New Thyroid numbers

TSH 2.37 (.40 - 4.50) (this is down, but still up, from 2.7 5 months ago, but previously I had never been over a 1.7)
T4, Free 1.1 (0.8-1.8)
T3, Free 3.6 (2.3-4.2)
Reverse T3 16 (8-25)
ThyroGlobulin Antobodies <1
Thyroid Peroxidase Antibodies <1

Iron, Total 86 (50-180)
Iron Binding 469 (250-425)
% Saturation 18 (15-60)
Ferritin 17 (20-380)

T3 Free looks really good but T4 Free is on the low side. I have started supplementing with Lugols 5%, 2 drops in 8oz water.

I have chronically low Ferritin, subterranean, but am and have been supplement between 62mg-124mg of Vitron-C per day for about 3 months now. With this test result I switched a different iron called Ferrets high-potency 106mg. I take it with Orange juice in the AM on an empty stomach, eat red meat 2-4 nights per week, and use a cast iron skillet every day.

Vince,
Attached is something I worked on to track a few labs. You might find it useful. Easy to add other labs to see where you are with the range. Notes were added by me when I was trying to get the wife's DR. (QUACK) to understand that she was hypo.... Sorry to say that once a QUACK always a QUACK.... Will send something VIA PM

My only opinion would be, be careful when supplementing with iodine, too high levels and can cause havoc on your thyroid.

Vince, overall how do you feel. The FT3 & FT4 values are a bit imbalanced, which would usually indicate pooling (unless taking Cytomel, etc.). However, your RT3/FT3 ratio is good ... Then again, the ferritin result would also usually indicate a problem with FT3? So it's kind of mixed, but do you feel energetic, metabolism good, no unusual skin dryness or indications that your FT3 isn't working in the body for you?

I would say your ferritin level defines you as hypothyroid. No way your thyroid receptors are working. You must have a lot of hypothyroid symptoms. My mom is similar and supplementing wasn't doing a thing so they bring her in monthly to the hospital and give it to her in IV form and it works pretty good. I wondered why they didn't do shots but the damn MD's won't talk to me even if my mom says it ok.

Im leaning hard on iron and Ferritin these days for a little explanation in my TSH having gone up twice now, never been over 1.7 as I recall. COnsult with Defy last week chalked it up to FT3 was really good so no concerns with Thyroid. I could use a little more energy, sleep is OK to good, I'm already feeling a tick better having added 2 drops of Lugols 5% each morning. Dry skin, yes, but I chalk that up to 2 a day showers and winter dry skin, not Hypo. The iron thing is perplexing that I haven't been able to get that to rise, Ferritin, that is, so I've been working that on the grounds that it's not good but also is it keeping my FT3 from being used in the body.

Im using that Ferrets supplement with Lysine and 1000mg Vit C 1-2 times day right now.

I don´t want to jeopardize your post but what kind of "first hand medication/supplement" would be accurate to treat pooling issues?
In the eyes of my GP there would be no treatment what so ever "no way in heaven" everything is within range except for the Ferritin. If no panic attacks no concern about pooling problems etc.. I believe many share this experience when talking to a mainsteam GP.

That's the problem with mainstream GP's the large majority of them do not fully understand how thyroid should be diagnosed or treated. Most of them only run a TSH and claim your normal.

The side angle I was/am working on with the iron was a potential pooling issue but that doesn't seem to show up in these tests.

ratbag said:

That's the problem with mainstream GP's the large majority of them do not fully understand how thyroid should be diagnosed or treated. Most of them only run a TSH and claim your normal.

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As long as it's <4.0 the max lab range, most will tell you you're good-to-go which is not good.

I believe the capable Thyroid MD's are now concluding that any TSH of 2 or over has underlying issues somewhere. Did you calculate your RT3 and FT3 ratio? I know there are calculators for that but I've never fully understood that part. If your ferritin is 17 I do not understand how you would have a normal RT3. I was at 15 for a while and was in really bad shape with hypo symptoms.. it was a hot summer and I was freezing cold all the time. Once my ferritin got to 90 I was much improved but I still have some receptor problems for my T3 as Dr. Saya told me. I still have something that's preventing my T3 receptors from fully functioning.

It may be that I've got too much Iron as in Hemachromatosis ( a percentage of hemchromatosis patients have that T3 receptor issue) But I'm trying to get this sorted with my MD's here in Canada but I'm really not going anywhere fast. I have an appoint with a genetics lab next week to see if I have the hemachromatosis gene (defect) or what ever it is. But they won't give me a full iron panel... so I went out and paid for one privately and it showed my Iron serum at the very top of range with Transferrin over range and my ALT was above range... all these are markers for hemachromatosis. I showed this to my MD but because my iron serum was not actually over range he said I was fine! The run around is unbelievable. I'm going to have to fly down to see Dr. Saya and get on with this or it'll never improve.

Tommy Wall said:

I don´t want to jeopardize your post but what kind of "first hand medication/supplement" would be accurate to treat pooling issues?
In the eyes of my GP there would be no treatment what so ever "no way in heaven" everything is within range except for the Ferritin. If no panic attacks no concern about pooling problems etc.. I believe many share this experience when talking to a mainsteam GP.

