3

votes

Would you help hack my thyroid labwork? It would mean a LOT to me.

Answered on August 19, 2014
Created August 17, 2011 at 8:10 PM

Basically, I've had various symptoms that all started around when my anxiety went through the roof senior year of highschool; hair loss, hyperhidrosis (possibly unrelated), gluten sensitivity, IBS type things, sebhorreic dermatitis.

I am 24 now and had a bunch of labwork done. Here it is.

  1. TSH, 3rd Generation 2.97 (.40-4.50 mIU/L)
  2. T4, FREE 1.4 (.8-1.8 ng/dL)
  3. T3, FREE 2.9 (2.3-4.2 pg/mL)
  4. T3, REVERSE 47 H (11-32 ng/dL)
  5. CORTISOL, TOTAL 23.2 H (3.0-17)
  6. Ferritin 148
  7. B12 342

P.S. My free T3/RT3 ratio is 6.2 . I read it is supposed to be above 20 or higher to be healthy.

Thanks in advance. It really means a lot.

Edit: Is anyone familiar with the Free T3/RT3 ratio hypothesis?

Cbb1134f8e93067d1271c97bb2e15ef6

on August 26, 2011
at 02:41 AM

Orangepeels: You didn't state if weight is an issue for you, and somehow I got the impression from info in your question and replies that it is not. So, I assume you are eating fruits, safe starches, etc and not VLC. Here is a Paul Jaminet post that speaks to your T3 reverseT3 and cortisol. I don't think it is a "solution" for you specifically, but would be good to review well and discuss with an MD, as well as review your diet. http://perfecthealthdiet.com/?p=4383

77877f762c40637911396daa19b53094

(78467)

on August 20, 2011
at 11:53 PM

Click the link in my response and you will go to the site @orangepeels. My question was answered quickly when I joined. I think the whole thyroid thing is pretty complicated and not many docs are up on it. Good luck.

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 19, 2011
at 10:44 PM

Do you know the site? I'm not on any thyroid meds, but I think my root cause could be the cortisol.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 05:06 AM

Make sure you get in like 1000C/day and 500IU E/day for Omega3 use over 3 months - oxidation prevention.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 05:05 AM

One more thing: Given your diet history and your sort of "sliding scale" paleo so far, I'd suggest a high quality multivit, make sure you are getting enough D - consider 5,000IU/daily, look @ Zinc 50mg/daily, maybe magnesium citrate 400mg - possibly take at night. I'd also suggest starting on a HIGH quality, higher dose Omega3 like Carlsons or Barleans and getting the dose up to maybe 3 grams/day. Read Rob Wolf's site. It can be very helpful with alot of what you've got going on - skin (hair) psoriasis, anxiety, general stress tolerance and in my esperience good for gut. Pivotal in my healing.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 12:11 AM

+1 - Good question, also good history.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 12:07 AM

Thanks for the info. With what you've got going on, going as "clean" and high % paleo as you can will only be a good thing!;)

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 12:05 AM

(continued) with you, I think. And be open to getting *serious* about stress reduction. Often unis have counseling services. They are short term supportive services that could be *ver* helpful with some stress reduction techniques and other helpful tools. Don't be closed to them. Then there's the whole sleep and lifestyle piece as you are aware. If you give it adequate time, you may find a goodly reduction in your gut/scalp/anxiety issues. Check out Dr. Emily Deans Evolutionary Psych blog if you havent. Check: Zinc, magnesium, anxiety.

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 18, 2011
at 12:04 AM

From the "stop the madness" website you linked. "... you are looking for a problem in the ratio between the RT3 and the Free T3. i.e dividing the Free T3 by the Reverse T3 (Free T3 ÷ RT3). For healthy amounts of RT3, The ratio result should be 20 or larger. If lower, you have a problem." Well, I used their calculator and got a 6.2 . That's definitely gotta be bad right?

