Just fot thyroid results, not sure next step

[mooseman109]

I did a full thuroid work up as i have seen requested here. I did not do iron or feratin, Just plain forgot to order them. Bith have always been mid range.
I wake up middle of the night hot nearly everynight and tend to crash mid day. That being said I am usually iup at 4:30 weekdays and ma in gum at 5:15 for heacy weight routine

TSH 1.64. (.450-4.50)
T4 free. .81. (.82-1.77)
T3 free. 3.6. (2.2-4.4)
Reverse T3. 8.9. (9.2- 24.1)
TPA. 11. ( 0- 34)
Thyrogobulin antibodies <1.0. (0.0-.9)
Vit D 25 hydroxy. 39.1. (30-100)
I do not have weight gain issues. Total T was 793on last labs 4 weeks ago and free t was 22.4. Just switched to daily test cyp shots of 10mg anout 4weeks ago. Will do new labs in another 4 weeks.
So i am a little low on T4and reverse t 3. Does this mean my body is efficiently using up the t3? I really have no idea.

 

[Vince Carter]

Your reverse T3 is good so I don't see a pooling issue for you. I don't like this Thyroid mania that's going on on the forum lately, "hypo" Thyroid is a fad that's gotten a grip here.
I think your Free T3 is just fine. Problem will be those that advocate its not optimal and has to be in the top 90% blah blah. You're obviously producing sufficient amounts of T4 which is creating T3.

If you felt compelled to try something I'd recommend Iodine and Selenium but I'd don't advocate treatment of T3 in situations like yours.

 

[ratbag]

But your FT4 is well below 50% and I'd bet that's because your on TRT. We are seeing more of this association now. I wouldn't assume your FT4 is Ok just because your FT3 is good. I bet if you looked at your pre TRT labs you would see your FT4 is higher than it is now. You need to know your ferritin as a minimum. You didn't really say how you feel overall?

 

[mooseman109]

VC I agree Reverse T3 is good.
Ratbag, i feel fine actually. There is no prior thyroid lab test to compare to unfortunately , I have never run those labs before. Other than the tired mid day and waking up hot nightly I feel great. Again those issues probably have nothing to do with thyroid function.
I have little knowledge on this issue and there has been a ton of stuff of late discussing this and a few folks have suggested getting these labs run, so I did.

 

[Joey786]

If you feel fine then there’s no need to a do anything. Your numbers look good. Crash at mid day could be diet related.

 

[mooseman109]

If you feel fine then there’s no need to a do anything. Your numbers look good. Crash at mid day could be diet related.

Thanks, my thoughts as well. Also getting up at 4-4:30.

 

[Vettester Chris]

Moose, your FT4 is a tad below reference range, so call it 0% of Ref Range, and FT3 is at 64%.

Do you take Cytomel T3 medication?

If you don't take T3 meds then something isn't right (?). T4 could be on the low end and converting excessively to T3, and possibly T3 is pooling (?), explaining the variances between the two. RT3 also converted from T4, is a diversion pathway when the body is stressed, sick, or imbalances exist. However, iff T4 is low to begin with then T4 to RT3 conversion would be impacted as well, resulting lower RT3. Elevated T3 that is "pooling" will affect the TSH loop (it recognizes both T4 and T3), which will in turn reduce demand for thyroid hormone production; impacting T4.

It gets a bit confusing and there could be a myriad of explanations. I think the best place to start is with the iron & ferritin labs, also a 4x cortisol w/ DHEA correlation analysis would be suggested. Keep us posted ...