@burnedout2010 2785 wrote:

Most of the Armour-friendly thyroid docs warn against treating those of us with elevated RT3 with T4 alone. I had pretty good results with a custom-compounded sustained-release T3 [liothyronine] (baseline TSH was always 2.5+ for most of my life; dropped to under 2.0 on SRT3 for the first time ever). Unfortunately, my scrip ran out, and the doc treating me at the time closed up shop.

However, I still have elevated TSH, e2, RT3, and a nodule showed up on an ultrascan, the first one I ever had done. I understand and know all too well how unreliable TSH is. Nonetheless, there is a consistency of elevated TSH levels.

Dr. M. – I see that in some cases you treat with T4, sometime alone, and sometimes in combination with other thyroid meds. I realize how opposed most of the alternative docs are to using T4 [levo] alone and understand from your posts that once you treat the non-thyroid illness, you have had success with T4-alone protocols. Of course, that would be anecdotal observation, and I would like to understand more on this aspect.

What has been a successful protocol for treatment of an elevated RT3 issue?

Also, how would you treat a nodule (benign; less than 1cm) and do you see that as a result of hypothyroidism to begin with?

Another odd issue – I am dumping excessive amounts of iodine in my urine from normal supplementation (150mcg BID) @ over 21,000 ug/24hr (ref range 75-500).

Thyroid nodules need to be assessed by an endocrinologist.

I have had to use T4 alone in treatment for many patients because T3 or Dessicated Thyroid is simply not available to them.

Treatment using T4 alone in the presence of elevated Reverse T3 usually means addressing the actual cause of elevated Reverse T3. The protocol is to treat the actual cause of elevated Reverse T3.

Some causes of elevated reverse T3 include:
* Nutritional deficiencies, malnutrition
* Diabetes and other systemic illnesses
* Conditions which activate the immune system including infections, autoimmune disease, mental illness, etc.
* Stress, including trauma, surgery, etc.
* Etc.

Adding T3 to treatment may not address the problem that caused the elevation in Reverse T3, though it may help reduce Reverse T3. However, the treatment with T3 would still be incomplete since the underlying problem remains.