Aa
Can't get it.. high fT3, normal rT3, normal fT4 still hypo?!
hey there..
well actually i have done a new rT3 testing because the last one was 1/2 year ago. First of all... i have Hashis since 5 years.. and actually on 6 grain Acella. I get my labs checked every 1-2 months... and taking Acella since 1/2 year. prior to that i took synth levo.. and never felt good in 4 1/2 years.. NEVER.
the last blood test showed on 5,5 grain Acella:
18.05.2014
fT4 16,77 (10,8-25,8) = 40%
fT3 7,02 (3,4-7,2) = 96%
I still felt hypo... so i decided to go on more to check out if i feel better.... so i got up to 6 grain with the following results (i know. its just 3 weeks between 5,5 and 6 but i felt not so good so i wanted to know what its about):
03.06.2014 (other lab than on 18.05)
fT3 10,05 (3,4-7,2) pmol/l = 175%
fT4 19,18 (10,8-25,8) pmol/l = 55%
rT3 315,4 (380<attention614)
my fT3/rT3 ratio is 20.
So... why do i still have hypo symptoms? My Vit D is good, my B12 is good, my iron is good and cortisol was fine last year too.. but i will repeat a test soon to be sure that there is everything ok after beein on NDT.
I have no Hyper symptoms..my pulse is 66/min, bloodpressure ~130/80, Temperature armpit 36,6°C, no diarrhea, no weight loss (ive gained 3kg :) ), normal appetite... etc... im still pale when i have done much things.. dark eye circles are better with the higher dose now.. but are still there.. i have to regenerate too long after my workout or after work.. etc. I have to say, that my symptoms got better with increasing the acella.. but i whought that i would be fine when my fT3 is at ~90-110%.. but i wasnt :/
well actually i have done a new rT3 testing because the last one was 1/2 year ago. First of all... i have Hashis since 5 years.. and actually on 6 grain Acella. I get my labs checked every 1-2 months... and taking Acella since 1/2 year. prior to that i took synth levo.. and never felt good in 4 1/2 years.. NEVER.
the last blood test showed on 5,5 grain Acella:
18.05.2014
fT4 16,77 (10,8-25,8) = 40%
fT3 7,02 (3,4-7,2) = 96%
I still felt hypo... so i decided to go on more to check out if i feel better.... so i got up to 6 grain with the following results (i know. its just 3 weeks between 5,5 and 6 but i felt not so good so i wanted to know what its about):
03.06.2014 (other lab than on 18.05)
fT3 10,05 (3,4-7,2) pmol/l = 175%
fT4 19,18 (10,8-25,8) pmol/l = 55%
rT3 315,4 (380<attention614)
my fT3/rT3 ratio is 20.
So... why do i still have hypo symptoms? My Vit D is good, my B12 is good, my iron is good and cortisol was fine last year too.. but i will repeat a test soon to be sure that there is everything ok after beein on NDT.
I have no Hyper symptoms..my pulse is 66/min, bloodpressure ~130/80, Temperature armpit 36,6°C, no diarrhea, no weight loss (ive gained 3kg :) ), normal appetite... etc... im still pale when i have done much things.. dark eye circles are better with the higher dose now.. but are still there.. i have to regenerate too long after my workout or after work.. etc. I have to say, that my symptoms got better with increasing the acella.. but i whought that i would be fine when my fT3 is at ~90-110%.. but i wasnt :/
Do not try sugar binges at home kids! :) I eat very little sugar (started last July) now which is why I've reversed my insulin resistance. And finally I was able to lose weight since my insulin went down. I've also lost 13.3 kg (29.3 lbs) so far. The magnesium deficiency was causing serious sugar cravings in particular.
Yes it's very frustrating to not be free of symptoms. I did try Armour to see if that would help but wasn't a success so I'm back onto T4. I'll see how I feel when all my visceral fat (producing pro-inflammatory cytokines) disappears. I haven't had my RT3 tested. I've had hypothyroid symptoms for 25 + years though. Not sure if you can have chronic RT3 for that long.
Yes it's very frustrating to not be free of symptoms. I did try Armour to see if that would help but wasn't a success so I'm back onto T4. I'll see how I feel when all my visceral fat (producing pro-inflammatory cytokines) disappears. I haven't had my RT3 tested. I've had hypothyroid symptoms for 25 + years though. Not sure if you can have chronic RT3 for that long.
And through all this, even currently, do you know what your RT3 has been doing? There are those alternative thinkers who say that FT3:RT3 ratio is the best estimate we have of tissue thyroid levels.
I'm the opposite of you...happy with very low FT3 and FT4 levels. So, I recently had RT3 tested, and my ratio came out to something like 23, which would support that theory. One person's experience does not a theory prove, however. My FT3 is low, below range, but so is my RT3. So, even with low FT3 levels, my body seems to have achieved a balance.
