Need help to interpret labs

Question

Over the last 2 months I've been able to increase my Nature-Throid dosage to 3 grains divided dose daily.  The following are my labs on 3 grains.
TSH 0.059 (0.450 - 4.5)
FT4  1.26   (0.82 - 1.77)
FT3   3.9    (2.0 - 4.4)
RT3   305   (90 - 350)
TPO     50   (0 - 34)

antithyroglobulin  110  (0 - 40)
Total T4  9  (4.5 - 12.0)
Ferritin  112  (13 - 150)

I know that the TSH is very low.  Currently I'm not having any  hyper symptoms.  Basal temp has risen .6 degrees to 96.8 and average daily temps have risen .7 degrees to 98.2.  BP has come down slightly, pulse remain the same.  Skin has started to clear up.  Less hair loss.  Sleeping better.  Still very achy, and decreased energy, move very slowly in the morning.  I'll be seeing my Doctor soon and would like to know if I need to add Cytomel to decrease the RT3 or what exactly would be the best way to proceed.

Thanks!

This discussion is related to Low FT3, high rT3.

river1233 · Answer

Thank you both for the quick response.  Now I can relax about the RT3 and just be patient and let the Nature-throid do it's work.  I imagine since it's only been 4 weeks at 3 grains, I can see what happens over the next couple of weeks as far as symptoms go.  Would either of you try to increase up to 3 1/2 or 4 grains with these kind of labs?

Thanks again.

Barb135 · Answer

I agree with Sally; your FT3 is already in the upper end of the range and you most likely don't need it much higher.  As for your TSH being low - don't worry about that so long as your FT's are okay, which yours are.  My TSH consistently runs at less than 0.01 and I'm fine because my Free are good.  

Remember, TSH is a pituitary hormone and should not be used as a diagnostic to determine if you are hyper or hypo.  You need to go first by symptoms, then by the level of your Frees.

Super_sally888 · Answer

Hi,

in my opinon your levels look reasonable: in the upper 1/3 of the reference range.  

It would not be usual to add cytomel to nature thryoid becuase the amoutn of T3 in nature thryoid (from pig thyroid) is actually higher in proportion to the FT4 than it is naturally from human thyroid.

I would be patient, and also check other things contributing to how you feel:-

B12, iron, Vit D.

Make sure your diet is optimised, enough rest, and some moderatee exercise every day.

If all these other things are ok.  Then maybe a very small increase in meds?  Just a small change can make a big difference in how you feel.

Let us know what your doctor says.  Am sure others will chime in.