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 18, 2011
at 12:01 AM

I had a terrible high sugar, high processed, and high grain diet up until feb. 2010. And, from 2006-2010, I was eating junnkfood vegan food. I have been gluten/soy free since feb 2010, and have been 50-80% paleo on and off since march 2011.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 17, 2011
at 11:59 PM

(continued) and RT3 as indicators of the stress you are experiencing, which is likely not unusual in the uni students he sees. (This is not a justification, just giving you a picture of what might be going on.) In an of itself, the RT3 may be more of an *indicator* of your stress, rather than something that if "too high =indicator of "disease." At least in a strictly, diagnosable "today" sense. I would ask for a specific explanation as to why he is not concerned. You could also seek out a Family Doc in the community with a good rep. Ask around. You want someone who will work more holistically

Cbb1134f8e93067d1271c97bb2e15ef6

on August 17, 2011
at 11:55 PM

Just a *possible* interpretation: The Doc may feel like he has been able to rule out solid organic issues - as in thryroid disease, blaring iron deficiency issues, low B12. How you describe yourself is STRESSED. And you have health issues that can be seen and commonly are seen as stress linked. I assume you are at least recently eating "paleo?" Yes? And you've read some and are aware that your gut and skin issues may be related to former diet? And that a big piece of paleo/primal/ancestral is the STRESS piece - the get the cortisol down piece. The Doc may basically be looking at the cortisol

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 17, 2011
at 11:37 PM

The crappy health center doctor at my university didn't think anything was out of the norm. But, according to "stop the thyroid madness" the Free T3/RT3 ratio should be above 20, but mine is 6.2. I'm getting a food sensitivity panel tomorrow. Could I be causing stress on my body by ingesting a food I am sensitive to? Could my hairloss be related to the bad Free T3/RT3 ratio? How do I find a doctor that is actually good at this stuff?

Medium avatar

(39831)

on August 17, 2011
at 08:59 PM

Assuming you don't have hashimoto's or something, supplementing with kelp and selenium would likely lower TSH and optimize the conversion of t4 to t3. You want TSH to be below 1.

9d43f6873107e17ca4d1a5055aa7a2ad

on August 17, 2011
at 08:32 PM

here is my labwork for reference, though not as detailed http://paleohacks.com/questions/8479/whats-a-good-tsh-level#axzz1VJTbRaTv

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 17, 2011
at 08:22 PM

Not supplementing with iodine or selenium.

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 17, 2011
at 08:22 PM

I've always been stressed, especially since highschool (and I just graduated college). But, my main stressor now is the hair loss. Also, I do not take any thyroid supplements or idione.

Medium avatar

(39831)

on August 17, 2011
at 08:18 PM

Are you currently supplementing with iodine or selenium?

Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on August 17, 2011
at 08:16 PM

looking forward to some really good answers on this. I think we could stand to gain some additional insight on what can be deduced from these numbers and how to best address the thyroid issue as it seems to be connected to darn near everything.

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4 Answers

3
Cbb1134f8e93067d1271c97bb2e15ef6

on August 17, 2011
at 11:27 PM

Here's some info that will enable you to hack your own results - at least up to a point.

First:

"What is reverse T3? 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."

This may be related to your high cortisol level. Be aware that there is controversy as to the accuracy of a "snapshot" blood cortisol level and whether cortisol via saliva is a more accurate test. The following will take you through an explanation of a thyroid panel. It goes for about 4 pages. Go all the way through. It is well done and clear and I consider it to be a reliable source.

http://labtestsonline.org/understanding/analytes/thyroid-panel/tab/sample

Here's info for your ferritin level, which is within range.

http://www.nlm.nih.gov/medlineplus/ency/article/003490.htm

Here's info for your B12, which is also within range.

http://www.nlm.nih.gov/medlineplus/ency/article/003705.htm

The following is a possible explanation for your elevated cortisol and RT3. I have not read this site carefully and am uncertain of its quality. However, the info on this page is largely info that is available piecemeal on other sites in less accessible forms that to my knowledge is accurate. I don't know about the rest of the site. May have mixed quailty info, or other - unsure. So explore it in that vein.

"Why does my body produce RT3 (Reverse T3)? In any situation where your body needs to conserve energy, such as emotional, physical, or biological stress, your thyroid will properly convert any excess T4 to the inactive Reverse T3 (RT3) as a way to clear out the extra and unneeded storage T4. Reasons this can be propelled in action include being chronically or acutely sick (such as having the flu, pneumonia, etc), after surgery, after a car accident or any acute injury, chronic stress causing high cortisol, being exposed to an extremely cold environment, diabetes, or even being on drugs like beta blocks and amiodarone.,"

http://www.stopthethyroidmadness.com/reverse-t3/

So, these can all give you some good info. There is also a calculator for T3/RT3 on the site of the last link.

