Aa
Am I understanding my RT3 results?
I am on NT but after 2 years in treatment never felt well or even optimum.
My doctor order RT3 test, although he is not very knowledgeable about it. I got my results and I would like to know if I am interpreting them correctly.
FT3: 3.1 (2.3-4.2 pg/mL)
RT3: 36 (11-32 ng/dL)
I did the calculation according to some reading I did and my result is 8 something (it should be higher than 20). I hope I am correct. If this is true I have a high RT3 and I am getting too much T4 and I should get T3 only to lower my levels. I also read that I could take only T3 medication only until I get my levels down and after that? continue on T3 only o go back to NT?
Very sophisticated findings, but if I am right I have a case here and my path to recovery could be very close. I am very hopeful.
Thanks for your advise.
My doctor order RT3 test, although he is not very knowledgeable about it. I got my results and I would like to know if I am interpreting them correctly.
FT3: 3.1 (2.3-4.2 pg/mL)
RT3: 36 (11-32 ng/dL)
I did the calculation according to some reading I did and my result is 8 something (it should be higher than 20). I hope I am correct. If this is true I have a high RT3 and I am getting too much T4 and I should get T3 only to lower my levels. I also read that I could take only T3 medication only until I get my levels down and after that? continue on T3 only o go back to NT?
Very sophisticated findings, but if I am right I have a case here and my path to recovery could be very close. I am very hopeful.
Thanks for your advise.
I have just started treatment for rT3 issues and I am on cytomel only. My ND says that taking a supplement or medication with T4 is a mistake many doctors make and that taking only T3 is the best for recovery. You may want to talk to your doctor about the t4 he has you on, this could be the reason you are not seeing success as much. Also, if you haven't, check out www.*************************/reverse-t3/ it has a wealth of information that maybe you can share with your doctor if you see fit. I am not a doctor, I am just a thyroid patient and I hope this helps you find the recovery you want.
I had a very rapid heart bit when on Cytomel, my pulse was over 90 per minute which is rare for me. I had some anxiety attacks and itching all over my body. I never knew if it was the Synthroid or the Cytomel.
I was on very low dose..I remember Cytomel it was 5 mg in the morning and 5 in the evening.
The problems started two weeks after I started to add Cytomel at night.
My FT4 is 1.1 with a range of 0.60-1.8.
My Ft4 before treatment was something like 0.7. My Ft3 before treatment was below normal. If I drop the Ft4 I will go where I was in the beginning. I fear to have reaction to a only Ft3 regime...do not know what to do. Thanks for your interest and input.
You definitely have better lab results than me in the RT3 department. Good luck with you new dosage.
I was on very low dose..I remember Cytomel it was 5 mg in the morning and 5 in the evening.
The problems started two weeks after I started to add Cytomel at night.
My FT4 is 1.1 with a range of 0.60-1.8.
My Ft4 before treatment was something like 0.7. My Ft3 before treatment was below normal. If I drop the Ft4 I will go where I was in the beginning. I fear to have reaction to a only Ft3 regime...do not know what to do. Thanks for your interest and input.
You definitely have better lab results than me in the RT3 department. Good luck with you new dosage.
Yes, I agree, the information is contradictory. I will say that the so-called "Wilson's Protocol" , all T3 in increasing quantities, is the most controversial., and in my opinion would be the most extreme and hard on the body and most difficult to get a doctor to monitor.
What reaction did you have with the Cytomel, and what kind of T4 were you using at that time ? Do you remember the dose of both medications that you used ? I'm very curious. I had the opposite reaction : after I went on T4/T3 combination and it worked, I thought I would try to be more "natural" so I had my doctor switch me to Armor. This was early summer of 2010. I had an immediate nose dive ! This condition and the meds that work is incredibly individual.
I wish someone who has actually HAD this problem would post for us. I wonder what would happen is you added a small amount of Cytomel to your NT ? I'm not familiar with the ratio of T4/ T3 in that medication, but your FREE T3 is below the middle point in the range and, especially with your symptoms, could go higher...to at least 2/3 if not 3/4 of the range. You didn't post your Free T4, is it where you want it to be, mid-range ?
If I were you, I think I would try to raise the FREE T3 by adding extra to your current medication if your FREE T4 is optimum before I would drop the T4 all together...but I'm no doctor. Please let me know what you do and what happens ! All the best.
