Travis’s Log and Questions

[SpiritsMaterial]

Hello everyone, I’ve been dealing with adreansl and thyroid for about two years now, have been on a few message boards and am looking for different opinions. these labs were taken on 30mg cortef and 2gr erfa. I have been told I have an rt3 problem, I have treid cytomel-only therapy and didnt really like having my heart jump out of my chest. I’m exploring adding t3 to my erfa or adding t4 to my erfa (which is something new i’ve seen on this board).

Dhea has been low for me even before cortef, how do I raise? and i think some arimidex is in order.

CBC w/Diff

WBC 7.4 (4-10)

RBC 5.54 (4.45-5.86)

HGB 16.6 (13.6-17.5)

HCT 46.9 (42-52.1)

MCV 84.7 (81-99)

MCH 30.0 (27-34)

MCHC 35.4 (31-36)

RDW 12.1 (11-15)

PLT 266 (130-400)

MPV 11.1 (8-12)

NEUTROPHIL # 3.79 (1.6-6.7)

LYMPHOCYTE # 2.4 (.7-2.7)

MONOCYTE # .88 (.2-1.0)

EOSINOPHIL # .3 (0-0.5)

BSOPHIL # 0 (0-0.2)

NEUTROPHIL % 51.2 (43-78.5)

LYMPHOCYTE % 32.5 (9.9-42.2)

MONOCYTE % 11.9 (5.1-13.1)

EOSINOPHIL % 4.1 (0-6.5)

BSOPHIL % 0.3 (0-2.0)

Glucose 93 (70-99)

BUN 14 (7-22)

Creatinine .8 (.5-1.3)

est Creatinine 184

Bun/Creat 17.5 (8-27)

Sodium 142 (136-147)

K+ Serum 4.4 (3.6-5.3)

Chloride 108 (98-110)

Co2 Content 25 (22-34)

Anion Gap 9 (2-12)

Calc Osmol 283 (269-297)

Calcium 10.2 (8.7-10.7)

T Bili 0.7 (0.1-1.2)

Alk Phos 89 (30-128)

SGPT (ALT) 79 HIGH (5-47)

SGOT (AST) 26 (5-40)

Total Protein 7.1 (6.0-8.4)

Albumin 3.9 (3.3-5.1)

Globulin 3.2 (1.8-4.2)

A/G Ratio 1.2 (1.0-2.5)

T4 6.9 (4.5-12.0)

TSH <0.010 (.35-4.94)

Total T3 1.5 (0.6-1.6)

Free T3 4.2 HIGH (1.71-3.71)

Reverse t3 39 HIGH (11-32)

Ferritin 165 (20-345)

Prolactin 15 (3-19)

PTH Intact 35.2 (8.5-72.5)

Homocysteine 7.5 (6.3-15.0)

DHEA-s 157 (110-510)

Estradiol 53

SHBG 43 (7-49)

Total TEST 666 (241-827)

Vit D hydrox 59

i will soon be working with HAN

[SpiritsMaterial]

My big question is this…

How can I have HIGH RT3 AND HIGH FT3 on erfa, yet feel hypo? I know rt3 blocks receptors, but am i pooling from low corisol? even on 30mg cortef?

[leanguy]

@SpiritsMaterial 2636 wrote:

How can I have HIGH RT3 AND HIGH FT3 on erfa, yet feel hypo? I know rt3 blocks receptors, but am i pooling from low corisol? even on 30mg cortef?

It’s pretty common. The FT3 isn’t able to do its job because of your elevated RT3. It seems the only solution to reduce RT3 is to reduce T4 intake. I’d like to see Dr M’s opinion for cases like this. I know he doesn’t make a big deal about RT3 but a lot of people complain about feeling hypo even though their FT3 is good.

[SpiritsMaterial]

@leanguy 2643 wrote:

It’s pretty common. The FT3 isn’t able to do its job because of your elevated RT3. It seems the only solution to reduce RT3 is to reduce T4 intake. I’d like to see Dr M’s opinion for cases like this. I know he doesn’t make a big deal about RT3 but a lot of people complain about feeling hypo even though their FT3 is good.

Hey Leanguy,

We just spoke via PM on another forum today. About adding t4.

I am at a crux in my treatment and am looking at Dr. M’s suggestions, along wtih the STTM ladies, and Dr. J’s forum and am getting my head spun around.

I have low total t4 yet, high ft3 and rt3…how does one raise total t4 while brining rt3 down? A paradox it seems.

[leanguy]

@SpiritsMaterial 2645 wrote:

I have low total t4 yet, high ft3 and rt3…how does one raise total t4 while brining rt3 down? A paradox it seems.

You’re confusing me with the different names 🙂

I don’t think its possible to artificially raise t4 and bring down rt3. Everyone seems to use temporary T3-only therapy and then reintroduce t4. Again, I wish Dr M would chime in here.

[SpiritsMaterial]

@leanguy 2646 wrote:

You’re confusing me with the different names 🙂

I don’t think its possible to artificially raise t4 and bring down rt3. Everyone seems to use temporary T3-only therapy and then reintroduce t4. Again, I wish Dr M would chime in here.

As do I, b/c i wonder if my high rt3 has been causing me all my problems with erfa and cytomel, or my sub normal ttotal t4

[MetalMX]

I personally do not think RT3 itself is an issue for many although in some people it can arise for unknown reasons.

The low t4 and high free t3 would make sense if you had adrenal issues/low cortisol where a rapid conversion of T4 to T3 would be taking place and you would be getting more RT3. But you are on 30mg of Cortef.

Also remember HIGH cortisol can cause excess RT3 no doubt so have your cortisol levels checked now once you are on 30mg of Cortef it could be possible you need to lower your dosage.

Other than this all i can think of is to try some Lugol’s Iodine solution a lack of iodine could be causing RT3.

Their are also certain people who have mutations in the sodium/iodide symporter (NIS) gene which influences Iodine transport and can keep a person hypothyroid. The treatment for this is high doses of the coenzyme form of Vitamin B2 to support iodine transport as well as adequate iodine intake.

[SpiritsMaterial]

@MetalMX 2651 wrote:

I personally do not think RT3 itself is an issue for many although in some people it can arise for unknown reasons.

The low t4 and high free t3 would make sense if you had adrenal issues/low cortisol where a rapid conversion of T4 to T3 would be taking place and you would be getting more RT3. But you are on 30mg of Cortef.

Also remember HIGH cortisol can cause excess RT3 no doubt so have your cortisol levels checked now once you are on 30mg of Cortef it could be possible you need to lower your dosage.

Other than this all i can think of is to try some Lugol’s Iodine solution a lack of iodine could be causing RT3.

Their are also certain people who have mutations in the sodium/iodide symporter (NIS) gene which influences Iodine transport and can keep a person hypothyroid. The treatment for this is high doses of the coenzyme form of Vitamin B2 to support iodine transport as well as adequate iodine intake.

Metal,
I have had my AM serum cortisol checked at 8am not taking my first dose of Cortef, and it has only been 12.4….still very low it seems. This leads me to suspect a low cortisol issue still. I am hesitant to take iodine again b/c I have some (albeit a very small number of) Hashi’s ABS. I am looking for answers, thank you for your help.

[Author]

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