T3 Only??

[Franny2016]

Hi there! Its been a while... Update and question, please... I began using compounded T3-10mcg sustained 24hr release on April 3. It has made a difference.  I continued to use mcg Tirosint also. But then I travelled on April 20, and forgot my Tirosint!! So I used the T3-1x10mcg only for the 3 days I was gone, and felt fabulous!!  I came home and began taking Tirosint  again, and began to feel "off".  Since my Rt3 = 20 from March 13 labs, I decided to take a risk and STOP the T3, and see what happens. Well, it started out ok, but then I began to feel tired again.  So from yesterday, May 9, I began to take 2x10mcg T3 capsules.  I felt a little better. I've been using coffee to help w/energy.
My feet are staying a bit puffed. I suspect I am not getting enough thyroid hormone.  I see my Dr. next Friday.  Any thoughts??  I really appreciate it.
My symptoms - low grade tiredness, swelling in feet and ankles, shin pain when on threadmill.
My latest labs as of 4/15
Free T3 --  5.2 (2.0-4.4)
Free T4 --  1.5 (0.82-1.77)
TSH--0.33 (0.4 - 5.5)
Didn't test RT3
Vit D -- 29.4 (30-100)
Vit B12 -- 908 (200-1100)
Potassiun--3.6 (3.5-5.2)

I've been thinking that I could make it living only on T3...once I get the dosage correct.  Because if my RT3 is high, it means that my cells are not absorbing the T3 as it should anyhow, so why use it?

I appreciate your thoughts...

[Barb135]

There's a lot of controversy as to what a "thyroid friendly" diet is, so I wish you the best of luck with that...lol   I find that a generally healthy diet that limits breads, pasta, rice and processed foods and adds a lot of veggies, lean protein and healthy fats is the best.  I also make sure I get plenty of probiotic foods to make sure I have good gut microbiome... that seems to be a key, but maybe that's just me, too, I don't know.

Anyway, your chloride is too low and potassium and sodium are both on the low side, as well. Electrolyte imbalances are often caused by lack of fluid in the body, such as dehydration.

Your iron is relatively low, even though your ferritin is good.  You could try eating more iron rich foods.

Iodine is pretty useless if you've had TT...  

Your Free cortisol is lower than the reference range... What time of day was the sample collected?  Cortisol should actually be tested with a 24 hr saliva test, but most doctors don't do this and the test isn't covered by insurance.

Your CRP is definitely on the high side, which bears out the inflammation.  Diet can help with that, too; particularly, eliminating some of those fried foods, but you could try sauteing veggies in coconut oil, with some herbs and spices... tastes really yummy and the coconut oil can help with the inflammation, as can some herbs and spices - particularly fresh ginger or turmeric.

Are you supplementing zinc?  I've read that zinc is necessary for the production of thyroid hormones, but I'm not sure how it figures in when one has had TT.  It is necessary for other body functions, though.  You might talk to your doctor about supplementing.

You said you had an rT3 tested today... Did you also have Free T3 and Free T4?  I'll be interested to see those results when you get them back.

[Franny2016]

Hello Barb,
Thank you for your feedback!  You are so correct!  It is true that when I limit my carbs and processed foods, I do better overall.  I need to be consistent. I have probiotics, but again, need to be consistent.  Yeah, need to work on the iron also.
I did a blood test for cortisol and it was done early morning around 8:15am.  I am going to ask to do the 24hr saliva test…
You know, I have the veggies and the coconut oil at home– I just have to have the energy to make it.  I’ve also got fresh ginger and powered turmeric – unbelievable…will try to start working specifically on inflammation reduction tomorrow.
I have a zinc supplement – actually 2. The liquid tastes unpleasant, so recently I got the tabs. 50mg. I take this on and off.  Need to be consistent also.
I definitely have gut issues, and I read that zinc helps repair the gut.  I’m increasing my Vit D to help w gut issues also.
Yes indeed, I will have bloodwork back next week and will definitely share those with you.
Thank you again! :)

[Franny2016]

Hello Barb!  
Here are the results...
Reminder-I was using 2x10mcg compounded. Has stopped Tirosint 100mcg 11 days prior. I didn't use any T3 for 24 hrs before test.
5/11/17

Free T3 --  1.5** (2.0-4.4)
Free T4 --  0.5** (0.82-1.77)
TSH--16.97** (0.4 - 5.5)
RT3--7**

I'm actually glad that I did this because it provides a baseline of what it looks like without T4...considering I had a TT.
Well, I had to restart the Tirosint because I just didn't have the energy.  The bloating has me concerned.
I talk with my Dr. tomorrow.
What are your thoughts?
Thank you as always!

[Barb135]

I'm not sure you understand the concept of rT3... It's not the actual rT3 result that really matters; it's the FT3:rT3 ratio that's calculated using the results of Free T3 and rT3 that are analyzed from the same blood draw.

Free T4 is converted to, both, Free T3 and rT3 and not all rT3 is bad.  Our bodies need a balance of Free T4 and Free T3... not just one or the other.  High rT3 happens for several reasons, not because you aren't absorbing Free T3... it could be because you have inflammation in your body, high cortisol, inadequate iron, etc.

Because T4 is a slower acting hormone, with a long half life, it would take more than 3 days for the Tirosint to get out of your system.  You shouldn't have felt a lot of difference from not taking it the 3 days.  T3, on the other hand, is fast acting with a short half life, so it's in and out of your system within a few hours.

Your Free T3 is actually over range, indicating that you've taken too much and your Free T4 is at 72%, which is higher than the recommended mid range.  Both, along with symptoms, are indications that you are over medicated.

In addition, your vitamin D is too low.  Vitamin D should be, at least, 60, but I've read around 80 to be optimal. Are you supplementing to bring your level up?  Low vitamin D can cause some symptoms that can thyroid over or under medication.  

It also looks like your potassium is on the low side; what is your sodium level like?  Swelling/edema could be caused by an imbalance in electrolytes.

[Franny2016]

Hello Barb,

I appreciate your feedback!

I've added some more lab results below.  I take responsibility for my education on how this thyroid hormone works.  I had a TT, and am completely dependent on the hormones I take.
I am supplementing Vit D 5,000 4x weekly, but no changes seen in lab results. Maybe I need a more potent dosage.
I do have inflammation. I crave fried foods, which does not make it any better.  But i'm going to have to make a decision to go on a strict thyroid friendly diet - whatever that means. I just want my quality of life back.

Sodium – 139 (134-144)
Chloride – 95** (97-108)

The following were tested back in Jan 2017
Iron - 91 (40-190)
Ferritin – 97 (10-232)
Iodine – 58 (52-109)
CRP – 8.9 (1-3 is average; 3.1-10-higher)
Cortisol AM–13.2 (4-22)
Cortisol FREE-0.43 (.07-0.93)
DHEA Sulphate – 82 (19-231)
Zinc-7.4** (9-14)

I did more labs including rt3 today.  I see my holistic dr. next week.
I really appreciate your thoughts!

.