What reaction did you have with the Cytomel, and what kind of T4 were you using at that time ? Do you remember the dose of both medications that you used ? I'm very curious. I had the opposite reaction : after I went on T4/T3 combination and it worked, I thought I would try to be more "natural" so I had my doctor switch me to Armor. This was early summer of 2010. I had an immediate nose dive ! This condition and the meds that work is incredibly individual.
I wish someone who has actually HAD this problem would post for us. I wonder what would happen is you added a small amount of Cytomel to your NT ? I'm not familiar with the ratio of T4/ T3 in that medication, but your FREE T3 is below the middle point in the range and, especially with your symptoms, could go higher...to at least 2/3 if not 3/4 of the range. You didn't post your Free T4, is it where you want it to be, mid-range ?
If I were you, I think I would try to raise the FREE T3 by adding extra to your current medication if your FREE T4 is optimum before I would drop the T4 all together...but I'm no doctor. Please let me know what you do and what happens ! All the best.
I do not think this thread is helping me to be honest.
I am a little confused, since some of the links posted are contradictory.
Some of them say the only way to get rid of excess of RT3 is to follow a T3 only protocol and another one says to never get rid of T4 medicine because our bodies need it. In that case it would be appropriate to drop a little T4 and raise T3.
I do have RT3 according to my results. I have to see my doctor this week and I am not pretty sure what will happen. He does not know much about it , and when I tried Cytomel combine with T4 medicine I got a reaction and I had to change to NT. Not sure what should I do. Gook luck.
I am a little confused, since some of the links posted are contradictory.
Some of them say the only way to get rid of excess of RT3 is to follow a T3 only protocol and another one says to never get rid of T4 medicine because our bodies need it. In that case it would be appropriate to drop a little T4 and raise T3.
I do have RT3 according to my results. I have to see my doctor this week and I am not pretty sure what will happen. He does not know much about it , and when I tried Cytomel combine with T4 medicine I got a reaction and I had to change to NT. Not sure what should I do. Gook luck.
Thanks you two !
Goolarra, the link to diodinase is ABOVE, in my first response to Gimel. The range I am quoting for the FREE T3 IS for the Direct Dialysis test, which is different than the range for the FREE T3 test, which I think is "Index" or "serum"......it's the more usual test but does not account for the thyroid hormone binding caused by estrogen replacement therapy. The range for THAT test IS .8 - 1.8. I would be surprised if your Free T3 test said Direct Dialysis with that smaller range. Does it ? When I am testedin that range, my lab just says FREE T3. Those taking HRT should have the DIRECT test, as I understand it. And yes, the mid-range or slightly higher would still be optimum.
I want to change the T4 to get away from the red dye in the 112 mcg. So I will go back to the 100 mcg dose. Going to 112 mcg only raised T4 a measly .2 anyway. If it drops too much, next time I'll raise it to the next step above 112. I can't afford to buy 2 scrips for Cytomel, so I guess I'll go w/ the 50 mcg. Don't know what else to do. If it's too much, I should feel it, in which case I'll go back to 37 and 1/2 until I figure this out.
Alsonsina, is any of this helping you ? What are YOU going to do ? I'll keep you all posted on what happens to me. Best wishes.
Goolarra, the link to diodinase is ABOVE, in my first response to Gimel. The range I am quoting for the FREE T3 IS for the Direct Dialysis test, which is different than the range for the FREE T3 test, which I think is "Index" or "serum"......it's the more usual test but does not account for the thyroid hormone binding caused by estrogen replacement therapy. The range for THAT test IS .8 - 1.8. I would be surprised if your Free T3 test said Direct Dialysis with that smaller range. Does it ? When I am testedin that range, my lab just says FREE T3. Those taking HRT should have the DIRECT test, as I understand it. And yes, the mid-range or slightly higher would still be optimum.
I want to change the T4 to get away from the red dye in the 112 mcg. So I will go back to the 100 mcg dose. Going to 112 mcg only raised T4 a measly .2 anyway. If it drops too much, next time I'll raise it to the next step above 112. I can't afford to buy 2 scrips for Cytomel, so I guess I'll go w/ the 50 mcg. Don't know what else to do. If it's too much, I should feel it, in which case I'll go back to 37 and 1/2 until I figure this out.
