7729616 tn?1393799092

Do I need T3?

Hi there, I was diagnosed with Hashimoto's in Jan 2014 and here are my lab results:

Jan 2014

TSH - 2.7 (0.2-4.2)
No FT4 as TSH normal

Feb 2014

TSH - 3.6 (0.2-4.2)
No FT4 as TSH normal

Mar 2014

TSH - 1.87 (0.2-4.2)
FT4 - 16.6 (12-22)
FT3 - 4 (3.1-6.8)
Total Thyroxine - 101 (59-154)
Thyroglobulin Antibody - 103.5 (0-115)
Thyroid Peroxidase Antibody - 33.5 (0-34)

Thyroid's maximum activity to convert T4 to T3 - 22.28 (20-40) - after using SPINA software (software professional doctors use to measure thyroid's activity to convert I believe) - at the low end of the range.

- I am currently on 100mcg Levothyroxine but I would like to know if I am likely to be prescribed T3 as my FT3 is low and I still do not feel any different.

- I have seen a nutritionist and she has advised me of the following:
        * To go gluten and dairy free
        * To follow a protein-rich diet
        * To take a prebiotic, wholefood iron, a multivitamin, Rosehips, something called Bio-Kult and something called T-Convert.
        * To continue taking my Vitamin D at 3000IU and my B12 at 1000mg.
        * That I have a buildup of lymph in my legs, however they are not puffy or fat - in fact they are short and slim!
        * To continue charting my symptoms, diet, body temperature and blood pressure.

- I chart my symptoms, diet, body temperature and blood pressure daily in a journal, however my symptoms have not changed and my body temperature is still low. I am sure I am doing something wrong and I cannot work it out.

I do not know what more I can do and I see my doctor on Wednesday to discuss if I can be prescribed T3. I know full well that unless I show up at my appointment with evidence this is not likely but I am sure that T3 is what I need despite my labs coming back normal.

I'm especially surprised that my antibodies are within normal range and that I also have thyroglobulin antibodies. I have never been tested for thyroglobulin antibodies before so I do not understand why my doctors have not done this in the past.

Thanks for your help. :)
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351246 tn?1379685732
Thyroid peroxidase (TPO) is an enzyme in thyroid gland which helps in production of thyroid hormone. TPOab or antibody against this enzyme is present in cases where thyroid is attacked by body’s own immune system. Hence this is raised in autoimmune thyroid disease called Hasimotos thyroiditis. However, TPOab can also be raised in rheumatoid arthritis, Sjogren’s syndrome, lupus and pernicious anemia.Hence since you have other normal thyroid tests which happens in 10-15% cases of Hashimotos, other thyroid antibodies such as antithyroglobulin (anti-Tg) (done in your case and since within normal range—other antibodies may not be done), and to a lesser extent, TSH receptor-blocking antibodies, thyroid-stimulating antibody and cytotoxic antibody should be tested for.
Also, you may need to get rT3 done. rT3, unlike T3, does not stimulate thyroid hormone receptors but binds to these receptors, thereby blocking the action of T3. Thus the blood level of T3 varies in inverse ratio to the level of rT3.  What you probably have is rT3 dominance syndrome in which low thyroid symptoms exist (as you have—like low body temp), but the usual thyroid tests appear to be within normal limits. Normally it is treated by giving low T3 dose which eliminates T4 (which breaks down to fT3 and rT3 in the body) from the body and causes a decrease in the body’s synthesis of T3.
Also the tests should be repeated after 3 months.  If these are raised then you may need treatment for thyroiditis. As of now you may not need treatment. Please consult your doctor regarding this. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
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