2nd Request for help with latest RT3 Ratio and lab results

March 6, 2010

Val/Nick, or anyone else who can help:

I got my new labs back (from 2/26). They were:

TSH = 0.48 (up from 0.01 on 1/9/10)

FT3 = 1.4 (range 2.4-4.2) (on 1/9 it was 3.6)

RT3 = <25 (90-350) -- this value was 304 on 1/9/10, same lab

T4 = 2.69 (range 4.60-12.00)

T3 uptake = .67 (range 0.76-1.25)

For the life of me I cannot figure out my ratio -- can it have gone from 11.84

(in January) to 56 in 8 weeks? It was 8.26 in December (usually 8 weeks between

each set of labs). It's important for the ratio to be higher than 20, right?

I am on 50 mcg of T3 alone (generic cytomel). In January I also had my Hashi's

antibodies tested and they had risen slightly (TPOi was 193 and up from 168 over

the summer, and TgAb was 68, also up from 46 last summer). Doc told me in

January 'we don't use Hashi's antibodies to determine treatment for hypoT.'

So today, when I pointed out that my TSH had risen from 0.01 to 0.48

(essentially almost 50x what it had been 8 weeks ago!), that something was up,

even if we didn't run the Hashi's antibody tests this time around. She DOUBLED

my generic cytomel from 50 mcg/day to 100 (telling me to take it in 2 doses --

and I take it over 4 doses). She actually told me 'you know more about thyroid

than I do (she's a GP and I actually like her because at least she has deferred

to me, her novice patient, on my treatment and what thyroid hormone replacement

I preferred) but I think you might benefit from going to an endocrinologist',

adding that an endo would be more familiar with RT3 issues, Hashi's, blah blah.

Well, since I have been paying close attention to this forum as well as a couple

other thyroid forums, I don't have a whole lot of faith in endos, because

treating thyroid disease for them is booorrring because there aren't any fancy

schmancy drugs they can prescribe, so they're more interested in other endocrine

disorders.

So my question is this: Can anyone help me decipher what the heck my weird

results mean? It looks like I've cleared all my RT3, unless I'm reading these

results wrong. Can I go back to taking Nature-Throid (if I can find it), and if

so, how much would give me the equivalent of 100 mcg of T3 alone -- 4 grains? Or

if I add levothyroxine to the cytomel, how much should I take of that, and how

much cytomel should I eliminate in favor of the T4? I'm completely confused. I

eally have no hypo symptoms, never got any hypER symptoms being on 50 mcg of T3

alone, and just want to be on the right track. I take plenty of vitamins and

supplements, selenium included.

Thanks very much,

Therese

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