Alsonsina, is any of this helping you ? What are YOU going to do ? I'll keep you all posted on what happens to me. Best wishes.
I agree with gimel...I'm always a big fan of making ONE change at a time. Then you know what to attribute any changes in symptoms to.
Also, that super-broad range on the FT4 is still knocking me for a loop. The usual range we see for direct FT4 is approximately 0.8-1.8. There are variations among labs, but FT4 is pretty consistent at about 0.8-1.8. Now. we always say that we shoot for midrange, and that's because the ranges are flawed. My gut feeling (and I've tried to find something to confirm it and can't) is that the recommendation on your broad range wouldn't be midrange, but ABOVE 1.3, i.e. you only take off the same questionable part of the range that you'd take off with the narrower range. Am I making sense? Wondering what you think about this, gimel???
I have to agree that IF one were to go on a T3-only protocol, it would be absolutely necessary to find a doctor who is comfortable with the protocol. I don't think T3-only is something you want to mess with on your own or with a doctor who is letting you call the shots.
Do you have a link to the article you mentioned in your other thread that discusses the different deiodinases and the separate reaction of the pituitary to its deiodinase? I'd be really interested to read that since one of my problems is PRTH (pituitary resistance to thyroid hormone).
Also, that super-broad range on the FT4 is still knocking me for a loop. The usual range we see for direct FT4 is approximately 0.8-1.8. There are variations among labs, but FT4 is pretty consistent at about 0.8-1.8. Now. we always say that we shoot for midrange, and that's because the ranges are flawed. My gut feeling (and I've tried to find something to confirm it and can't) is that the recommendation on your broad range wouldn't be midrange, but ABOVE 1.3, i.e. you only take off the same questionable part of the range that you'd take off with the narrower range. Am I making sense? Wondering what you think about this, gimel???
I have to agree that IF one were to go on a T3-only protocol, it would be absolutely necessary to find a doctor who is comfortable with the protocol. I don't think T3-only is something you want to mess with on your own or with a doctor who is letting you call the shots.
Do you have a link to the article you mentioned in your other thread that discusses the different deiodinases and the separate reaction of the pituitary to its deiodinase? I'd be really interested to read that since one of my problems is PRTH (pituitary resistance to thyroid hormone).
Sorry for the delay in replying. I think if I were in your shoes I would leave the T4 dosage as is, and make a small increase in Cytomel and monitor the effect for at least several weeks and then decide on the next step based on how you are feeling. Then you are making only one change at a time.
Yeah, I have my own thread with my last 3 labs on it, but the party seems to be here on alfonsina's page ! Sorry, don't mean to co-opt your page alfonsina .....I guess for people who will find these in the archives, all info is good. OK, I will RE-post my last 3 labs. We don't test for TSH anymore because it was only .89 before I had symptoms and now is virtually non-existant. I have to factor in that I take estrogen and progesterone, and estrogen can bind the thyroid hormones....that's why the FREE T4 Direct test is supposed to be the better test for me.
March 10, 2011
I think my dose was 100 mcg T4 and 15 mcg Cytomel
My symptoms were bad. I think the previous endo had even had me at 75 mcg T4
TSH .06 ( .40- 4.50 )
FREE T4 Direct 1.6 ( .8 - 2.7 )
FREE T3 2.7 ( 2.3 - 4.2 )
Cortisol Total 3.2 ( 3.0 - 17.0 ) pm draw
May 23, 2011
100 mcg T4 and 25 mcg Cytomel
TSH below .01
FREE T4 Direct 1.1
FREE T3 3.1
Cortisol Total 7.2 ( 4.0 - 22.0 ) am draw
VIT D 43 ( 30 - 100 ) take 3000 units per day
Iron Total 74 ( 40 - 160 )
Ferritin 60 ( 20 - 288 ) take 1500 units liquid B12 for pernicious
anemia
Cholesterol Total 163 ( 125 - 200 ) normal for me, had been 220 before
adding T3 thyroid meds
HDL Cholesterol 66 ( above 46 )
Triglycerides 55 ( below 155 ) all of these back to normal
LDL Cholesterol 86 ( below 130 )
Glucose 97 ( 65 - 99 )
Everything else, like Creatinine, eGfr, potassium etc. are normal or BACK to normal. No testing for VIT A, Magnesium or Zinc. I eat meat and ice cream, btw......but I eat rationally. I take lots of vitamins including CAL- Mag, Selenium and Chromium. Still have edema and muscle spasms. Hair stops falling out in golf ball sized clumps. Body temp. still as low as 97.1, always below 98.2.
