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]

I should also mention that I have no drive or ambition....feel tired all of the time :(

[flyingfool]

Please post your latest thyroid lab test results and reference ranges.

Just being "somewhere" within the normal range is simply NOT good enough for many people. They need to be well up to at least 50% or more of the range.

Your vitamin levels seem pretty good. Some have reported that thye need the B-12 to be towards the very top of the range. But you've had marked improvement in all the levels.

Do you feel better with these new levels or about the same as when the levels were lower?

Fatigue is consistent with being low thyroid.  Do you have other Hypothyroid symptoms?

[Jackie419]

When I found out about my horrible vitamin levels, I also found out my RT3 was a bit high, so I had no idea which was making me feel so bad. It seems that each time I have had a great dealof stress in the last 4 months, I feel very bad. I was starting to get some energy and feel better a few weeks ago and then moved. I feel like death. I have NO idea what my thyroid numbers are currently, but this is what they were back in June:

TSH         .04     (.34- 5.60)
T4Free    1.16   (.61- 1.12)   LABCORP FT4: 1.59  (.82- 1.77) wtf?
T3 Free    4.1     (2.0- 4.4)
REVERSE T3   44.3   ng/dl  (13.5- 34.2)***
Antithyroglobulin ab  <20   ui/ml    (0-40)

I am desperately trying to get into a doctor who will retest these things. Was very surprised at how much my vitamins had come up, especially because I feel so bad and soooo depressed. Not sure WHAT the first FT4 is, never had seen a test like that, had it redone at Labcorp just days later. Thanks for your response!

[Barb135]

I'm sorry, can you refresh my memory, please?  Are you currently on a thyroid replacement medication?  If so, which med, dosage, and how long have you been on it?

Are you saying that the two FT4 results were done by different labs?  If FT4 was tested by LabCorp a few days later, why weren't FT3 and TSH tested again, too?

Either way, FT4 is high/high normal, according to the ranges. Both FT4 and FT3 indicate that you are bordering on hyper.  If you are on medication, you may be over medicated.

I'm not real "up" on RT3, but it's not the actual result that counts, it a ratio between FT3 and RT3.  

Stress does weird things to our body and when we are under a lot of stress, the adrenals kick in and often work overtime. Both excess cortisol and adrenaline can cause issues with the way we feel.  

The only thing that jumps out about the vitamin levels is the B12.  I find that I have to keep mine at the very top of the range in order to feel best...... the range my lab uses is 200-1100. Upper end is much higher than your lab uses.

We really to see current thyroid levels...... fatigue and being tired, no ambition, drive, etc can be caused by both/either hyper or hypo.  

Can you get current thyroid tests?

[Jackie419]

thanks, Barb.....I am on 3 1/4 grains of NP thyroid, have been on dessicated for years but went on compounded for a year and switched to NP (Acella) in Feb. It is stronger as my levelas went above range, so I lowered the dose back in March or April. I am tyring to twist a doctors arm to get the thyroid tests done again this or next week. I did the other FT4 above on my own as I had never seen those kind of ranges for a FT4 before and wanted to see one I am familiar with. Oddly, the best I have felt was when my FT3 was well over range. My FT3 was stalled out at 3.5 (same range as above) for a year and I still had hypo symptoms there. My FT3 went all the way down to 2.8, I believe with the Armour reformulation so I know what I feel like at every level. The trick now is finding a doc that knows what they are doing, have already wasted so much money and been fired by 2 docs........

[flyingfool]

I tend to agree with barb.  The numbers above would indicate that you may be slightly over medicated.  One mechanism the body can use to help itself not go hyper is to produce RT3 so that it is unusable to help lower the amount of FT3 that is available for use.

However you saying the best you've felt was when you are over range with FT3.  That is interesting and I don't think a very common occurrence.  If that is in fact true, you may have a hard time finding a Dr who will do that.  I suspect that a new Dr where you now live is most likely going to panic with such a low TSH and want to reduce your medication dosage.  So you may have to temper the Dr to not dramatically lower it.

RT3 ONLY is made from converting T4. So if possible you may want to drop the T4 amount.  Since you're on NDT the only way is to cut the overall dosage which would cut both T4 and T3.

[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.

[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]

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, 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!

[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]

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!

[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!!!

[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]

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.

[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]

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

[Jackie419]

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

[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]

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!

[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.

[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]

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!!

[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