# Should I get back on thyroid meds? Possible adrenal / reverse T3 issues



## RH789 (Jul 30, 2012)

Hello, everyone. I am new to this website. I apologize for the length of this post. I am just trying to give everyone all the information I have and you can read (or not read!) any or all of it. Thanks! I am terrified I will not get my life back. :confused0068:

I had a subacute (silent) thyroiditis. It follows a clinical course of hyper, normal, hypo, and then supposedly 80% recover to "normal" after 12-18 months.

I was diagnosed two years ago on August 1, 2010. I am still fairly debilitated by this - I sit on the couch unless I have a pressing responsibility. This is not normal for me, as I am someone who loves to take walks. I have a challenge doing anything remotely cardiovascular now, I simply have no stamina.

In February 2012, I reached my 18 month mark from my diagnosis and I was not feeling up to par, so I was started on 50 mcg Synthroid. Within two months, I gained 25 lbs. That worried me and made me think it was not a good idea for me to get on it. I was on the Synthroid for a total of four months. I was retaining a lot of water and I felt like I blew up like a whale. Well, a naturopath I saw convinced me to go off the Synthroid because of my elevated Reverse T3 and because it didn't seem like my body "liked" it. Here are my labs BEFORE I got on Synthroid, and then my labs at the six week check up after I had been on 50 mcg Synthroid.

Lab Tests on NO THYROID HORMONE:

TSH 2.79 (Range: 0.40 - 4.50 mIU/L)
Free T4 1.0 (Range: 0.8 - 1.8 ng/dL) (20 percent of range)
Free T3 2.8 (Range: 2.3 - 4.2 pg/mL) (26.3 percent of range)
Reverse T3 20 (11-32 ng/dL)
Thyroid Antibodies (ATA, TPO) NONE
RT3 ratio: 14

*****PUT ON 50 MCG of SYNTHROID*****

Lab Tests AFTER SIX WEEKS ON 50 SYNTHROID

TSH 2.77 (Range: 0.40 - 4.50)
Free T4 1.2 (Range: 0.8 - 1.8) (40 percent of range)
Free T3 3.5 (Range: 2.3 - 4.2) (63.2 percent of range)
Reverse T3 27 (11-32)
RT3 ratio: 13

I am now off Synthroid. I have been off it for five weeks and have lost almost 20 lbs.

I do not know what to do. Do I need to be on thyroid hormone? I do not know. Before I had any thyroid problems, years ago, I had my thyroid labs tested along with a bunch of other bloodwork. They are very similar to how I am when I am not on thyroid hormone. So, then I think to myself, well those lab values worked for me then, why do they not work for me now? Maybe I have another problem? Maybe I have an adrenal fatigue issue?

Here are those labs from years past, when I was feeling fine and before my thyroiditis:

07/2006
TSH 2.09 (Range: 0.40 - 5.50)

02/2009
TSH 2.85 (Range: 0.40 - 4.50)
Free T4 1.0 (Range: 0.8 - 1.8)

Then, I had my sister get her thyroid labs tested within the past month to see what hers are. I had this done because some people on the internet claim that people who have good thyroids have a TSH close to 1. My sister and I are similar in age and she is perfectly healthy, weighs about 115 lbs, runs everyday, and says she feels fine.

My sister's thyroid labs:

TSH 3.12 (Range: 0.45 - 4.5)
Free T4 1.06 (Range: 0.82 - 1.77) (25.2 percent of range)
Free T3 2.5 (2.0 - 4.4) (20.83 percent of range)

Well, hers are not all that great as you can see.

My main question is:

(QUESTION #1) what should I do? I have been to over 15 doctors at this point, all with various opinions. My endo said that if I were to get pregnant (not in the near future), he would want my TSH down to 2 so he would want me to get back on Synthroid.

I do not know why I gained so much weight on the 50 Synthroid. I do not know if I would lose all that weight I gained on it. I do not know if Reverse T3 matters or doesn't. Some people on the internet claim that Reverse T3 does not matter, as long as you get the Free T3 up to a certain point. Well, I would like to believe that but I also was miserable on Synthroid as we do not feel well when our levels are shifting plus I gained 25 lbs on it. So, with all due respect, I am skeptical about raising my Synthroid and possibly enduring several months of misery and weight gain all to find out that the specific theory about Reverse T3 is incorrect somehow.

(QUESTION #2) I wonder, if there is any information that can back up the theory that Reverse T3 does not matter as long as the Free T3 has been increased sufficiently?

Also, I will include the majority of all my labwork over the past two years. Something I have ALWAYS wondered, is:

(QUESTION #3) why, when I was switching over from hyper to hypo I was able to walk up to four hours a day and I had a lot of energy? Those dates when I was able to walk up to 4 hours a day were: late January, February, and March of 2011.

Thank you, everyone!!