What has your Doc/healthcare provider explained to you about these results?

Are you unclear or uncertain about whatever has been communicated to you?

Given the history you describe and symptoms, your results seem suggestive of the need to work on the STRESS/anxiety issues.

But I am not a physician and labs are only data. Appropriate interpretation from a solid clinical knowlege base and clinical correlation is quite another matter.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 05:06 AM

Make sure you get in like 1000C/day and 500IU E/day for Omega3 use over 3 months - oxidation prevention.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 05:05 AM

One more thing: Given your diet history and your sort of "sliding scale" paleo so far, I'd suggest a high quality multivit, make sure you are getting enough D - consider 5,000IU/daily, look @ Zinc 50mg/daily, maybe magnesium citrate 400mg - possibly take at night. I'd also suggest starting on a HIGH quality, higher dose Omega3 like Carlsons or Barleans and getting the dose up to maybe 3 grams/day. Read Rob Wolf's site. It can be very helpful with alot of what you've got going on - skin (hair) psoriasis, anxiety, general stress tolerance and in my esperience good for gut. Pivotal in my healing.

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 12:07 AM

Thanks for the info. With what you've got going on, going as "clean" and high % paleo as you can will only be a good thing!;)

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 17, 2011
at 11:37 PM

The crappy health center doctor at my university didn't think anything was out of the norm. But, according to "stop the thyroid madness" the Free T3/RT3 ratio should be above 20, but mine is 6.2. I'm getting a food sensitivity panel tomorrow. Could I be causing stress on my body by ingesting a food I am sensitive to? Could my hairloss be related to the bad Free T3/RT3 ratio? How do I find a doctor that is actually good at this stuff?

Cbb1134f8e93067d1271c97bb2e15ef6

on August 17, 2011
at 11:55 PM

Just a *possible* interpretation: The Doc may feel like he has been able to rule out solid organic issues - as in thryroid disease, blaring iron deficiency issues, low B12. How you describe yourself is STRESSED. And you have health issues that can be seen and commonly are seen as stress linked. I assume you are at least recently eating "paleo?" Yes? And you've read some and are aware that your gut and skin issues may be related to former diet? And that a big piece of paleo/primal/ancestral is the STRESS piece - the get the cortisol down piece. The Doc may basically be looking at the cortisol

Cbb1134f8e93067d1271c97bb2e15ef6

on August 17, 2011
at 11:59 PM

(continued) and RT3 as indicators of the stress you are experiencing, which is likely not unusual in the uni students he sees. (This is not a justification, just giving you a picture of what might be going on.) In an of itself, the RT3 may be more of an *indicator* of your stress, rather than something that if "too high =indicator of "disease." At least in a strictly, diagnosable "today" sense. I would ask for a specific explanation as to why he is not concerned. You could also seek out a Family Doc in the community with a good rep. Ask around. You want someone who will work more holistically

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 18, 2011
at 12:04 AM

From the "stop the madness" website you linked. "... you are looking for a problem in the ratio between the RT3 and the Free T3. i.e dividing the Free T3 by the Reverse T3 (Free T3 ÷ RT3). For healthy amounts of RT3, The ratio result should be 20 or larger. If lower, you have a problem." Well, I used their calculator and got a 6.2 . That's definitely gotta be bad right?

Cbb1134f8e93067d1271c97bb2e15ef6

on August 18, 2011
at 12:05 AM

(continued) with you, I think. And be open to getting *serious* about stress reduction. Often unis have counseling services. They are short term supportive services that could be *ver* helpful with some stress reduction techniques and other helpful tools. Don't be closed to them. Then there's the whole sleep and lifestyle piece as you are aware. If you give it adequate time, you may find a goodly reduction in your gut/scalp/anxiety issues. Check out Dr. Emily Deans Evolutionary Psych blog if you havent. Check: Zinc, magnesium, anxiety.

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 18, 2011
at 12:01 AM

I had a terrible high sugar, high processed, and high grain diet up until feb. 2010. And, from 2006-2010, I was eating junnkfood vegan food. I have been gluten/soy free since feb 2010, and have been 50-80% paleo on and off since march 2011.

2
3e09df17db550681d1c9b00f428eed8d

on March 03, 2012
at 09:02 AM

Hey man (or woman?),

I know this is an old thread, but I'm around your age and I've had similar problems. I think I can help.