It still seems to me that you ought to be able to hit a happy medium of meds where enough thyroid hormone is getting into your cells to relieve your hypo symptoms, but not so much that you feel hyper. According to your description, it's like your FT3 hits a certain level, and the flood gates open allowing too much FT3 in, but if FT3 isn't high enough, those gates close, and you don't get enough. Typically, nature does not work on the flip of a switch.
Have you ever considered giving up sugar binges? LOL Reading between the lines (I get a LOT of info there!), it sounds like some lifestyle changes might really improve your situation. While I don't put a lot of stock in most of the lifestyle changes that purport to "cure" autoimmune disease, I think basically low stress (which can be managed), well balanced diet, etc. certainly helps whatever might ail you. You seem to have accepted that "this is the way it is". Just thinking out loud...
I'm the opposite of you...happy with very low FT3 and FT4 levels. So, I recently had RT3 tested, and my ratio came out to something like 23, which would support that theory. One person's experience does not a theory prove, however. My FT3 is low, below range, but so is my RT3. So, even with low FT3 levels, my body seems to have achieved a balance.
It still seems to me that you ought to be able to hit a happy medium of meds where enough thyroid hormone is getting into your cells to relieve your hypo symptoms, but not so much that you feel hyper. According to your description, it's like your FT3 hits a certain level, and the flood gates open allowing too much FT3 in, but if FT3 isn't high enough, those gates close, and you don't get enough. Typically, nature does not work on the flip of a switch.
Have you ever considered giving up sugar binges? LOL Reading between the lines (I get a LOT of info there!), it sounds like some lifestyle changes might really improve your situation. While I don't put a lot of stock in most of the lifestyle changes that purport to "cure" autoimmune disease, I think basically low stress (which can be managed), well balanced diet, etc. certainly helps whatever might ail you. You seem to have accepted that "this is the way it is". Just thinking out loud...
My free T3 was 8 pmol/L (2.8 - 6.8). I'm clearly not the same as Jenn in regards to needing sky high T3 but my cells still are resistant to some degree to thyroid hormone.
A similar condition would be when I had insulin resistance where my insulin was elevated to "squeeze" enough glucose into the cells and so my glucose levels were normal but I have damage and from chronically high insulin levels.
My endo suggested my cellular issues might be an immune system problem. He didn't officially state on paper I have THR but there is no test to prove it and I doubt he's going to put that down as an official diagnosis.
I'm agree with my endo about immune system issues. And the finger is pointed directly at pro-inflammatory cytokines. This makes sense as my cellular issues worsen with stress and binge eating sugar. For instance, if I binge on sugar then my hypo symptoms worsen very quickly.
Harvard Medical School: "Don't be so refined. The bolus of blood sugar that accompanies a meal or snack of highly refined carbohydrates (white bread, white rice, French fries, sugar-laden soda, etc.) increases levels of inflammatory messengers called cytokines. Eating whole-grain bread, brown rice, and other whole grains smooths out the after-meal rise in blood sugar and insulin, and dampens cytokine production."
Hypothyroid: A Comprehensive Assessment: "The thyroid receptors may also become resistant to the hormone from elevated pro-inflammatory Th1 cytokines from chronic inflammation, persistent elevated cortisol from chronic stress, deficient vitamin A, and methylation defects as seen with elevated homocysteine."
A similar condition would be when I had insulin resistance where my insulin was elevated to "squeeze" enough glucose into the cells and so my glucose levels were normal but I have damage and from chronically high insulin levels.
My endo suggested my cellular issues might be an immune system problem. He didn't officially state on paper I have THR but there is no test to prove it and I doubt he's going to put that down as an official diagnosis.
I'm agree with my endo about immune system issues. And the finger is pointed directly at pro-inflammatory cytokines. This makes sense as my cellular issues worsen with stress and binge eating sugar. For instance, if I binge on sugar then my hypo symptoms worsen very quickly.
Harvard Medical School: "Don't be so refined. The bolus of blood sugar that accompanies a meal or snack of highly refined carbohydrates (white bread, white rice, French fries, sugar-laden soda, etc.) increases levels of inflammatory messengers called cytokines. Eating whole-grain bread, brown rice, and other whole grains smooths out the after-meal rise in blood sugar and insulin, and dampens cytokine production."
Hypothyroid: A Comprehensive Assessment: "The thyroid receptors may also become resistant to the hormone from elevated pro-inflammatory Th1 cytokines from chronic inflammation, persistent elevated cortisol from chronic stress, deficient vitamin A, and methylation defects as seen with elevated homocysteine."
I still don't think we're talking about the same condition. Have you been formally diagnosed with THR?
