# RT3/FT3 Ratio?



## Zugora (Feb 14, 2010)

A moderator on another board mentioned to me that my RT3/FT3 ratio was 14.6 (too low and should be 20 or higher) and suggested that because of this, I might do well with a T3 only med, such as Cytomel. ??

RT3: 175 (range: 90-350)
FT3: 2.6 (range: 2.0-4.4)

Does anyone know anything about this??

Thanks for your help.


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## Andros (Aug 26, 2009)

Zugora said:


> A moderator on another board mentioned to me that my RT3/FT3 ratio was 14.6 (too low and should be 20 or higher) and suggested that because of this, I might do well with a T3 only med, such as Cytomel. ??
> 
> RT3: 175 (range: 90-350)
> FT3: 2.6 (range: 2.0-4.4)
> ...


Reverse T3 (RT3 or REVT3) is a biologically inactive form of T3. Normally, when T4 is converted to T3 in the body, a certain percentage of the T3 is in the form of RT3. When the body is under stress, such as during a serious illness, thyroid hormone levels may be outside of normal ranges even though there is no thyroid disease present. RT3 may be elevated in non-thyroidal conditions, particularly the stress of illness. It is generally recommended that thyroid testing be avoided in hospitalized patients or deferred until after a person has recovered from an acute illness. Use of the RT3 test remains controversial and it is not widely requested.
http://labtestsonline.org/understanding/analytes/t3/tab/faq

While not the expert here, I am given to understand that we all have some rT3 and I don't think yours is high enough to be of any concern.

However, if you have the time, peruse this site and see what conclusion you come to.

http://www.thyroid-rt3.com/

However......................your FT3 is in the basement. What thryoxine are you taking and how much?

Also, Dr. Lam has info on his site.


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## Zugora (Feb 14, 2010)

Andros said:


> However......................your FT3 is in the basement. What thryoxine are you taking and how much?


I am currently at 3/4 grain of Armour and holding (have been there for 4.5 weeks). The labs listed in my signature are prior to starting Armour.

I am not feeing any better since starting Armour. Since starting, I have periods of hyper/hypo-type sxs, more heart-racing-type feelings (even though tested heart rate is fine), adrenaline rushes and then crushing fatigue. Doc suggests adrenal issues and says my cortisol is not where it should be. His protocol is for me to start a low physiologic dose of hydrocortisone (Cortef) - no more than 20 mg/day, spread out throughout the day. He tells me this is a safe dosage of HC. He says that I need to have proper cortisol levels in order for the thyroid meds to reach the cells, otherwise it is just pooling in the blood. Once optimal thyroid levels are reached and are stabilized, the HC would be slowly tapered down.

Not sure what will work or what exactly is going on. All I know is that I feel like crap and have been feeling that way for years. So frustrated and very scared. Thanks for your feedback.


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## Andros (Aug 26, 2009)

Zugora said:


> I am currently at 3/4 grain of Armour and holding (have been there for 4.5 weeks). The labs listed in my signature are prior to starting Armour.
> 
> I am not feeing any better since starting Armour. Since starting, I have periods of hyper/hypo-type sxs, more heart-racing-type feelings (even though tested heart rate is fine), adrenaline rushes and then crushing fatigue. Doc suggests adrenal issues and says my cortisol is not where it should be. His protocol is for me to start a low physiologic dose of hydrocortisone (Cortef) - no more than 20 mg/day, spread out throughout the day. He tells me this is a safe dosage of HC. He says that I need to have proper cortisol levels in order for the thyroid meds to reach the cells, otherwise it is just pooling in the blood. Once optimal thyroid levels are reached and are stabilized, the HC would be slowly tapered down.
> 
> Not sure what will work or what exactly is going on. All I know is that I feel like crap and have been feeling that way for years. So frustrated and very scared. Thanks for your feedback.


Have you started the Cortef yet? I have an opinion for what it's worth. You are still on a low dose of Armour as you well know for we have been discussing this.

It is my feeling that as the Armour is slowly titrated and you get closer and closer to the euthryoid state, the adrenal situation will resolve it's self in due time.

I hate that you are so frightened. And I know you know that I care very much about what is happening to you. If only I had a "magic wand!"


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## Zugora (Feb 14, 2010)

Andros said:


> Have you started the Cortef yet? I have an opinion for what it's worth. You are still on a low dose of Armour as you well know for we have been discussing this.
> 
> It is my feeling that as the Armour is slowly titrated and you get closer and closer to the euthryoid state, the adrenal situation will resolve it's self in due time.
> 
> I hate that you are so frightened. And I know you know that I care very much about what is happening to you. If only I had a "magic wand!"


Thank you so much, Andros. Your support is so appreciated. I haven't started the Cortef yet. I have the prescription filled, but I wanted to do some more research on it before taking it. I've heard conflicting issues about the adrenal issues: some say the adrenal and thyroid issues will work themselves out as you titrate; others say thyroid meds won't work and you won't handle titration if cortisol production is depleted.

Not sure what to do.


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## Andros (Aug 26, 2009)

Zugora said:


> Thank you so much, Andros. Your support is so appreciated. I haven't started the Cortef yet. I have the prescription filled, but I wanted to do some more research on it before taking it. I've heard conflicting issues about the adrenal issues: some say the adrenal and thyroid issues will work themselves out as you titrate; others say thyroid meds won't work and you won't handle titration if cortisol production is depleted.
> 
> Not sure what to do.


There are two tenets that I am very fond of, "At first do no harm" and "Less is always better!"


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