My recommendations:

1) The overriding imperative for you is to reduce stress by all possible means. Stress is a very significant biochemical phenomenon. A dominance of stress hormones could potentially cause all of the problems you describe, especially a low ratio of T3 to RT3, which may be the primary mechanism behind the majority of your symptoms.

"Stress" includes not only psychological stress, but physical stress: don't exercise too much (no more than about 30 minutes a day maximum), eat plenty of carbs from quality sources like sweet potato, and don't drink, smoke, or do drugs. And don't obsess over your diet! Just eat well, eat hearty, ENJOY your meals and try to relax as much as possible.

2) I would supplement iodine and selenium according to Paul Jaminet's recommendations, which you can find by doing a little digging on his blog. Basically, you start with a low dose and increase it very gradually over a long period of time. Don't get impatient, because increasing the dose too quickly can cause problems. Make sure to take some selenium (200 mcg) daily along with it. You should also tend to other important micronutrients like zinc, magnesium, vit. D, vit. A, and all of the other essential vitamins and minerals.

3) Your ferritin is probably higher than optimal. If you can, I would test other markers of iron status (transferrin saturation, serum iron, iron binding capacity, etc.). Learn how to interpret them--it's fairly easy. A high or even high normal transferrin saturation, high serum iron, and low iron binding capacity indicate some degree of iron overload. If this is the case, you would probably benefit from donating blood frequently enough to get the ferritin down around 30.

4) Your B12 levels seem pretty low to me, though you don't give units, and I don't know much about normal or optimal levels. I think mine are usually much higher than that. Low B12 is usually accompanied by low levels of other important B vitamins, notably B6 and folate. A deficiency of any or all of those vitamins would definitely cause anxiety and poor stress tolerance, as well as creating other downstream biochemical logjams that could influence thyroid function.

You should (a) get a Complete Blood Count and (b) get your homocysteine levels tested. If MCV is greater than 92 or homocysteine is greater than 7, you probably have a deficiency of folate, B12, B6, or TMG or some combination of all of them. If so, you would GREATLY benefit from supplementing all four in their methylated forms (methylfolate, methylcobalamin, pyridoxal-5-phosphate, and TMG). After some tinkering to dial in the best dose of each (too much can cause problems), this will help to reduce anxiety and stress, improve sleep and mood, and generally help the biochemical machinery of the body run more smoothly. Very important, this.

Magnesium will also help reduce anxiety and tension and improve sleep.

Once you get the thyroid hormones functioning properly, many of your other symptoms will resolve spontaneously. Thyroid is absolutely central to all aspects of health. And stress of any kind sabotages thyroid function quite significantly. That's why it's priority number 1.

Good luck!

0
77877f762c40637911396daa19b53094

(78467)

on August 18, 2011
at 06:35 AM

I suggest you go to http://health.groups.yahoo.com/group/NaturalThyroidHormones/ , join, and post your lab results for the gurus there to go over.

When I switched from Eltroxin to Desiccated Thyroid I found them to be very knowledgable and helpful at analyzing my lab tests.

If it appears you have adrenal issues, there is another site for advice on that.

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 19, 2011
at 10:44 PM

Do you know the site? I'm not on any thyroid meds, but I think my root cause could be the cortisol.

77877f762c40637911396daa19b53094

(78467)

on August 20, 2011
at 11:53 PM

Click the link in my response and you will go to the site @orangepeels. My question was answered quickly when I joined. I think the whole thyroid thing is pretty complicated and not many docs are up on it. Good luck.

0
Af1d286f0fd5c3949f59b4edf4d892f5

(18452)

on August 17, 2011
at 08:20 PM

orangepeels -

do you supplement with iodine? or take a thyroid supp? (I'm not saying whether you should or shouldn't... I am asking for background information purposes)

your cortisol looks much higher than the 'max'. Are you stressed?

I don't know what to make of these numbers because I am not familiar with what they mean, but I am hoping that someone with experience in dealing with these types of lab numbers might have some insight for us.

Thanks!

05a1cb4b0c28558c2be2b7ac81b9467a

(106)

on August 17, 2011
at 08:22 PM

I've always been stressed, especially since highschool (and I just graduated college). But, my main stressor now is the hair loss. Also, I do not take any thyroid supplements or idione.

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