July 12, 2011
112 mcg T4 and 31 and 1/2 mcg Cytomel
TSH below .01
FREE T4 (not Direct, error) 1.3 ( .8 - 1.8 )
FREE T3 3.7
Hair grows back and is no longer limp. Slightly less edema. Slightly less dry skin. Rash still comes and goes.
August 24, 2011
112 mcg. T4 and 37 and 1/2 mcg Cytomel
FREE T4 Direct 1.4
FREE T3 3.8
rT3 23 ( 11 - 32 ) ratio is 1.6 / aka 16 ( below 2 / 20 )
Before I got the results of the rT3 test, I was going to raise the T4 to get it up to 1.7, which would be 1/2 way in the range. Then because of the rT3, my PCP agreed I should raise the Cytomel to 50 and lower the T4 to 100 and then repeat the test in about 5 weeks. Now I'm not so sure. When I first went on the combination protocol (at MY insistence ), I had NO benefit from taking Synthroid/ T4. They initially added 25 mcg Cytomel to the 75 mcg Synthroid. In 3 days I woke up without depression for the first time in 10 years and in 3 weeks I lost 15 lbs. After 6 weeks, the Synthroid was raised to 100mcg, I slowly lost another 10 lbs. and was only 10 lbs. over my lifetime weight. Then the pharmacy changed the Cytomel to the generic, 4 months later I had a bad reaction and my T3 was cut in 1/2, which immediately put me back to square one.......extreme depression and gained 15 lbs. in 3 weeks, brain fog, dyslexia, vision problems, anxiety. Every time I was tested after that (with obsolete tests anyway), I was not told to take medicationAFTER the labs, so of course the T3 kept coming back high while my symptoms were extreme....lost 1/2 my hair again as the various endos kept insisting I lower and then go off meds. I refused, my PCP started letting ME decide on my meds based on labs SHE orders, and now, finally, after a year and a half, I'm almost back to the good way I felt on 100 mcg T4 and 25 mcg Cytomel. But not until the myxedema made me crazy and drove my blood pressure up to 196/98 and my cholesterol to 220. I looked like a pumpkin, but they kept insisting I wasn't hypothyroid, that I was only on thyroid meds to control the growth of nodules on my thyroid. That worked, btw....they shrank.
So Mel. I am terrified to mess myself up again, but I have only lost 8 lbs. of the weight I gained when they lowered my meds and as I said, the edema, though better, is painful.
What to do ? Hypothyroidism : My Hobby.
March 10, 2011
I think my dose was 100 mcg T4 and 15 mcg Cytomel
My symptoms were bad. I think the previous endo had even had me at 75 mcg T4
TSH .06 ( .40- 4.50 )
FREE T4 Direct 1.6 ( .8 - 2.7 )
FREE T3 2.7 ( 2.3 - 4.2 )
Cortisol Total 3.2 ( 3.0 - 17.0 ) pm draw
May 23, 2011
100 mcg T4 and 25 mcg Cytomel
TSH below .01
FREE T4 Direct 1.1
FREE T3 3.1
Cortisol Total 7.2 ( 4.0 - 22.0 ) am draw
VIT D 43 ( 30 - 100 ) take 3000 units per day
Iron Total 74 ( 40 - 160 )
Ferritin 60 ( 20 - 288 ) take 1500 units liquid B12 for pernicious
anemia
Cholesterol Total 163 ( 125 - 200 ) normal for me, had been 220 before
adding T3 thyroid meds
HDL Cholesterol 66 ( above 46 )
Triglycerides 55 ( below 155 ) all of these back to normal
LDL Cholesterol 86 ( below 130 )
Glucose 97 ( 65 - 99 )
Everything else, like Creatinine, eGfr, potassium etc. are normal or BACK to normal. No testing for VIT A, Magnesium or Zinc. I eat meat and ice cream, btw......but I eat rationally. I take lots of vitamins including CAL- Mag, Selenium and Chromium. Still have edema and muscle spasms. Hair stops falling out in golf ball sized clumps. Body temp. still as low as 97.1, always below 98.2.
