T Nation

My Thyroid Levels


#1

Background:

July 2010 Surgery gone wrong, bowel torn open, massive infection, surgery to clean up that mess, wound left open, three months to close. Starvation in hospital, IV nutrition denied, lost two pounds per day. I was a zombie for a long time, brain fog too. I am a prime candidate for adrenal fatigue.

October 2010, energy levels started to crash, felt dead, that was depressing.

Jan 2011, routine TRT LEF male panel. TSH is 1.60, was 0.98 Jun/2010. Later checked body temps, which were low. Checked the salt that wife purchases... listed natural iodine, but amount was insignificant. Took large amounts of iodoral and found that I felt better very fast. My low body temps were fixed.

July 2011, repeat male panel and added thyroid panel.

I was hoping that the added iodine would fix the TSH problem. The iodine improved my life greatly, but TSH is still in the same territory as before. The other thyroid numbers may have been a mess prior to the iodine replenishment.

This my first/only thyroid panel.

Thyroid results:

TSH 1.53 -male panel
TSH 1.57 -thyroid panel, same draw as above, same lab performed both tests

T4 5.1 [4.5 - 12] mid=8.25 way too low
fT3 3.4 [2.0 - 4.4] mid=3.3 looking good
fT4 1.15 [.82 - 1.77] mid=1.295 a bit low
rT3= 220 [90-350] do not know how to interpret, need ideas, this may have been worse.

cortisol 16.2 @ 11:41 AM, seems OK
AM 6.2-19.4
PM 2.3 - 11.9

Ferritin 112 [30-400] eating a lot of red meet, iron intake should be good.
RBC is mid scale
Hemoglobin 15.2 [12.5 - 17.0]
serum iron 77 [40 - 155]

TT, FT, E2 are great
PSA, CRP and homocysteine are really good
BP is good, never changed

Odd changes:

Doc wanted me to stop taking 10mg lovastatin, speculation re side effects. With that drug total cholesterol was down to 180. Now without it is 202. I don't have an expectation that this will be sustainable.

Serum glucose was 102-104 in the past. This time it was 87. That is a huge change.

So what do you guys think about the thyroid and rT3 situation?

Energy level quite good at time of these tests, initiating and getting a lot of work done.

Surgery to correct incisional hernia in August, looking forward to that!


#2

Isn't the target for glucose in the upper 90s? I'm not sure what being low means but that's what I've heard is optimal.

Assuming your FT3 and RT3 are the same units as mine (lab ranges are equal), your FT3:RT3 ratio is 14.7 (calculated at http://www.stopthethyroidmadness.com/rt3-ratio/ ). Optimal is supposedly over 20 (according to STTM and thyroid-rt3.com), but this doesn't really make sense to me as you'd have to be much higher in the FT3 lab range than the RT3 lab range to score that high.

That said, I wouldn't worry about RT3 levels if your energy is feeling great. That is the better barometer IMHO.


#3

This is where I started just recently if it helps at all.

TSH 2.79(.450-4.5)
Total T4 7.7 (4.5-12)
FT3 2.6 (1.2-4.9)
T3 uptake 34 (24-39)

I started with Nature Throid(generic for Armour)and it worked at first but all symptoms came back with vengance. So I started reading Stop the thyoid maddness and learned about RT3 and how it can reak havoc on your body by making what FT3 you have useless by clogging the receptors. So after again looking at my begining labs. I saw that my FT3 to RT3 ratio was in the toilet. Why I don't know because both Ferritin and cortisol check out good. I started on a T3 only medication by dosing according to STTM and my symptoms. It's been 30 days now and all symptoms have gone. In my last blood work Dr. did not run thyroid labs like I asked only my Test and E2. We found that fixing my thyroid is going to alow me drop my Test dose to almost half. I'm staying steady on the thyroid of 12.5mcg Every 4hrs per wake time and going to the new lower dose of T and will test everything in about 3-4 more weeks.
I hope some of this helps as I'm still learning myself but below are a few links to help get you started.
Purchance seems to know alot about the thyroid.
Good luck man.

