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Reverse T3 and Synthyroid
Will taking Synthyroid cause my Reverse T3 to go even higher inside of to the FT3 where it's needed?
I have Hashi's. The whole Reverse T3 situation confuses me.
6/5/2014
TSH 2.73 (.55-4.78) dr does believe it should be 2-2.50
Free T3 2.9 (2.3-4.2)
Free T4 1.35 (.89-1.76)
Reverse T3 24 (9.2-24.1)
TPOab 992.40 (<60)
Thanks
I have Hashi's. The whole Reverse T3 situation confuses me.
6/5/2014
TSH 2.73 (.55-4.78) dr does believe it should be 2-2.50
Free T3 2.9 (2.3-4.2)
Free T4 1.35 (.89-1.76)
Reverse T3 24 (9.2-24.1)
TPOab 992.40 (<60)
Thanks
You're right. Those labs are in no way hyper. Both FT3 and FT4 are right on the floor of the ranges, hypo by any standards. What is interesting is that in the 2.5 years since 2/2012, your labs without meds have improved tremendously. That's very unusual when you have Hashi's.
It takes some time for T4 to build in your blood, and it's not unusual when first starting or increasing to have symptoms worsen for a while or have a few new ones pop up. You were on a very low dose, and sometimes that will actually make your FT4 go down a bit since it can lower your TSH, so your thyroid isn't stimulated to produce as much natural hormone. Intolerance to a very low dose can also be due to adrenal issues.
TPOab is considered basically either positive or negative. Some people with very high antibody counts seem to feel better than others with low ones. Also, antibody counts vary wildly, so they can swing around even intraday. There are those who will disagree with me, but I don't think it makes a whole lot of difference. As antibodies kill off the thyroid, it can "dump" hormone, i.e. the hormone from the dying cells gets dumped into the bloodstream in a pretty uncontrolled fashion. If you're fairly hypo, this can be just the pick-me-up you've been looking for. If you're not, however, it can make you temporarily hyper.
One of the "burning" questions in my mind that in all my reading I have not been able to find an answer to is how many antibodies it takes to destroy a thyroid. If TPOab is 900, is the thyroid being destroyed twice as fast as someone with a count of 450? Is a very high antibody count just overkill on the immune system's part? Is there a "magic" number, i.e. once your antibodies are over X, it doesn't matter any more if they're higher.
Antibodies can be present for years, or even decades, before they cause enough damage to produce symptoms. Sometimes it takes years to effectively "kill" the thyroid, sometimes it's just a few months. However, we have no idea how antibody levels might interact with other factors to destroy function sooner or later. For example, does a high antibody count when you still have a lot of thyroid function left affect you more than a high count when your thyroid is almost dead?
On the antibody front, there are a lot more questions than answers. Researchers are only beginning to scratch the tip of the iceberg when it comes to autoimmune diseases, and there are a lot of AIs ahead of us in line.
Do you have any other health concerns that might exacerbating the autoimmune response? Any chronic diseases, recent trauma, stress (physical or psychological), recent surgery, vitamin or mineral deficiencies, lifestyle changes, menopause, etc.?
It takes some time for T4 to build in your blood, and it's not unusual when first starting or increasing to have symptoms worsen for a while or have a few new ones pop up. You were on a very low dose, and sometimes that will actually make your FT4 go down a bit since it can lower your TSH, so your thyroid isn't stimulated to produce as much natural hormone. Intolerance to a very low dose can also be due to adrenal issues.
TPOab is considered basically either positive or negative. Some people with very high antibody counts seem to feel better than others with low ones. Also, antibody counts vary wildly, so they can swing around even intraday. There are those who will disagree with me, but I don't think it makes a whole lot of difference. As antibodies kill off the thyroid, it can "dump" hormone, i.e. the hormone from the dying cells gets dumped into the bloodstream in a pretty uncontrolled fashion. If you're fairly hypo, this can be just the pick-me-up you've been looking for. If you're not, however, it can make you temporarily hyper.
One of the "burning" questions in my mind that in all my reading I have not been able to find an answer to is how many antibodies it takes to destroy a thyroid. If TPOab is 900, is the thyroid being destroyed twice as fast as someone with a count of 450? Is a very high antibody count just overkill on the immune system's part? Is there a "magic" number, i.e. once your antibodies are over X, it doesn't matter any more if they're higher.
Antibodies can be present for years, or even decades, before they cause enough damage to produce symptoms. Sometimes it takes years to effectively "kill" the thyroid, sometimes it's just a few months. However, we have no idea how antibody levels might interact with other factors to destroy function sooner or later. For example, does a high antibody count when you still have a lot of thyroid function left affect you more than a high count when your thyroid is almost dead?
On the antibody front, there are a lot more questions than answers. Researchers are only beginning to scratch the tip of the iceberg when it comes to autoimmune diseases, and there are a lot of AIs ahead of us in line.
