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New Labs...need help adjusting meds

I got some lab results back at the beginning of the month, and adjusted
my meds and will repeat in about 6 weeks. I wondered if someone could
see if they agree with my changes. I did have RT3 dominance at one
point on meds and did the Cytomel clearance and then gradually went back
to Armour because I think I need some T4.

Lab RESULTS 12/3/12 while taking 2 Grains of Armour plus 5 mcg of

TSH 0.011 (0.450-4.500)

T4, Free 1.22 (.82-1.77)

Reverse T3, Serum 24.5 ng/dL (9.2-24.1)

Vitamin D 45.8

Ferritin, Serum 107

T3, Free 4.1 pg/mL (2.0-4.4)

T3 142 ng/dL (71-180)

I didn't get another B12 ran because it has always been fine.

I have been gluten free for 3 months now, and was able to stop Iron last
month with Ferritin stabilizing, and I started taking 10,000 IU's of D3
for the last 2 weeks and am going to go back down to 5,000 IU's daily
trying to bump that D3 up to at least 80. Using the RT3 ratio and these
lab results, I'm only at 16.7 I was also experiencing acne on my
forehead, back and neck. I was still feeling cold and hair still
falling out during these labs.
Once I got these labs and figured out the RT3 ratio I decided to drop
down to 1 Grain of Armour and 10 mcg of Cytomel which I know is leaving
me 4 mcg shy of the T3 I was currently taking, but I do not want to go
through that whole RT3 dominance thing again! When I went just strictly
T3 while eliminating the RT3 dominance I had a lot of hair loss! I've
read the research that T4 actually helps with hair growth and hair loss.
I don't want to eliminate the T4, but how is the best way to keep
adequate T4 and T3 without risking RT3 dominance? Currently my symptoms
are some bone aching (particularly in my wrists and arms), feeling cold
and hair loss. The acne is not as bad as it was at my previous dosages
when lab was taken.

Do you think I'm going in the right direction by backing down to 1 Grain
of Armour and using 10 mcg of T3 and retest my labs or should I go ahead
and increase to 15 mcg of T3 (which would be pretty close to the amount
of T3 I was on initially) with the 1 Grain of Armour and see if that
lowers that RT3 a little?

I appreciate any help on this. I'm going to start taking Saw Palmetto
also just to see if that helps in the hair department. I can saw that
the diameter of my hair looks better then I can remember it ever
looking. I just wish the shedding would stop and I could notice some
regrowth. I was having regrowth at one point just prior to falling into
the RT3 dominance which I think was caused by my low Ferritin at the
time. I'm thinking I was at 2.5 to 3 Grains of Armour at that time, but
was having some elevated pulse.
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Avatar universal
What does your Dr. think?

Sounds like you are self medicating.  That is not generally a good idea.

Have you thought about not using Armour and using both synthetic T4 as well as Synthetic T3 (Cytomel)?  I have nothing against Armour, but going all synthetic offers some more options as far as dosing goes sine you can adjust each T4 and T3 independently.

Also keep in mind that symptoms tend to lag blood labs by a few weeks.

i don't know how fast you are making these changes. But quick changes are usually never a good thing in terms of thyroid dosage and symptoms.  The slow steady approach is almost always a better way to go.

Your FT4 is at 42% which really isn't too bad.  Your FT3 is at 87.5% of the range so I'm not sure you really want to raise that up much.

The only way RT3 is produced is from converting T4. So the only way to limit that production is either to minimize the amount of T4 available so that it isn't there to be converted, or to alter the conversion process so that it doesn't produce RT3.

One way to help alter the RT3 production is a reduction of stress.  It seems stress is a big factor in the production of RT3. So it that is possible that may be one way.

Another thing to consider and I can hardly believe I'm saying it, is that you may be OVER medicated and generally need to lower your dosage.  The conversion to RT3 is one way the body protects itself from going hyper.  It is possible that your body is sensing the high levels of FT3 available and rather than making more T3 it switches to produce RT3 to try to prevent going Hyper.  Pretty ingenious of the body to have this sort of protection.  But obviously it can get fouled up too.

I'm just mentioning over medicated as a possibility.

First I've heard of low Ferritin as causing hairloss.  maybe I'm just unaware.
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Avatar universal
Thanks for your response.

Just FYI, I do have a doctor that is great about listening to how I feel and my symptoms related to my meds.

I think I'm going to stay where I am and see how it works out in 6 weeks.

Yes, a Ferritin lower than 40 can cause hair loss and hypothyroid should shoot for 80 which is what I have been told by several doctors.
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