this past June, for all I know, I have had a higher one for who knows how long. I think I was hoping that with my vitamin levels coming up etc that the RT3 would go down, no such luck. I will get better at all of this, learning a lot right now. Going to have to look at an old thread, but going to drop my dose slightly again. Just SLIGHTLY, I promise!

[goolarra]

What "newer med" are you on?

According to those who believe the ratio of FT3 to RT3 IS important (and I don't know which camp I'm in), some say that "normal" is approximately 1.0-2.0, the closer to the upper end the better.  I've heard others say that it should be above 2.0.  Confusing...  However, either of those two groups would agree that anything below 1.00 is considered "RT3 dominance", and yours is well below at 0.74.

[Jackie419]

ps. not sure what my ratio number means in regard to the optimum ratio numbers, a bit slow today lol

[Jackie419]

Thanks, as always for your input...just didn't expect the RT3 to be even higher this time. Although there is a whole new stressor this past week,and it's a pretty big one, and my tests were taken during this time.
I had decreased my meds slightly the past couple of months, only by 15mg...looks like I will shave off a little more. I remember still feeling a bit hypo when my FT3 was at 3.5 some time ago, but this old RT3 is throwing a wrench into all of this. I may have to spring for the Compounded again, although I hate to switch meds again, I am wondering if this problem could also be related to the newer med I am on???. At this point I only see even more extreme stress ahead so I suppose I will hunker down, keep working on those vitamin levels and see 2 docors this month, a gyno and an MD---and I bet you the Gyno knows more about the tyhroid than the MD does!!!
I

[goolarra]

The ratio of FT3 to RT3 is:

FT3 / RT3 * 10 (the "10" is a fudge factor to adjust for units; sometimes you have to use 100)

3.9 / 52.8 * 10 = 0.74

Depending on who you read, FT3/RT3 ratio should be between 1 and 2, closer to 2, or over 2.  Others, of course, will tell you that FT3/RT3 ratio isn't important at all (if FT3 is good, RT3 doesn't matter at all).

There are only two ways your body can get rid of FT4...convert it to FT3 or to RT3.  Your FT3, even with the high RT3, is at 79% of range.  That's pretty high.  IF all that RT3 were being converted to FT3 instead, you'd most likely be over the top.  

RT3 is a case of "read three authors, get four opinions"...all very confusing.  I'm really wondering if your body isn't telling you something... that your FT4 is too high (it's at 75% of range)???  Of course, the stress factor has to be taken into account as well.  RT3 isn't the evil twin; it's your body's natural way of protecting itself from excessive FT3 levels in times of stress, illness, starvation, etc.  It's only when excessive RT3 production outlives its usefulness and lingers after the stressor is gone that it's a problem.  It might be something that will resolve...    

[Jackie419]

Hi Barb!, thanks for writing... the ft3 is 3.9  (2.0- 4.4) pg/mL
                                                        rt3 is 52.8  (13.5- 34.2) ng/dl

I will post some other results when I get up later...they are the ones I am still trying to figure out what they do but you may see something in them...I don't know how to do the ratio on the rt3/ft3 so thanks for asking.

[Barb135]

There isn't anything here that really stands out, except that your thyroid hormones are both at the top of the range and RT3 is very high.

The ratio of FT3 to RT3 is more important than the actual RT3 result. Are they reported in the same units on your lab report?

What parameters, on your blood work are out of range? There might be something else that might shed some light.

[Jackie419]

OK, didn't start a new thread for this,may have to....got bloodwork done finally and this can't be good...got just my vitamins checked 3 weeks ago, results above. My RT3 went up. dang.

