# High rT3, declining TSH, normal FT3, high FT4, low vit D 25?



## Changexpert (Feb 10, 2015)

Hello,

I am a 26 yr old male. My story is really long and complicated, but I will try to be concise. I have been suffering from hair loss after severe weight loss (+100 pounds) over 10 months. This happened 8 years ago. I have maintained healthy weight since then, but I do gain/lose weight very easily. Hair loss problem worsened when I got two big surgeries in year 2013 and 2014 respectively. Both surgeries required general anesthesia and a lot of antibiotics afterward. Also, I was on rounds of antibiotics for acne previously, which seemed to damage my gut health. As a result, I seem to have leaky gut, causing bacteria to proliferate. Recently, I was diagnosed with mild infection of H. Pylori as well. Currently, I am suffering from dysphagia, occasional heartburn, constipation, hemorrhoids, constant fatigue, shallow sleep at night, and worsened hair loss.

I have been trying to figure out what the heck is going on with my body since September of last year. I finally decided to get blood test at the end of November, and the results are shown below.

TSH November - 1.86 (reference: 0.45 - 4.5 uIU/mL)

TSH December - 1.23 uIU/mL, after 26 days

Free T3 - 3.0 (2.0-4.4 pg/mL)

Free T4 - 1.91, high (0.82 - 1.77 ng/dL)

rT3 - 30.8, high (9.2 - 24.1 ng/dL)

FT3/RT3 ratio < 10 (> 20 needed)

Thyroglobulin Antibody - 0.9 (0.0 - 0.9 IU/mL)

TPO Ab - 14 (0 - 34 IU/mL)

Vitamin D - 22.8 (30 - 100 ng/dL)

WBC November - 3.0, low (3.4 - 10.8 xE3/uL)

WBC January - 4.8, greatly improved, but still low

Neutrophil November - 0.9, very low (1.4 - 7.0 xE3/uL)

Neutrophil January - 2.5, greatly improved, still low

Neutrophil, Lymphs, Monocytes, Eos, Basos % November

29%, 58%, 9%, 3%, 1% (not normal as Neutrophil needs to be way higher)

Neutrophil, Lymphs, Monocytes, Eos, Basos % January

53%, 37%, 7%, 2%, 1%

Test confirmed that I do not have Hashimoto's disease, but I am not sure if I do have Graves. However, I highly doubt that I have Graves disease as my thyroglobulin antibody level was within reference range.

My TSH level is declining rapidly, and I am not sure why. Low/declining TSH along with high FT4 and high rT3 makes me suspect that I have hyperthyroidism. I think my body have gone into "defense mode" to accommodate physical stress from two big surgeries and damages in the digestive system. My physician says I am fine, but I feel lethargic all the time. I can't think or focus and definitely need remedy for whatever condition I have.

I strongly do not want to go on prescription meds because my body may not be strong enough to take it currently. It looks like my immune system is becoming functional again as seen with increased neutrophil and WBC count. However, I am shedding excessive hair currently, at least 1.5 times more compared to the past, which worries me significantly. Shedding is occurring everywhere, from back to front, including sides.

Could you please tell me what condition I have currently and how to treat it naturally? I am willing to take supplements that are proven to work, just not prescription meds. I would sincerely appreciate any insights... Thanks in advance.

PS: One other thing to note is that I have difficult time with urination. I can hold off the urge, but it takes me long time to get the last few drips out in the restroom. Appearance is always murky, never clear, along with full of foams. No burning, itching, or bleeding in the urination. Also, the smell is horrible :[ I am suspecting urinary tract infection, but my doctors have not mentioned anything about this matter. I realize this may have been too much information, and if it offended anybody, I apologize sincerely.


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## Lovlkn (Dec 20, 2009)

You are low in D - a symptom of this is fatigue. Has your doctor started you on a prescription to get your levels up?50K IU weekly for 12 weeks is the customary protocol.



> Thyroglobulin Antibody - 0.9 (0.0 - 0.9 IU/mL)


I for one would be concerned about this , especially since you are having difficulty swallowing. An ultrasound of your thyroid would be a good idea.

http://labtestsonline.org/understanding/analytes/thyroglobulin/tab/test/


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## jenny v (May 6, 2012)

Yeah, your vitamin D is very low and that needs to be addressed. Also, have you ever done a full iron panel (including ferritin)?

Are you on a good probiotic? Gut health has to be good otherwise it doesn't really matter if you're on prescriptions or supplements, nothing will get absorbed properly.


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## Changexpert (Feb 10, 2015)

Lovlkn said:


> You are low in D - a symptom of this is fatigue. Has your doctor started you on a prescription to get your levels up?50K IU weekly for 12 weeks is the customary protocol.
> 
> I for one would be concerned about this , especially since you are having difficulty swallowing. An ultrasound of your thyroid would be a good idea.
> 
> http://labtestsonline.org/understanding/analytes/thyroglobulin/tab/test/


I've been taking vitamin D on and off, not religiously. I just had a blood test today for vitamin D 1,25 level to see if I really need vitamin D. My calcium level was normal, so I do not have hyperparathyroidism. If my vitamin D 1,25 (active form) comes low as well, I will concentrate on raising my vitamin D level.

I believe dysphagia was caused by damaged esopheagal lining due to acid reflux. Acid reflux was definitely caused by low stomach acid in my case because at one time, I was drinking 5-6 liters of water daily. Drinking water can be beneficial, but the problem for me was that I drank it right after I had a meal, diluting stomach acid every time. I know that acid reflux was caused by low stomach acid because when I took Prilosec (PPI) and Pepto Bismol, symptoms immediately worsened. I am currently supplementing HCL for every meal.



jenny v said:


> Yeah, your vitamin D is very low and that needs to be addressed. Also, have you ever done a full iron panel (including ferritin)?
> 
> Are you on a good probiotic? Gut health has to be good otherwise it doesn't really matter if you're on prescriptions or supplements, nothing will get absorbed properly.


Yep, my iron panel including ferritin came back normal. Both were on higher end, but my iron level has been dropping. Upon research, I realized that h. pylori uses iron to make biofilms, which may be the suspect for dropping iron level.

I tried probiotics already, and things got worse from it actually. I started out with low count probiotics and gradually increased dosage. The last probiotics I consumed was Renew Life Ultimate (150 bil cfu) and it only made me sicker by giving me digestive issues like dysphagia, heartburn, and gurgling stomach.

Simultaneously, I tried lots of fermented foods like Kimchi and Sauerkraut. However, fermented foods are very high in histamine, which can lead to inflammation. I have become mildly intolerant to histamine over last year, possibly due to leaky gut. As a result, fermented foods did not agree with me either.

In addition, I have taken soil based probiotics, only to realize that SBO can be opportunistic in an immuno-compromised environment. So, I stopped taking it and immediately felt better, but symptoms (hair loss, dysphagia, fatigue) never went away completely.

All these trial and error led me to think that I might have SIBO, but I am not 100% sure on this yet... I have no idea how to treat SIBO as it is one of the hardest gut issue to address. Probiotics is supposed help, but it will surely worsen my allergy from histamine intolerance. Any suggestion on this issue would be greatly appreciated.


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