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Pooling is the result of T3 not getting transported effectively into the body and utilized into the cells. Several variables need to be in play, primarily iron, ferritin, cortisol, and in some respects D3, magnesium and other electrolytes, in order for T3 to be fully effective. The body will 'usually' shift it's conversion and production of Reverse T3, when imbalances are evident (causing FT3 to pool), and/or other issues (sickness, injury, pathology, etc.) are evident, which puts the demand on the body to conserve energy.

Although, the RT3 serum & RT3/FT3 ratios are good markers to help assess pooling, it doesn't mean that pooling can't happen if the RT3 picture looks normal. Keep in mind, T4 converts down to T3, and it also converts to RT3. When problems occur, the body will shift the T4 conversion (T4 to T3) to higher rates of RT3 (T4 to RT3). It makes sense, as it's one of the body's way to converse energy and keep low until things are better ... BUT, if T4 levels are low to begin with, then obviously that will be relative to the amount actual RT3 being converted downstream.

To treat pooling, you need to identify the 'cause' of what's preventing T3 from reaching the cells. In Vince Carter's case, the RT3/FT3 ratio is 22, which fine, but FT4 is at the low end of the reference range, and FT3 is more towards the top. I lean with Ratbag on the fact that hypothyroidism is almost a given when ferritin is that low.

New numbers slight improvement in these and I have felt a bit more energy sometimes in the afternoon I've been a little "chatty" but not jittery, Ive been able to sweat in the gym lifting weights which is a little different for me, too.

I succeeded in getting my iron and Ferritin to move with 325mg iron supplement once to twice per day with 2g of Vitamin-C and Lysine.

Im very perplexed at how my TSH is still going up given my free T3 is quite good:

TSH 3.15 .40 - 4.5
Free T4 1.1 .8 - 1.8
Free T3 3.9 2.30 - 4.2


Iron: 121 50 - 180
Ferritin: 41 20 - 380
Iron TBIC: 408 250 - 425
Saturation: 30 15 - 60

Your FT4 looks to be low. You are 30% above bottom of range.
Your FT3 looks good at 84% above bottom of range.

Some explanation here:
http://www.tiredthyroid.com/optimal-labs.html

It's interesting that your FT3 went up with your TSH and all you did (I assume) was increase your iron supp dosage. I wonder what effect this had on your HCT. It's good you feel a little better. The FT4 is 50% @ 1.2 so your not that far off. I wonder if you supp'd T4 if that would actually do anything. What part of the range are we shooting for on FT4? Your iron panel certainly looks much better.

ratbag said:

It's interesting that your FT3 went up with your TSH and all you did (I assume) was increase your iron supp dosage. I wonder what effect this had on your HCT. It's good you feel a little better. The FT4 is 50% @ 1.2 so your not that far off. I wonder if you supp'd T4 if that would actually do anything. What part of the range are we shooting for on FT4? Your iron panel certainly looks much better.

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Ive been running 2 drops of Lugols 5% and 200mcg Selenium per day, I don't think I disclosed that. With the iron suppl and obvious improvement My HCT though as you think it has with the iron is really not under control, the iron seems to be spurring the HCT/HGB/RBCs.

Ive been working towards the point that it's FT3 which matters, not T4 though I do note that it is low or not in proportion to the T3. Reverse T3 was omitted by Quest.

Actually once I got my iron up my FT3 also rose. When my ferritin was tanked my FT3 was lower than normal even though my T3 dosing had not changed. Ferritin does affect FT3... at least it did for me. Supposedly iodine increases TSH so perhaps that's all there is to it. Are you still supping iron and trying to raise your ferritin further? What do you think your HCT is now? I never felt any negative symptoms of high HCT even when it was at 60. But my MD stated I did not have polycythemia and told me to stop worrying over it.

RATBAG,
My math:
FT4 = 1.1
RANGE LOW = 0.8
RANGE HIGH = 1.8
RANGE = 1
DELTA ABOVE LOW RANGE = 1.1 MINUS 0.8 = 0.3 ABOVE LOW RANGE
RANGE = 1
THERFOR 0.3 is 30% of the range of 1
FT4 is 30% above low range.
I may be wrong but I think the critical numbers are where you fall WITHIN the range.
Are you on NDT?
A quick look at optimal levels here:
http://www.tiredthyroid.com/optimal-labs.html
would indicate the FT4 is less then the start of the optimal zone.
https://stopthethyroidmadness.com/lab-values/
"FREE T4: T4 is the thyroid storage hormone. Free in front of the T4 means you are measuring what is available and unbound. Generally, those on an optimal amount of desiccated thyroid will have a free T4 around mid-range when their free T3 is at the top and in the presence of healthy adrenals. If you have low FT4 and a mid-range or slightly higher FT3, it usually means the T4 is converting like mad to give you the T3 you do have, which means hypo."
Might be something to look into.

Yes good work Orrin, I hadn't checked to see what optimal was but I know it's not the same for everyone. Perhaps taking some synthroid will help that.

Problem is that most DRs only look at ranges, and if you are within range that say you are fine. They do not treat to symptoms and do not think in terms of OPTIMAL levels.
Attached is a great BLOG post for all that gives a really easy to read understanding of this issue.