TSH     .02               .34- 5.60
FT3     3.9                2.0- 4.4
FT4     1.53              .82-1.77
RT3     52.8              13.5- 34.2

B12-                 725              180-914
Folate LvL-      24.8             5.9- 24.8
Vit D 25 OH    61.2              30-100
Sodium Lvl      138              136-144
Potassium       3.4                3.6- 5.1M
Magnesium     1.97            .40- 2.10
Calcium            8.9              8.9- 10.3

I have all the bloodwork, don't know what half of it is, but a lot of highs and lows on it...just wanted to post the basics- just ask if there is something else I can post. I am under even more stress than in recent past. This past week has been a nightmare and got this bloodwork done on Tues. I FINALLY am seeing a doctor late in the month, although I think he will pass me off to a "specialist". Any thoughts would be appreciated!!!

[Jackie419]

Well, if this chiro ever sends me the order, at least i can know what my thyroid levels are doing even the RT3, getting the problem corrected will then be the next hill to climb since he can't prescribe. As long as I can get the order, I can get it all checked- the only one I'd have to pay for then is the adrenal/hormone tests but I really don't think my adrenals are at play at this point. I've knocked off the folic acid since higher levels of that can be bad and still working on my B12.

I can't thank you guys enough for your continuing input and support- I would be so alone and confused in all of this otherwise. It means a lot to me.

I will post my new test results as soon as I get them!

[flyingfool]

Seems like this may be stress induced. Stress is known to affect the production of reverse T3 (RT3).  Higher RT3 means less FT3 and/or less receptors for the FT3 to occupy. The end result is that at the cellular level you can be hypo even when labs would or might suggest you should be just fine.

TSH is horrible in this situation since the Pituitary is essentially blind to RT3.

Just a thought.

I'd suggest getting tested for RT3. But that may be difficult because it is an expensive test and if you can not find a Dr to even do FT3 and FT4 then finding one to do RT3 would be even more difficult.  However your series of incidents would indicate a possible RT3 issue.

[Jackie419]

Thanks, Barb. I was supposed to do this test over 2 months ago....the chiro has said they mailed it TWICE now...can't get anywhere with these people, but I digress...
was supposed to get my adrenals tested and i asked them to check my female hormones as well. I think what I have going on is the low vitamins, the change in thyroid med, and my female hormones being out of whack.

I am 47, went off of bc pills a year ago while I was coming back from the Armour crash. I know I had to be vitamin deficient before I moved back in April, but I did feel great and energetic before the move---even when packing a whole apartment. Seems like major stress right after the move knocked me off my feet. Found out a month or two later i was vitamin deficient with a high RT3. I know my FT4 was a bit high, but my FT3 was what I had been shooting for.

After 2 months of vitamins and better eating,I was starting to feel better and then moved into another house and BLAM- wasted again. I don't feel like socializing or doing anything- no energy, major symptom is depression as it is heightened.

My biggest problem has been waiting for doctor appointments only to find out they only go by the TSH or want to then pass me off to the next tSH-tester.....too bad it's a chiro that knows what to test---irony at it's finest!

[Barb135]

Since you lowered your dose after the last tests, I totally agree that you should not change it again, until after you test.

What will you be testing with the saliva kit?

[Jackie419]

Thanks to both of you. I can't take Cytomel, have tried it before and just can't. The real problem I have with doctors is that they DO all go by TSH only...and you can't even get them to address the frees or anything else for that matter. I was severly hypo 2 years ago with a 20 lb weight loss and no one thought to look at my vitamin levels. And I mean hypo with a FT3 of 2.7 and Ft4 of .79, I think.
I'm not trying to get my Ft3 above range again, just thought it interesting I felt so good then. I know starting a new med is what did it, kl42 and I switched to Acella NP on the same day, his levels went too high as well.
I have a chiro (ahem) who is supposed to be sending me a saliva kit and another bloodwork order this week (we'll see) so I don't want to change dose until I do testing again, as I DID lower my dose slightly after that last result- I forgot to mention that.
I just know I still felt hypo with lower levels of Ft3 and Ft4 in the past. It ***** when several things are going on at the same time and they all have basically the same symptoms! Thanks so much for your input!

[Barb135]

You can try dropping your dose of NP and add cytomel, if you want to keep your FT3 up.  You should be aware that some symptoms can "cross over" and apply to both/either hypo and hyper.