July 12, 2011
112 mcg T4 and 31 and 1/2 mcg Cytomel
TSH below .01
FREE T4 (not Direct, error) 1.3 ( .8 - 1.8 )
FREE T3 3.7
Hair grows back and is no longer limp. Slightly less edema. Slightly less dry skin. Rash still comes and goes.
August 24, 2011
112 mcg. T4 and 37 and 1/2 mcg Cytomel
FREE T4 Direct 1.4
FREE T3 3.8
rT3 23 ( 11 - 32 ) ratio is 1.6 / aka 16 ( below 2 / 20 )
Before I got the results of the rT3 test, I was going to raise the T4 to get it up to 1.7, which would be 1/2 way in the range. Then because of the rT3, my PCP agreed I should raise the Cytomel to 50 and lower the T4 to 100 and then repeat the test in about 5 weeks. Now I'm not so sure. When I first went on the combination protocol (at MY insistence ), I had NO benefit from taking Synthroid/ T4. They initially added 25 mcg Cytomel to the 75 mcg Synthroid. In 3 days I woke up without depression for the first time in 10 years and in 3 weeks I lost 15 lbs. After 6 weeks, the Synthroid was raised to 100mcg, I slowly lost another 10 lbs. and was only 10 lbs. over my lifetime weight. Then the pharmacy changed the Cytomel to the generic, 4 months later I had a bad reaction and my T3 was cut in 1/2, which immediately put me back to square one.......extreme depression and gained 15 lbs. in 3 weeks, brain fog, dyslexia, vision problems, anxiety. Every time I was tested after that (with obsolete tests anyway), I was not told to take medicationAFTER the labs, so of course the T3 kept coming back high while my symptoms were extreme....lost 1/2 my hair again as the various endos kept insisting I lower and then go off meds. I refused, my PCP started letting ME decide on my meds based on labs SHE orders, and now, finally, after a year and a half, I'm almost back to the good way I felt on 100 mcg T4 and 25 mcg Cytomel. But not until the myxedema made me crazy and drove my blood pressure up to 196/98 and my cholesterol to 220. I looked like a pumpkin, but they kept insisting I wasn't hypothyroid, that I was only on thyroid meds to control the growth of nodules on my thyroid. That worked, btw....they shrank.
So Mel. I am terrified to mess myself up again, but I have only lost 8 lbs. of the weight I gained when they lowered my meds and as I said, the edema, though better, is painful.
What to do ? Hypothyroidism : My Hobby.
I see your FT3 and rT3 levels above, please refresh my memory about your FT4 level. Also don't forget this link.
http://hormonerestoration.com/files/ThyroidPMD.pdf
Note that the doctor states, "Since NDT has more T3 than the human thyroid gland produces, the well- replaced patient’s FT4 will be below the middle of its range, and the FT3 will be high “normal” or slightly high before the next AM dose." I am not advocating NDT here, just that the good levels seem to be around midrange for FT4 and high "normal" or slightly high before the next AM dose. That same doctor once stated that dosage is irrelevant. The only thing that is important is to get the FT3 and FT4 levels high enough to relieve hypo symptoms.
I also think that I saw that you were taking T4. Since you said that your FT4 was below the midpoint and your FT3 is 3.8, you seem to be adequately converting your T4 med to T3. In this case, why not try increasing your T4 med slightly and test again in 4-6 weeks?
I'm sure that you have been tested for all the "usual suspects", but let me ask anyway. Vitamin A, D, B12, iron/ferritin, zinc, selenium, RBC magnesium?
http://hormonerestoration.com/files/ThyroidPMD.pdf
Note that the doctor states, "Since NDT has more T3 than the human thyroid gland produces, the well- replaced patient’s FT4 will be below the middle of its range, and the FT3 will be high “normal” or slightly high before the next AM dose." I am not advocating NDT here, just that the good levels seem to be around midrange for FT4 and high "normal" or slightly high before the next AM dose. That same doctor once stated that dosage is irrelevant. The only thing that is important is to get the FT3 and FT4 levels high enough to relieve hypo symptoms.
I also think that I saw that you were taking T4. Since you said that your FT4 was below the midpoint and your FT3 is 3.8, you seem to be adequately converting your T4 med to T3. In this case, why not try increasing your T4 med slightly and test again in 4-6 weeks?
