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988694 tn?1332363079

new numbers and same symptoms?

About a a month in a half ago my doctor switched me to a different dose. My numbers are now high and different from my last labs, but I continue to feel the same. I have been feeling with a better mood after the switch, however my headaches don't go away, and allergies, constipation are the same.

Back in November I had these results, I was taking 2 grains of NT and something like 30 mg of Cytomel. I felt very nervous and anxious and could not concentrate, I had constipation, hair loss, bleeding before period, and headaches:

TSH: 0.01    0.4-4.50
Free T4: 0.8  0.8-1.8
Free T3   4.2  2.3 -4.2
Reverse T3: 28   11-32

I started then taking 100 Synthroid and 2 and 1/4 grains NT. After a month in this dose:
TSH: 0.01          0.4-4.50    
Free T4:  2.2        0.8-1.8
Free T3:  5.2        2.3 -4.2
reverse:   58         11-32

I actually I started to feel a little better on this dose, my mood above all and sleeping a little better, but my constipation and headaches continued (and bleeding before periods). I don't get relief no matter what I do, it seems. My doctor decreased my dose, of course, but I told him, that in the past my numbers went up very quickly, but after some months they start to drop on a same dose. He only then decreased the 1/4 NT and I am taking 100 Synthroid and 2 grains of NT. He wanted to decrease more. My numbers are out of the whack, I know, but I feel better than when I was trying to increase my T3 only, because of reverse T3 to high.

Also, probably the ratio in NT of T3 and T4 is a little to high. I mean too much T3 in it. Synthroid increased my free T3 naturally.

Why do you think I do not get relief on my symptoms? should I wait more, maybe in some more months I will see a difference? the migraines are the worst part of it, started when hypo (when numbers started to drop) and have not stopped. Thanks.


5 Responses
499534 tn?1328707778
Well now it looks like you are hyper on all levels. Has your doctor ever had you on Cytomel only to see if your reverse T3 levels correct back to normal range? Usually this is the course of treatment for reverse T3 issues.
What type of doctor is treating you for this? Is he well versed in thyroid disorders?
Avatar universal
You mention the Reverse T3 levels being high and wanting to DECREASE your T3.  That is exactly the opposite of what you need.

Reverse T3 (RT3) is ONLY produced as a result of conversion of T4 into T3.  Laura is right that in order to decrease the amount of RT3 you need almost to be on 100% T3 until the RT3 metabolizes.

The reason why you may not feel relief could be in fact due to the RT3 levels.  You see the body's cells will receive the RT3 molecule but it is inactive and therefore has no results

Essentially with too high RT3 your body's cells get plugged up with RT3 and there are less receptors for the FT3 that actually do the work.

The situation you may be in is like a car that has a full tank of gasoline but the fuel filter is plugged and not enough gas reaches the engine.  So it runs like crap.  In your case the RT3 have plugged the receptors and your body is not getting enough actual FT3 thyroid hormone to run well so you feel like crap.

This to me explains why you should be likely having HYPER symptoms with those high numbers of FT3 and FT4.  But you aren't because of the RT3 plugging problem. The gas tank is full if not over full but you are not burning any gas.

You need to clean out the fuel filter.  By taking only T3 that leaves virtually no T4 left to be converted.  If there is no converting going on, there are no creation of more RT3.  Once the RT3 clears out you may be set.

Keep in mind that you have to be very vigilant with this method as you will go from being Hypo from the plugged situation to Hyper in a VERY short time.  Since T3 is fast acting medicine you MUST be aware of Hyper symptoms and stop taking the T3 as soon as you recognize going Hyper.  Then you can start on a medicine regime that will try to balance your FT4 and FT3 levels.  Many people this works the first time. If you have continued problems with RT3 then you may have to be fairly heavily weighted towards a T3 medicine to keep the amount of T4 levels low to keep the RT3 levels low.

I hope I makes sense to you.

As far as TSH. It appears that your TSH is completely suppressed by medication so it is of almost no value what so ever.

If I were a Dr. (Which I am not) and treating you.  I would wean you off of the Synthroid.  I would add Cytomel to keep your FT3 levels in the upper 1/3 of the range.  Then I would start stepping you off the NT and increasing your Cytomel to continue to keep FT3 levels in upper 1/3 of the range. All the while keeping track of the RT3 levels.  Maybe you would not even need to come completely off the NT.  Towards the end as the NT was gone and possibly heavy reliance on T3 med I would be testing you every 2 weeks max. to try to keep a handle on how the unplugging process is going and ov course you train yourself to recognize the signs of Hyper to stop or dramatically reduce the Cytomel upon noticing you going Hyper.

You mentioned that you had 30 mcg of Cytomel.  If that was not started slowly and worked up to it is no wonder you went off the wall.  That is a HUGE jump from especially since you already were taking NT which has a T3 component.

Check out these websites for more info on RT3

http://tiredthyroid.com/rt3.html

http://thyroid-rt3.com/

http://www.custommedicine.com.au/health-articles/reverse-t3-dominance/
988694 tn?1332363079
Thanks for your replay. The doctor that is treating me is a family/general practitioner, since endocrinologists refused to treat me. He understands about how important frees are, but about reverse, he did not know much about it. He added Cytomel and reduced NT and reverse got better, in numbers, but for about three months I was feeling miserable when trying to bring my FT3 up. That is why we are trying now to bring T4 up instead. I have read some people with reverse T3 feel better with more T4.
988694 tn?1332363079
Thank you for your extensive and knowledgeable replay. As I mentioned to Laura, my doctor tried to bring up my T3 by lowering my NT and by adding Cytomel. I started to add Cytomel slowly, but to be honest I had a lot of irregular heart beat. I got irregular heart beat when I am hypo as well, so it is very confusing to me to really know what is going on.

I tried and decreased my NT up to 1.5 and increased Cytomel, and that are the numbers you see in my original post. My Free T4 is in the lower range and Ft3 in the upper, but as I said, I really was having a terrible time, I thought I was going nuts, and after two or three months I thought I should feel better in that regime, I think.

My doctor never wanted me to have me on Cytomel only. I  do feel better with more T4 than when I was doing the opposite, although I still have a lot of hypo symptoms. I am a happier person that is for sure. That is the weird part because my reverse is so high...I wonder if there are some people with high reverse T3 and feel good anyway.

The website you mentioned, tired thyroid, is the one that says that T3 only protocol might not work for everybody and that more T4 could be beneficial. I do not know. I been in this for more than two years and struggling, but I have to say something: Compare to how I felt before taking any medicine, I feel much better on medicine. Less acne, more regular periods, besides the spotting, more concentration, to name the most important changes. Hair continues to fall like crazy, it is dry, like my skin and so on. Thanks!!
988694 tn?1332363079
I forgot to tell you that I have been looking for an holistic doctor, I wanted to switch doctors, but my insurance does not cover it:(
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