Re: Advice required on lab results

[Guest guest]

Hi,

If you divide the free t3 by the reverse t3, you get 11..... could be a

reverse t3 problem? Ideally the ratio needs to be more than 20.

The reverse t3 would push up the free t3 number, so the ratio of Ft4/Ft3 would

be high.....

.

>

> My Wife has just received her latest lab results from Genova.

> Total T4 77.5 nmol/L ref range 58-154 nmol/L

> TSH 0.731 mIU/L 0.4-4.0

> Free T4 13.6 pmol/L 10-22

> Free T3 3.78 pmol/L 2.8-6.5

> FT4/FT3 Ratio 3.6 2-2.5

> Reverse T3 0.32 pmol/ml 0.14-0.54

> TgAb 20 IU/ml 0-40

> TPO Ab 15.5 IU/ml 0-35

> The commentary says Secondary or Tertiary Hypothyroidism is possible due to

anterior pituitary or Hypothalamic Hypofunction. Is this due to the low TSH

which we know is due to taking T3 and T4?

> My Wife is taking 75mcg Levothyroxine and 12.5mcg of Cynomel daily and these

were not taken for 24hrs before test. She is also on 30mg Hydrocortisone Roussel

per day.

> Any attempt to increase the dose of Cynomel causes tachycardia but we don't

know why.

>

> Any advice would be appreciated

> Many thanks.

> Ian

>

[Guest guest]

Hello Ian

Her free T4 at 13.6 is low, but not unexpected in somebody

taking T3, though I would have expected her free T3 in that case to be much

higher, even having stopped it for 24 hours before the blood test. When taking

thyroid hormone replacement, and especially T3, the result should be into the

upper third of the reference range and yes, the commentary suggesting Secondary

or Tertiary Hypothyroidism due to anterior pituitary or hypothalamic

hypofunction is a possibility with such a very low TSH.

Your wife's doctor would need to refer her to a good

endocrinologist to find if the problem lies with her pituitary gland not

sending a good signal to her thyroid, and therefore her thyroid not producing

sufficient T4 and T3. You need to find a good doctor that understands this.

Type in low TSH, low FT4, low FT3 into Google to try to find a good medical

article that addresses her situation (like Medline) to show her doctor at her

next appointment.

Also, has she been tested to check her levels of ferritin, vitamin

B12, vitamin D3, magnesium, folate, copper and zinc to see whether any of these

could be the cause of her lack of thyroid uptake?

Luv - Sheila

My Wife has just received her latest lab

results from Genova.

TSH 0.731 mIU/L 0.4-4.0

Free T4 13.6 pmol/L 10-22

Free T3 3.78 pmol/L 2.8-6.5

FT4/FT3 Ratio 3.6 2-2.5

Reverse T3 0.32 pmol/ml 0.14-0.54

Any attempt to increase the dose of Cynomel causes tachycardia but we don't

know why.

___

[Guest guest]

Hi Angel,Thanks for your advice. I think my wife would prefer it was adrenal rather than pitiutary.She is due for another TSH test for her GP next week so we will see what that turns up.Thanks again,IanFrom: judith franklin <angel47572000@...>thyroid treatment Sent: Sat, 26 March, 2011

11:41:12Subject: Advice required on lab results

Hi , your wife looks like she has a reverse T3 problem , so it may well need to take only T3 but as she has some adrenal probs this could be an issue.best to get the adrenals well and then retest to see if the RT3 is better. the FT4/FT3 could be higher.???? probably down to the adrenals .!!!!Angel.