I'm sure that you have been tested for all the "usual suspects", but let me ask anyway. Vitamin A, D, B12, iron/ferritin, zinc, selenium, RBC magnesium?
MEL ! ! !
You are my hero ! That is the most cogent thing I've read about rT3 yet, and coincides with my own intuition and the way I'm currently feeling. I had just read this article on diodinase function a few days ago, which given my own personal and family history, caused me to question the T3 only protocol. Here is the link to that article if you're interested:
http://nahypothyroidism.org/deiodinases/
Would you be able to go to MY post, instead of alfonsina's, and look at my labs ? I need to get new meds today or I won't have any and I'm SO confused as to what to do. Before I had the rT3 test, I was going to raise the T4 to get my FREE T4 to the middle, as it's a little below. And I hoped that would raise my FREE T3 level along with it. My FREE T3 is the best it's been so far, but I still have a little room to grow. It's the edema that is bothering me the most, it's painful. I also have painful muscles and FEET ! What's up with that ? At least my hair grew back. I also have respiratory infections all the time. That became almost ongoing after exposure to environmental toxins, around the same time my thyroid symptoms started. I'm taking an awful lot of thyroid medication to still be having symptoms. And of course I don't have a TSH level any more !
Thank you thank you thank you for the info. I know it will help alfonsina as well. Is there a way we can enter these types of info into a members archive ? It would save so much time.
You are my hero ! That is the most cogent thing I've read about rT3 yet, and coincides with my own intuition and the way I'm currently feeling. I had just read this article on diodinase function a few days ago, which given my own personal and family history, caused me to question the T3 only protocol. Here is the link to that article if you're interested:
http://nahypothyroidism.org/deiodinases/
Would you be able to go to MY post, instead of alfonsina's, and look at my labs ? I need to get new meds today or I won't have any and I'm SO confused as to what to do. Before I had the rT3 test, I was going to raise the T4 to get my FREE T4 to the middle, as it's a little below. And I hoped that would raise my FREE T3 level along with it. My FREE T3 is the best it's been so far, but I still have a little room to grow. It's the edema that is bothering me the most, it's painful. I also have painful muscles and FEET ! What's up with that ? At least my hair grew back. I also have respiratory infections all the time. That became almost ongoing after exposure to environmental toxins, around the same time my thyroid symptoms started. I'm taking an awful lot of thyroid medication to still be having symptoms. And of course I don't have a TSH level any more !
Thank you thank you thank you for the info. I know it will help alfonsina as well. Is there a way we can enter these types of info into a members archive ? It would save so much time.
Ran across a good link that made me think of your questions.
http://tiredthyroid.com/rt3.html
http://tiredthyroid.com/rt3.html
Hi, it's me again,
Alfonsina, I read the links (thanks !) but still feel ignorant about what to do with my meds, how about you ? gimel and FF....I think alfonsina and I understand about the ratio, but thanks for commenting. I can't speak for her, but it's taken me so long just to feel this good....still some symptoms but better....that I'm very leary of the information that suggests going off T4 completely and then titrating upwards w/ T3 until the rT3 disappears, all the while having hypo symptoms up the wazoo. Oh, and then being prepared for that blast of hyper symptoms that they say happens all at once at the moment the rT3 finally says byebye, so that you have to be prepared to radically adjust your T3 way down again. Sounds like hell on the system, and I've read that metabolism can become permanently tweaked from too much meddling w/ the meds, at least as far as myxedema goes, a symptom that's lingering this time for me.
I have to order my meds tomorrow......guess I'll lower my T4 a little (FreeT4 almost at mid-range) and raise the T3, which is about 2/3 in the range....wait 5 weeks and retest for Frees and rT3 and see what happens. Scary. i would give anything for a doctor to be guiding me.
Alfonsina, if you find out anything more, will you let me know, and I'll do the same ? Thanks !
Alfonsina, I read the links (thanks !) but still feel ignorant about what to do with my meds, how about you ? gimel and FF....I think alfonsina and I understand about the ratio, but thanks for commenting. I can't speak for her, but it's taken me so long just to feel this good....still some symptoms but better....that I'm very leary of the information that suggests going off T4 completely and then titrating upwards w/ T3 until the rT3 disappears, all the while having hypo symptoms up the wazoo. Oh, and then being prepared for that blast of hyper symptoms that they say happens all at once at the moment the rT3 finally says byebye, so that you have to be prepared to radically adjust your T3 way down again. Sounds like hell on the system, and I've read that metabolism can become permanently tweaked from too much meddling w/ the meds, at least as far as myxedema goes, a symptom that's lingering this time for me.