If you skim through a bit of the link I posted, you will see that Jenn was barely not feeling hypo with an FT3 over 900 (range not specified, even though she was asked several times). She was taking massive doses of T3 just to barely keep hypo symptoms at bay.
What were you taking while hyper? Do you know what your FT3 was doing? I believe you said your FT4 was 25 (10-20).
I think the fact that you felt hyper almost precludes THR.
Of course, you know that your blood levels don't change within a day (unless you were taking straight T3), so how do you explain going back to having hypo symptoms so quickly?
If you skim through a bit of the link I posted, you will see that Jenn was barely not feeling hypo with an FT3 over 900 (range not specified, even though she was asked several times). She was taking massive doses of T3 just to barely keep hypo symptoms at bay.
What were you taking while hyper? Do you know what your FT3 was doing? I believe you said your FT4 was 25 (10-20).
I think the fact that you felt hyper almost precludes THR.
Of course, you know that your blood levels don't change within a day (unless you were taking straight T3), so how do you explain going back to having hypo symptoms so quickly?
That mind picture..ummm LOL but yeah that explains it pretty much. :) I have hyperthyroid symptoms and hyperthyroid labs. I was hyperthyroid for a year actually which caused a whole other sleuth of health problems. When I realised how bad my health was being affected (and major muscle atrophy to go with it), I stopped medication cold turkey I right back to hypothyroidism in a day or so.
"My cells can't get enough thyroid hormone into the cells which is why I do best when I'm hyperthyroid to "squeeze" enough in there for lack of a better explanation. :)"
Define hyperthyroid! Do you actually feel hyper or are you defining it by labs? If you feel hyper, is there no gradual transition from hypo to hyper?
I understand what you mean that it seems like it has to be squeezed in. My mind pictures it kind of like the egg and the sperm. Even though only one sperm gets in, you have to have enough concentration of them around the egg so that the wall of the egg cell gets broken down enough for the lucky one to pop in.
Define hyperthyroid! Do you actually feel hyper or are you defining it by labs? If you feel hyper, is there no gradual transition from hypo to hyper?
I understand what you mean that it seems like it has to be squeezed in. My mind pictures it kind of like the egg and the sperm. Even though only one sperm gets in, you have to have enough concentration of them around the egg so that the wall of the egg cell gets broken down enough for the lucky one to pop in.
I'm talking about the same condition. My cells can't get enough thyroid hormone into the cells which is why I do best when I'm hyperthyroid to "squeeze" enough in there for lack of a better explanation. :)
On commonness and rarity of thyroid hormone resistance: A discussion based on mechanisms of reduced sensitivity in peripheral tissues...
"Reduced sensitivity to thyroid hormone (TH) in peripheral tissues can occur as defects in TH transport into the cell, intracellular TH metabolism, cytosolic mechanisms, TH entry into the nucleus, thyroxin receptors (TRs) and receptor binding, transcription and post-transcriptional mechanisms.
Current literature reveals an extensive list of mutations, drugs, toxins, metabolites and autoimmune antibodies that may impair TH action in the cell, but such impairment may not be picked up by assays of TH and TSH in blood plasma. Substances may induce tissue specific resistance to thyroid hormone (RTH), e.g. by affecting numbers of different TR isoforms.
Recent literature also indicates mechanisms by which different conditions, for example, chronic fatigue syndrome (CFS), chronic renal failure (CRF) and nonthyroidal illness, can be accompanied by acquired RTH caused by inhibition of TH metabolism, cell uptake, TR binding and transcription. This prompts us to reassess commonness and rarity of congenital vs. acquired RTH."
On commonness and rarity of thyroid hormone resistance: A discussion based on mechanisms of reduced sensitivity in peripheral tissues...
"Reduced sensitivity to thyroid hormone (TH) in peripheral tissues can occur as defects in TH transport into the cell, intracellular TH metabolism, cytosolic mechanisms, TH entry into the nucleus, thyroxin receptors (TRs) and receptor binding, transcription and post-transcriptional mechanisms.
Current literature reveals an extensive list of mutations, drugs, toxins, metabolites and autoimmune antibodies that may impair TH action in the cell, but such impairment may not be picked up by assays of TH and TSH in blood plasma. Substances may induce tissue specific resistance to thyroid hormone (RTH), e.g. by affecting numbers of different TR isoforms.
Recent literature also indicates mechanisms by which different conditions, for example, chronic fatigue syndrome (CFS), chronic renal failure (CRF) and nonthyroidal illness, can be accompanied by acquired RTH caused by inhibition of TH metabolism, cell uptake, TR binding and transcription. This prompts us to reassess commonness and rarity of congenital vs. acquired RTH."
Unfortunately, a number of different conditions get labeled "thyroid hormone resistance". I don't believe Red and I are describing the same condition when we talk about it.
