[Savestheday]

I am currently on Cytomel only (50mcg) for symptoms of hypothyroidism. I also have adrenal fatigue which I am starting to recover from, as well as very low serotonin and estrogen dominance. My latest lab results are:

Free T3: 2.8 (2.3-4.2 pg/ml)
Free T4: .3 (.8-1.8 ng/dl)
Reverse T3: <5 (11-32 ng/dl)
Ratio FT3 to RT3: 56

When I calculate my ratio using 5 for the reverse T3, I get 56. I have read that if you do not have reverse T3 problems then you should be at 20 or above. 56 seems a little high compared to 20 especially since my RT3 was out of range. Can anyone tell me if this is a good ratio, or should I be worried?

Thank you in advance

 

[lainey]

You really should avoid posting the same question twice in two different sub folders. It just confuses things.

This is what I wrote in the "lab results" sub folder:

Given your high dose of cytomel, your free T3 is really quite low. Is there a particular reason why you are not using any T4 medication?

Really, you should not need to use a calculator on your numbers, nor be concerned about ratios. Reverse T3 is made when the conversion from T4 is very rapid. You have very little T4 for that to happen--and you won't, because if your thyroid is probably no longer making it, and you are not replacing it, but the T3 only.

Dosing is based on TSH and the free T4 and T3 values--in your case, the first two would likely be suppressed due to the high amount of T3 your are taking.

 

[Savestheday]

I am on T3 only because that's what my doctor recommended for me. T3 is the active hormone, and my T4 level was normal when I was first put on thyroid medicine. He told me by taking T3, my T4 levels will be suppressed. I tried weaning off my medicine because my labs were pretty normal to begin with despite my hypothyroid symptoms, but my body would not let me. My thyroid lobes were slightly elongated in my ultrasound and that along with my symptoms is why I was put on thyroid medication.

 

[lainey]

Well of course you can't go off it.

Taking T3 suppresses T4, as it is the active hormone. Without exogenous T3, then you have no stored T4 for your body to use to convert on its own. You would have to go through the traditional period of hypo symptoms while your stores of T4 build back up.

And if your labs were pretty normal to start with, what was the thinking behind the huge dose of cytomel? Obviously the doctor knew it would suppress your T4 (some act like they don't), so he was really setting you up for an imbalance in your numbers if there wasn't one before.

 

[Andros]

I am currently on Cytomel only (50mcg) for symptoms of hypothyroidism. I also have adrenal fatigue which I am starting to recover from, as well as very low serotonin and estrogen dominance. My latest lab results are:

Free T3: 2.8 (2.3-4.2 pg/ml)
Free T4: .3 (.8-1.8 ng/dl)
Reverse T3: <5 (11-32 ng/dl)
Ratio FT3 to RT3: 56

When I calculate my ratio using 5 for the reverse T3, I get 56. I have read that if you do not have reverse T3 problems then you should be at 20 or above. 56 seems a little high compared to 20 especially since my RT3 was out of range. Can anyone tell me if this is a good ratio, or should I be worried?

Thank you in advance

Lainey is correct; you need "some" T4 for peripheral Deiodination and conversion for T3 to become biologically active. What you are not able to use, reverts to rT3.

And you may not need such a high dose of Cytomel if you add T4. Talk to your doctor about this. I believe the ratio of T4 to T3 should be 4 to 1. If I am wrong; somebody correct me.