I have to order my meds tomorrow......guess I'll lower my T4 a little (FreeT4 almost at mid-range) and raise the T3, which is about 2/3 in the range....wait 5 weeks and retest for Frees and rT3 and see what happens. Scary. i would give anything for a doctor to be guiding me.
Alfonsina, if you find out anything more, will you let me know, and I'll do the same ? Thanks !
There appears to be two approaches to evaluating the FT3/ rT3 ratio. Both depend on the measurement units used for each test. By one method, the ratio would be .86, with a recommended range being 1 - 2, and higher being better. With the second method, the ratio calculates to 8.6, and the recommendation is that it should be 20 or higher.
With either approach, it is clear that you do have reverse T3 dominance. I have no personal experience with this problem. Many of the Professional organizations claim that rT3 dominance is not really a problem that requires a different treatment protocol. Some say that if left alone, it will eventually go away. Of course this is not very comforting to a suffering patient. The approach to treatment seems to be consistent with this link.
http://www.thyroid-rt3.com/howisit1.htm
With either approach, it is clear that you do have reverse T3 dominance. I have no personal experience with this problem. Many of the Professional organizations claim that rT3 dominance is not really a problem that requires a different treatment protocol. Some say that if left alone, it will eventually go away. Of course this is not very comforting to a suffering patient. The approach to treatment seems to be consistent with this link.
http://www.thyroid-rt3.com/howisit1.htm
I got the ratio of RT3 divided by FT3. Which is the inverse of what you all did.
So I guess I was incorrect.
But when you do the math above you actually get 3.1/36 = 0.086. So the conversion must be to multiply by 100 because the units are not the same as the FT3 is in pg/ml and RT3 is in ng/dl. And thus you apparently have to multiply by 100 to get a final result of 8
In any event it would suggest that it is not between 10 and 20 so there is some RT3 problem going on.
So I guess I was incorrect.
But when you do the math above you actually get 3.1/36 = 0.086. So the conversion must be to multiply by 100 because the units are not the same as the FT3 is in pg/ml and RT3 is in ng/dl. And thus you apparently have to multiply by 100 to get a final result of 8
In any event it would suggest that it is not between 10 and 20 so there is some RT3 problem going on.
Apparently we are in the same boat, although you seem to be in a better shape than me. Your ratio is closer to 20 than mine (If my calculation is right)
I read the link you posted.
RT3 seems to be a complex problem, and for I was reading a lot of people with this problem stay on T3 only medicine for life. Not to say that I would like to do that, however, it seems to me that once you have RT3 it is difficult you can add or go back to T4and T3 medication (NT, Erfa, Synthroid, etc).
Please read this links...while we wait for some wise member of this forum to get back to us.
http://misslizzy.me/reverse-t3-rt3-and-thyroid-res
http://thyroid-rt3.com/
I read the link you posted.
RT3 seems to be a complex problem, and for I was reading a lot of people with this problem stay on T3 only medicine for life. Not to say that I would like to do that, however, it seems to me that once you have RT3 it is difficult you can add or go back to T4and T3 medication (NT, Erfa, Synthroid, etc).
Please read this links...while we wait for some wise member of this forum to get back to us.
http://misslizzy.me/reverse-t3-rt3-and-thyroid-res
http://thyroid-rt3.com/
Thank you for posting.
about your comment "the big problem would be finding a Dr. who actually believes in this condition" I think you area absolutely right. However, as I said in my previous post my doctor tested me because I asked him to. He took with him a copy I brought to my visit which explained the RT3 problem.
Apparently he is not very knowledgeable about it, so my problem in this case wouldn't be either he believes or not, my concern would be does he know how to treat RT3?
about your comment "the big problem would be finding a Dr. who actually believes in this condition" I think you area absolutely right. However, as I said in my previous post my doctor tested me because I asked him to. He took with him a copy I brought to my visit which explained the RT3 problem.
Apparently he is not very knowledgeable about it, so my problem in this case wouldn't be either he believes or not, my concern would be does he know how to treat RT3?