If I were you, I'd do some reading about thyroid hormone resistance (THR). It's a genetic mutation, and people who have it sometimes have to run FT3 levels at many TIMES the upper limit of the range.
You might check out this thread:
http://www.medhelp.org/posts/Thyroid-Disorders/Thyroid-Hormone-Resistance/show/1202364
Just out of curiosity, what is your TSH doing throughout all this?
If I were you, I'd do some reading about thyroid hormone resistance (THR). It's a genetic mutation, and people who have it sometimes have to run FT3 levels at many TIMES the upper limit of the range.
You might check out this thread:
http://www.medhelp.org/posts/Thyroid-Disorders/Thyroid-Hormone-Resistance/show/1202364
Just out of curiosity, what is your TSH doing throughout all this?
Hey
Can you give me a link to the article from Dr. Mercola's article? Im a male with a weight of 72 kg .. actually i really dont Know what to Do .. First i will wait until monday because then i got my labs checked again
Can you give me a link to the article from Dr. Mercola's article? Im a male with a weight of 72 kg .. actually i really dont Know what to Do .. First i will wait until monday because then i got my labs checked again
My free T4 labs are 10 - 20 pmol/L. I have had labs done when I was hyperthyroid from thyroxine medication building up in the blood and my free T4 was 25 pmol/L and my TSH < 0.05 mU/L. Within a day or two of stopping medication, I was severely hypothyroid again.
You cannot measure cellular thyroid resistance with any labs unfortunately.
But my cells do not like me at all~! lol I had a two month Hashitoxicosis flare up (really bad hyperthyroid symptoms due to Graves antibodies showing up) and some of my symptoms I had for decade/s vanished one month into my hyperthyroid flare up and then returned when the flare up was over.
And I had severe hypothyroid symptoms with TSH 6, free T4 13. Prior to any thyroid gland issues, my TSH 1.5, free T4 16 (if I recall correctly).
This is from Dr Mercola's article: How To Monitor Your Treatment With Natural Hormone Therapy...
"A small number of large, overweight, thyroid-resistant women may need 6-8 grains of Armour Thyroid or the equivalent of thyroxine per day (counting 0.1mg of T4 as 1 grain of Armour Thyroid)."
But my cells do not like me at all~! lol I had a two month Hashitoxicosis flare up (really bad hyperthyroid symptoms due to Graves antibodies showing up) and some of my symptoms I had for decade/s vanished one month into my hyperthyroid flare up and then returned when the flare up was over.
And I had severe hypothyroid symptoms with TSH 6, free T4 13. Prior to any thyroid gland issues, my TSH 1.5, free T4 16 (if I recall correctly).
This is from Dr Mercola's article: How To Monitor Your Treatment With Natural Hormone Therapy...
"A small number of large, overweight, thyroid-resistant women may need 6-8 grains of Armour Thyroid or the equivalent of thyroxine per day (counting 0.1mg of T4 as 1 grain of Armour Thyroid)."
Hi Red Star,
Thanks for your answer... How did you find out your resistance? Did you up your armour on your own? What are your labs when you feel good ?
Thanks for your answer... How did you find out your resistance? Did you up your armour on your own? What are your labs when you feel good ?
I have thyroid cellular resistance (I also have Hashimoto's for the past 5 years) for 25 + years causing hypothyroid symptoms. I cannot have my T4 levels down in the mid range area. I found that out the hard way trying out Armour! I convert T4 to T3 with no problems so I take synthetic T4.
To be free of hypothyroid symptoms I need to be hyperthyroid. However, my cellular issues has improved since reversing my insulin resistance. I've read the visceral fat (dangerous internal fat around the organs) releases pro inflammatory hormones, one of them being inflammatory cytokines. I'd be very happy if I'm free of hypothyroid symptoms when I get rid of all my visceral fat.
"In order for thyroid hormone circulating in blood to have a physiological effect, it must first activate receptors on cells. Inflammatory cytokines have been shown to suppress thyroid receptor site sensitivity."
To be free of hypothyroid symptoms I need to be hyperthyroid. However, my cellular issues has improved since reversing my insulin resistance. I've read the visceral fat (dangerous internal fat around the organs) releases pro inflammatory hormones, one of them being inflammatory cytokines. I'd be very happy if I'm free of hypothyroid symptoms when I get rid of all my visceral fat.
"In order for thyroid hormone circulating in blood to have a physiological effect, it must first activate receptors on cells. Inflammatory cytokines have been shown to suppress thyroid receptor site sensitivity."
mh strange ok one more try:
rT3 315,4 (380 till 613 "maybe, pay attention", greater than 614 --> rT3 issue)
rT3 315,4 (380 till 613 "maybe, pay attention", greater than 614 --> rT3 issue)
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