Do you have any other health concerns that might exacerbating the autoimmune response? Any chronic diseases, recent trauma, stress (physical or psychological), recent surgery, vitamin or mineral deficiencies, lifestyle changes, menopause, etc.?
"The thyroid autoantibodies to thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) are secondary response to thyroid injury. Both are polyclonal IgG antibodies and the amount present correlate with lymphocytic infiltration of the thyroid, have completement-fixing cytotoxic activity and TPO autoantibodies correlate with thyroidal damage." - The Immunoassay Handbook by David Wild.
TPOAb correlate with thyroid damage. I lowered my TPOAb somewhat eating brazil nuts (high in selenium).
TPOAb correlate with thyroid damage. I lowered my TPOAb somewhat eating brazil nuts (high in selenium).
The worst that I remember where the inability to even walk at times. The dizziness and balance were terrible. The tireness was worst than anything I ever felt even now. I basically never got out of bed or literally had to crawl or use a cane and sit to take a shower at times. My head felt like it was going to explode at times. All I did was sleep. Didn't want to eat. Never felt that bad before or after.
Took about 2 weeks to feel like I did before and that wasn't so great but a bit better.
My blood results a month after starting/stopping showed no signs of hyper. Never have.
I know that I should have stuck it out. Reading here, as well as the dr said I should given it more time.
TSH from 3.140 to 3.230 (.27-4.2)
FT4 from .94 to 1.13 (.93-1.7)
FT3 from 2.5 to 2.8 (2.5-4.3)
TPO 483 <35 (1st time tested)
It was 25 mg daily.
Does the higher TPO levels mean anything, like it's destorying my thyroid faster or symptom-wise cause I've actually felt not too terrible the past few days. Just some soreness and tired, but I have been more active than I have been in awhile. In between naps, of course.
Took about 2 weeks to feel like I did before and that wasn't so great but a bit better.
My blood results a month after starting/stopping showed no signs of hyper. Never have.
I know that I should have stuck it out. Reading here, as well as the dr said I should given it more time.
TSH from 3.140 to 3.230 (.27-4.2)
FT4 from .94 to 1.13 (.93-1.7)
FT3 from 2.5 to 2.8 (2.5-4.3)
TPO 483 <35 (1st time tested)
It was 25 mg daily.
Does the higher TPO levels mean anything, like it's destorying my thyroid faster or symptom-wise cause I've actually felt not too terrible the past few days. Just some soreness and tired, but I have been more active than I have been in awhile. In between naps, of course.
High cholesterol is, of course, a symptom of hypo. So, my personal feeling on that is to address the root cause, rather than the symptom.
No, you don't have to be positive for both to have Hashi's. Some of us are TPOab positive, some TGab positive and some both. If TPOab is positive, you have Hashi's, but if it's negative, you still have to test TGab to rule it out. So, you test both, but only one has to come back positive. U/S will probably further confirm.
Typically, the rule is to fix the adrenals first. If you have adrenal issues, taking thyroid meds can be almost impossible. We often see cases where people can't increase or can't find a workable dose...one dose is to low, but increase it just a little, and it's too high.
You can see that your T4 level is bouncing around a little. On 12/23, TT4 (unfortunately not FT4) was 60% of range, on 2/26 it was down to 18%, and currently back to 53%. 18% is way too low. Your levels may be swinging on a much shorter interval than these intermittent labs show.
FT3 has been steadily dropping from 3.3 to 3.0 to 2.9.
What side effects did you experience on levo in 2012? What dosage were you started on?
No, you don't have to be positive for both to have Hashi's. Some of us are TPOab positive, some TGab positive and some both. If TPOab is positive, you have Hashi's, but if it's negative, you still have to test TGab to rule it out. So, you test both, but only one has to come back positive. U/S will probably further confirm.
Typically, the rule is to fix the adrenals first. If you have adrenal issues, taking thyroid meds can be almost impossible. We often see cases where people can't increase or can't find a workable dose...one dose is to low, but increase it just a little, and it's too high.
You can see that your T4 level is bouncing around a little. On 12/23, TT4 (unfortunately not FT4) was 60% of range, on 2/26 it was down to 18%, and currently back to 53%. 18% is way too low. Your levels may be swinging on a much shorter interval than these intermittent labs show.
FT3 has been steadily dropping from 3.3 to 3.0 to 2.9.
What side effects did you experience on levo in 2012? What dosage were you started on?
Hi
No she hasn't. And getting her to try anything was a fight. She does want to start at 11.5 first. She believes that my liver is toxic,(detox it), leaky gut, try gluten-free (did it before-no difference) and my saliva tests did show the cortisol was very high.Morning blood was fine and always has been. Am taking her Adneral fix pills. Haven't started the med yet.