Dear alfonsina and FF,
I also calculate your ratio as 8.6 (or .86, depending on the scale you use) w/ a normal range of 10-20 ( 0r 1.00 -2.00, same deal) So FF, how did you come up with 1.16 for her ? And yes, the research I did says to stop hypo symptoms the ratio needs to be at the very top, or even slightly higher than normal. Your ratio is even lower than mine. Thanks for posting, FF, and glad your wife is finally getting the Ft3 test, BRAVO for perseverance ! Now, does anybody have any idea what alfonsina and I are supposed to do about adjusting our meds ? ? ?
I also calculate your ratio as 8.6 (or .86, depending on the scale you use) w/ a normal range of 10-20 ( 0r 1.00 -2.00, same deal) So FF, how did you come up with 1.16 for her ? And yes, the research I did says to stop hypo symptoms the ratio needs to be at the very top, or even slightly higher than normal. Your ratio is even lower than mine. Thanks for posting, FF, and glad your wife is finally getting the Ft3 test, BRAVO for perseverance ! Now, does anybody have any idea what alfonsina and I are supposed to do about adjusting our meds ? ? ?
I've read something that says that you need to look at the ratio. And the ratio should be between 1 to 2. Preferrabely towards 2.0
You may have to divide or multiply by 10 if the answer is goofy and that is due to the two different units that they are measured in.
In your case the RT3 to FT3 ratio is 1.16. So it is in the range specified but towards the low end.
There is a condition where your body produces a lot or RT3 so they "fill up" the body's receptors and there is not enough FT3 remaining. The RT3 while it will be accepted, is unusable to the body.
I'm not sure the cure for this. But increasing the pure T3 medication would be one way to force more FT3 into the bloodstream so that they can be used. I'm also not sure if this can be a temporary thing where you can "train" your body to get rid of the RT3 phenomenon.
The big problem would be finding a Dr who actually believes in this condition. I don't think it is real common. And heck, many people can not find a Dr who will even believe in the need for FT3 testing and disregarding TSH let alone one who believes there is a person who has an RT3 thyroid resistance problem.
You may have to divide or multiply by 10 if the answer is goofy and that is due to the two different units that they are measured in.
In your case the RT3 to FT3 ratio is 1.16. So it is in the range specified but towards the low end.
There is a condition where your body produces a lot or RT3 so they "fill up" the body's receptors and there is not enough FT3 remaining. The RT3 while it will be accepted, is unusable to the body.
I'm not sure the cure for this. But increasing the pure T3 medication would be one way to force more FT3 into the bloodstream so that they can be used. I'm also not sure if this can be a temporary thing where you can "train" your body to get rid of the RT3 phenomenon.
The big problem would be finding a Dr who actually believes in this condition. I don't think it is real common. And heck, many people can not find a Dr who will even believe in the need for FT3 testing and disregarding TSH let alone one who believes there is a person who has an RT3 thyroid resistance problem.
I found this article this morning on rT3 / FREE T3, so sending it to you. The articles on "Wilson'd Syndrome" seem goofy to me, but this was more explanatory and more conservative in nature. Interesting that it comes from a compounding pharmacy site.
Nobody is helping us out here ! Wonder if it's because they don't have an understanding of the problem ? Scary to be monitoring one's own drug protocol in this way.
http://www.custommedicine.com.au/health-articles/reverse-t3-dominance/
Nobody is helping us out here ! Wonder if it's because they don't have an understanding of the problem ? Scary to be monitoring one's own drug protocol in this way.
http://www.custommedicine.com.au/health-articles/reverse-t3-dominance/
I am having the same problem and asked the same question in my post. My FreeT3 is 3.8 and my rT3 is 23 with the same ranges as yours. I've been on generic T4 and Cytomel for 2 years and still have some symptoms as well. What is your TSH ? Mine is less than .04, so I get nothing but grief from endos.
I also read that my ratio should be above 20. Mine is 16.5. We should read each other's posts, and hope that someone more knowledgeable can give us some guidance. It's easier for me to adjust my dose than it would be for you because I take the two medications separately.
Good and good health !
I also read that my ratio should be above 20. Mine is 16.5. We should read each other's posts, and hope that someone more knowledgeable can give us some guidance. It's easier for me to adjust my dose than it would be for you because I take the two medications separately.
Good and good health !
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