Link to FT3-RT3 raio calc.
http://www.stopthethyroidmadness.com/rt3-ratio/

Info on RT3 and doising T3 only
http://www.stopthethyroidmadness.com/reverse-t3/


#4

SC and RR, I have not looked for what is optimal for glucose, but fasting glucose may not be what you had in mind. I am glad to see a reversal of a trend for increasing glucose numbers.

The STTM site seems to be math impaired, or they cannot manage technical writing. As my fT3 is good, rT3 needs to be lowered. As I am not been treated for hypothyroidism, my only recourse is to assume that I have increased rT3 from adrenal fatigue and need to follow recommendations for that. I have Wilson's book, read that a long time ago for general education. As I seem to be improving, perhaps rT3 will resolve in time. The surgery next month will set me back, but I have a good mental attitude going into that.


#5

I'm curious, what about STTM is disagreeing with what you say? STTM says your FT3:RT3 ratio is suboptimal, which is what you just said as well.

Yes adrenal fatigue can cause increased RT3, so you're probably right.


#6

I think hes talking about how their units don't match the ratios...like if you use the calculator they have with the given units, and then do the actual math on a piece of paper, they are off by a factor of like 100...the "20" that they recommend is really something like 2000. It is sort of silly...I guess that's what you get when a bunch of women sit around trying to do math...


#7

This doesn't make a lot of sense with his excellent serum cortisol result...

KS: If you suspect adrenals (which I dont) you should rule them out with the 4x saliva cortisol test, which you can now get from Quest and Labcorp.

I think your adrenals look fine.

I disagree with your assessment of ft3 levels--above midpoint is a good start, but the recommendations on STTM are to shoot for the upper quartile of the range...the higher the better....I tend to agree

It looks like your pituitary would agree since it is pumping out more TSH in an attempt to coax thyroid into more hormone output...

On a related note, since T3 is a Tyrosine based hormone, would it make sense to consider tyrosine supplementation? I know personally all my amino acids are low, so that may be something to consider...

What are you going to do about your rising CHOL?


#8

Good point - I wondered about that too, but both on STTM and thyroid-rt3 they say "don't worry about the units just move the decimal so it's on the right order of magnitude"... so the 20:1 thing isn't necessarily the same units.

I think it's fucking retarded and makes it way harder to do the math. They treat you like you're retards and just say "you know it shouldn't be 1:1 or 100:1 so just move the decimal place till it's close to 20". I haven't been able to find the actual ratio you need when you make the units consistent. I'm a math major so this method really pisses me off.


#9

It drove me nuts trying to figure it out when I first read about it. Most people probably don't even notice. I can't remember the actual ratio, but it wouldn't be too difficult to figure out.

Edit: Its a factor of 10^3. So your ideal ratio should be 20,000:1 and not 20:1. Happy math.


#10

I am happy with total cholesterol =200, so will do nothing for now.

I will check out Tyrosine, good idea. http://en.wikipedia.org/wiki/Tyrosine


#11

KS, are you having higher elevated cholesterol issues with no cause of what could be causing it? I am just asking since I am in a similar situation everything is in check but cholesterol is just elevated no matter what I do. VT suggested I try and eliminate milk from diet and see what happens. If that does not work I am also worried that the only solution is going to be medication. What are you thoughts on the medication you have been taking?


#12

^^^iroczinoz: your problems appear to go deeper than just cholesterol, if I remember correctly...Im not sure if milk would have much bearing on CHOL directly, but could through proxy


#13

Yeah I understand your logic on the milk and cholesterol. I have been drinking a lot of milk since I can remember. Can't hurt to eliminate it and see if it makes any changes.


#14

My cholesterol was 277 two years ago, 10mg lovastatin took that to 180 which is excellent. Now without the statin I have 200 and I am very happy with that. I don't think that I have a cholesterol problem, but I am fully prepared to see things differently with the next lab work in 6 months.


#15

Total cholesterol is meaningless (as is the LDL number), and all cholesterol lowering drugs have significant negative side effects; what matters is LDL particle size. If your HDL is high (eat animal fat) and trigs are low (cut way down on grains and sugar) then your LDL particles will be big and fluffy, and you're golden.

The statin almost certainly fucked up your body's production of co-enzyme Q10, so a Q10 supp is advised (like cholesterol, Q10 is needed by every cell in your body).