My stats are (Range: TSH 0.40 - 4.50 // Free T4 0.8 - 1.8 )

08/01/10 TSH 0.03

08/09/10 TSH 0.01

09/23/10 TSH 0.41

10/28/10 TSH 1.36 -- T4 0.96

12/6/10 TSH 3.80 -- T4 0.92

12/28/10 TSH 0.99

02/11/11 TSH 2.45 -- Free T4 1.1
*****PUT ON 25 MCG of SYNTHROID*****

03/28/11 TSH 4.18 -- Free T4 0.9
*****PUT ON 50 MCG of SYNTHROID*****

04/28/11 TSH 0.6 -- Free T4 1.1

06/06/11 TSH 1.23 -- Free T4 1.2

06/14/11 *****PUT ON 25 MCG of SYNTHROID, 5 of CYTOMEL*****

07/07/11 TSH 2.91 -- Free T4 0.9

T3 Uptake 34 (Range 22-35 Percent)

Free T3 2.9 (Range 2.3-4.2 pg/mL)

Ferritin 51 (Range 10-154 ng/mL) <-------- FERRITIN

07/14/11 *****PUT ON 50 MCG of SYNTHROID, 10 of CYTOMEL*****

08/04/11 TSH 0.36 -- Free T4 0.9

08/12/11 *****PUT ON 50 MCG of SYNTHROID, 15 of CYTOMEL*****

08/22/11 TSH 0.07 -- Free T4 1.1 -- Free T3 3.3

08/26/11 *****Discontinued Thyroid Medication*****

10/06/11 TSH 2.97 -- Free T4 1.0

10/28/11 TSH 1.71

12/22/11 TSH 2.25 (Range: 0.40 - 4.50)

Free T4 1.0 (Range: 0.8 - 1.8)

Free T3 3.1 (Range: 2.3 - 4.2)

Thyroid Antibodies (ATA, TPO) NONE


----------



## CA-Lynn (Apr 29, 2010)

Hang tight for Andros and the others to come online on Wednesday.

I will say that most of us feel a lot better when the TSH is pretty darned low. Here's my TSH for the last several tests....when I've felt the best I've felt in a while:

0.045	0.032	0.026	0.122	0.025	0.077	0.233

Normal range: .4 - 5.5

I feel like crap at 1.7

So yes, I think you need thyroid medication.

Others will chime in soon.


----------



## CA-Lynn (Apr 29, 2010)

Duplicate post deleted.


----------



## RH789 (Jul 30, 2012)

Thanks so much, CA-Lynn! May I ask, do you have Hashi's, antibodies, or family history?

I have none of the above. I just don't know what to do. My labs are almost exactly how they were BEFORE the thyroiditis, so why are they not working for me now?

I blew up 25 lbs with the 50 Synthroid. I am worried about gaining MORE weight, especially since I cannot exercise.

And, again, the biggest question mark is how come I was able to walk during those couple of months before I was transitioning hypo?

Should I just ignore RT3? ugh! Don't know what to do!

Thanks, AGAIN!!


----------



## Andros (Aug 26, 2009)

RH789 said:


> Hello, everyone. I am new to this website. I apologize for the length of this post. I am just trying to give everyone all the information I have and you can read (or not read!) any or all of it. Thanks! I am terrified I will not get my life back. :confused0068:
> 
> I had a subacute (silent) thyroiditis. It follows a clinical course of hyper, normal, hypo, and then supposedly 80% recover to "normal" after 12-18 months.
> 
> ...


There are other antibodies that could be attacking the receptor sites and causing the numbers to be a little out of kilter.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

You were on a very low dose of Synthroid. The doc should have had you coming in every 6 to 8 weeks for labs and further titration until you felt well.

Your rT3 is very low and we all have some rT3.

You may wish to read this:

rT3
http://thyroid-rt3.com/whatis.htm

If I were you, I would insist on an ultra-sound of the thyroid. You need to know if there are any notable irregularities.

And I agree; I don't think your sis has good numbers. Thyroid Disease is insidious and the patient often will just grow right into it in the early stages.


----------



## lainey (Aug 26, 2010)

Everyone has some rT3. It is a product of T3 synthesis. Yours is not high.

I see that your free T4 and T3, which are supposed to be the best indicator of thyroid status, changed very little during your med changes and hold steady off medication and are similar to before your bout with thyroiditis. If your TSH values are similar to what they were when you were feeling well, I feel that likely something else is the problem.

Plenty of people feel fine with a TSH such as yours and your sisters, it is not so "high" as to indicate problems. Remember, on the internet you are seeing posts from a limited population of people. Keep in mind that the ranges for these are developed by taking samples from thousands, and "normal" for thyroid numbers extends like a tail on the curve upwards quite a ways. My own numbers tend to hover in the same area as yours and I am active and normal weight, no worries.

There are other brands of thyroid replacement besides Synthroid--Levoxyl, Unithroid and Tirosint are a few available here in the US. While Synthroid did not have a positive impact, another brand might. Likewise, you're not hurting anything going without it, your numbers didn't change much on it and it didn't make you feel better so....


----------