She's an Intergated Medicine practioner and Synthoid user herself so wants all these super vitamins and herbs too. She didn't really discuss the Reverse T3 at our last visit. But says she believes it's important and the frees. I feel she did it so I would take Crestor because my cholesterol did go up alot in 4 months. Tried the Crestor for 4 days then had liver side effects as warned could happen so stopped. She wasn't happy.
I read on another side that you have to postive on both the TPO and Tgab to have Hashi's, is that true?
Is it fix the adernals first or fix the thryoid first?
Symptoms have been getting worse over the last few months.
Same lab on both. Different dr ordered them. My last two results were
2/26/2014
TSH 2.57 (.55-4.70)
FT4 1.05 (.89-1.76)
FT3 3.0 (2.3-4.2)
TPOab 228 (<60)
Tgab <20 (<40)
TSI <1.0 (<or= 1.3)
12/23/2013
TSH 2.86 (.55-4.70)
Total T4 9.0 (4.5-12.0) Didn't do a FT4
Free T3 3.3 (2.3-4.2)
TBOab 228 (<60)
Tgab <20 (< or = 40)
Reverse T3 18 (8-25)
Also just had a thyroid ultrasound, awaiting the results.
Tried levothyroxine back in 2/2012 but stopped after 2 weeks. Couldn't take the side events. Numbers were way off then and didn't know about the TPO.
Appreciate your time.
No she hasn't. And getting her to try anything was a fight. She does want to start at 11.5 first. She believes that my liver is toxic,(detox it), leaky gut, try gluten-free (did it before-no difference) and my saliva tests did show the cortisol was very high.Morning blood was fine and always has been. Am taking her Adneral fix pills. Haven't started the med yet.
She's an Intergated Medicine practioner and Synthoid user herself so wants all these super vitamins and herbs too. She didn't really discuss the Reverse T3 at our last visit. But says she believes it's important and the frees. I feel she did it so I would take Crestor because my cholesterol did go up alot in 4 months. Tried the Crestor for 4 days then had liver side effects as warned could happen so stopped. She wasn't happy.
I read on another side that you have to postive on both the TPO and Tgab to have Hashi's, is that true?
Is it fix the adernals first or fix the thryoid first?
Symptoms have been getting worse over the last few months.
Same lab on both. Different dr ordered them. My last two results were
2/26/2014
TSH 2.57 (.55-4.70)
FT4 1.05 (.89-1.76)
FT3 3.0 (2.3-4.2)
TPOab 228 (<60)
Tgab <20 (<40)
TSI <1.0 (<or= 1.3)
12/23/2013
TSH 2.86 (.55-4.70)
Total T4 9.0 (4.5-12.0) Didn't do a FT4
Free T3 3.3 (2.3-4.2)
TBOab 228 (<60)
Tgab <20 (< or = 40)
Reverse T3 18 (8-25)
Also just had a thyroid ultrasound, awaiting the results.
Tried levothyroxine back in 2/2012 but stopped after 2 weeks. Couldn't take the side events. Numbers were way off then and didn't know about the TPO.
Appreciate your time.
Early stages of Hashi's can be characterized by swings from hypo to hyper. This may be what you're experiencing. Do you have other FT3 and FT4 results to compare these to to see if your levels are swinging?
Your current FT4 level is 53% of range. The target for FT4 is middle (50%) of range, so that looks really good and shows that you still have a lot of thyroid function left.
FT3 is a little on the low side of the upper half (50+%) of range guideline. Yours is 32% of range. However, my personal feeling (all the usual disclaimers: not a doctor etc.) is that people who are not on meds or who take T4 only meds often run FT3 on the low side.
As far as TSH is concerned, it's very volatile, and I know people who'd be miserably hypo between 2 and 2.5 and people who'd be miserably hyper. TSH should not be your doctor's main concern.
Will Synthroid raise your RT3? That seems like a simple question, but it's much more complex than it appears, and the answer is that you'll probably never know until you try it and see what it does. We're all very individual, and Person A can start Synthroid and have RT3 go up, while Person B's will go down and it will have absolutely no effect on Person C's.
Has your doctor offered any alternative besides Synthroid?
Your current FT4 level is 53% of range. The target for FT4 is middle (50%) of range, so that looks really good and shows that you still have a lot of thyroid function left.
FT3 is a little on the low side of the upper half (50+%) of range guideline. Yours is 32% of range. However, my personal feeling (all the usual disclaimers: not a doctor etc.) is that people who are not on meds or who take T4 only meds often run FT3 on the low side.
As far as TSH is concerned, it's very volatile, and I know people who'd be miserably hypo between 2 and 2.5 and people who'd be miserably hyper. TSH should not be your doctor's main concern.
Will Synthroid raise your RT3? That seems like a simple question, but it's much more complex than it appears, and the answer is that you'll probably never know until you try it and see what it does. We're all very individual, and Person A can start Synthroid and have RT3 go up, while Person B's will go down and it will have absolutely no effect on Person C's.
Has your doctor offered any alternative besides Synthroid?
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