Question for Chris Vette regarding thyroid BW

[Bass]

Hey Chris, I am ready to do a complete thyroid panel but need your help to get the right ones. this is what I got from Private MD Labs as a package, anything else need to be added?

Thyroid Profile II Comprehensive
Tri-iodothyronine (T3), Free, Serum
Thyroxine (T4) Free, Direct
Reverse T3
Thyroid Antibodies:
-Antithyroglobulin Antibody
-Thyroid Peroxidase (TPO) Antibodies

Test Results will include: Free Thyroxine Index; T3 Uptake (THBR); Thyroid-Stimulating Hormone (TSH); Thyroxine (T4); Tri-iodothyronine (T3); Thyroid Antibodies: Thyroid Antithyroglobulin Antibody; Thyroid Peroxidase (TPO) Antibodies; Tri-iodothyronine (T3) Free, Serum; Thyroxine (T4) Free, Direct, and Reverse T3.

Thanks!

 

[Vettester Chris]

Bass, looks like you covered the bases ... Both antibodies are covered (TPO and TgAb, which is perfect! You can toss the T3 uptake if it's a la carte.

The only other areas to cover beyond this would be the transport and deiodinase elements, which all play a role in making sure the thyroid is healthy and productive. This would include Iron (TIBC, transferrin saturation, iron serum), ferritin, magnesium, potassium, B12, D3, and cortisol. I know most of your labs are GTG (D3, B12 & Iron), and you might have magnesium and potassium on your metabolic panel.

The RT3 "ratio" will be an indicator if "something" isn't in order, like cortisol, and/or if T3 is pooling. Again, from what I've seen with your program, I'm pretty sure everything else is in order. I'll be waiting to hear the results!

 

[Bass]

excellent! i'll post the results when I get them. thanks Chris!

 

[Bass]

Chris, here is what o ordered, I hope its all in there.

001545 Alanine Aminotransferase (ALT/SGPT)
005009 Complete Blood Count (CBC) With Differential
140244 Estradiol, Sensitive
004598 Ferritin, Serum
001321 Iron and Total Iron-binding Capacity (TIBC)
235010 Lipid Panel With LDL:HDL Ratio
010322 Prostate-specific Antigen (PSA), Serum
005280 Reticulocyte Count
070104 Reverse T3, Serum
006684 Thyroid Antibodies
027011 Thyroid Profile II
001974 Thyroxine (T4), Free, Direct, Serum
010389 Triiodothyronine, Free, Serum

 

[Bass]

Okay Chris, whenever you got tome please look at my BW. thanks in advance!

Numbers our of range are in bold.

WBC 6.1 3.4-10.8 x10E3/uL SO
RBC 5.73 4.14-5.80 x10E6/uL SO
Hemoglobin 16.1 12.6-17.7 g/dL SO
Hematocrit 49.1 37.5-51.0 % SO
MCV 86 79-97 fL SO
MCH 28.1 26.6-33.0 pg SO
MCHC 32.8 31.5-35.7 g/dL SO
RDW 15.1 12.3-15.4 % SO
Platelets 156 155-379 x10E3/uL SO
Neutrophils 59 40-74 % SO
Lymphs 32 14-46 % SO
Monocytes 8 4-12 % SO
Eos 1 0-5 % SO
Basos 0 0-3 % SO
Neutrophils (Absolute) 3.6 1.4-7.0 x10E3/uL SO
Lymphs (Absolute) 1.9 0.7-3.1 x10E3/uL SO
Monocytes(Absolute) 0.5 0.1-0.9 x10E3/uL SO
Eos (Absolute) 0.1 0.0-0.4 x10E3/uL SO
Baso (Absolute) 0.0 0.0-0.2 x10E3/uL SO
Immature Granulocytes 0 0-2 % SO
Immature Grans (Abs) 0.0 0.0-0.1 x10E3/uL SO


Lipid Panel With LDL/HDL Ratio
Cholesterol, Total 210 HIGH 100-199 mg/dL SO
Triglycerides 118 0-149 mg/dL SO
HDL Cholesterol 54 >39 mg/dL SO
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.
VLDL Cholesterol Cal 24 5-40 mg/dL SO
LDL Cholesterol Calc 132 HIGH 0-99 mg/dL SO
LDL/HDL Ratio 2.4 0.0-3.6 ratio units SO


Thyroid Profile II
TSH 2.820 0.450-4.500 uIU/mL SO
Thyroxine (T4) 6.0 4.5-12.0 ug/dL SO
T3 Uptake 36 24-39 % SO
Free Thyroxine Index 2.2 1.2-4.9 SO
Triiodothyronine (T3) 74 71-180 ng/dL SO

Thyroid Antibodies
Thyroid Peroxidase (TPO) Ab <6 0-34 IU/mL SO
Thyroglobulin, Antibody <1.0 0.0-0.9 IU/mL SO
Low positive Thyroglobulin antibodies are seen in a portion of the
asymptomatic populations.
Antithyroglobulin antibodies measured by Beckman Coulter Methodology
Thyroxine (T4) Free, Direct, S
T4,Free(Direct) 1.22 0.82-1.77 ng/dL SO

Reverse T3, Serum
Reverse T3, Serum 27.4 HIGH 9.2-24.1 ng/dL BN

Iron and TIBC
Iron Bind.Cap.(TIBC) 338 250-450 ug/dL SO
UIBC 256 150-375 ug/dL SO
Iron, Serum 82 40-155 ug/dL SO
Iron Saturation 24 15-55 % SO


Prostate Specific Ag, Serum 0.8 0.0-4.0 ng/mL SO

Estradiol, Sensitive
Estradiol, Sensitive 25 3-70 pg/mL BN

ALT (SGPT) 19 0-44 IU/L SO

Ferritin, Serum
Ferritin, Serum 15 LOW 30-400 ng/mL SO

Reticulocyte Count
Reticulocyte Count 1.3 0.6-2.6 % SO

Triiodothyronine,Free,Serum
Triiodothyronine,Free,Serum 2.7 2.0-4.4 pg/mL SO

 

[Vettester Chris]

Bass, I'm typing from the phone. I'm going to be pretty tied up for a few days with a business deal. Hopefully some others will chime in. Your RT3 ratio is probably going to be off ... Got to run, doors are closing ...

 

[Bass]

no hurry Chris, thanks for the response. I look forward to your interpretation when you have the chance.

 

[Vettester Chris]

Bass, I have just a little bit, so I'll cover a few things that I see from your labs.

Yes, your FT4 and FT3 exhibits hypothyroidism. Your FT4 is at 42% of the lab reference value, your FT3 is to the left of it at 29%. As mentioned in other threads, in ideal situations you would like to see these labs at the 50% to 80% (upper end). IMO, I think your thyroid is under-active no matter how you slice it, but you have a underlying issue that might make it difficult to treat this effectively with NDT medication(s) ...

Your Reverse T3 is high as you can tell, and I highly suspect your low ferritin to be a factor, if not "the" factor. I know you donate blood frequently, and that's no doubt one of the contributors to a lower ferritin score. I do it for necessity of controlling my ferritin, which will be off the charts high without donating. The short and simple is that ferritin is needed in the transport process of getting T3 to the cells. When low, T3 isn't working at the cellular level, it begins to pool. The body will offset by producing more RT3 (negative charge) until the improvement begins.

Many in the STTM group, including myself, would like to see a FT3: RT3 ratio that is > 20:1. Yours is at 9.9:1. Your iron serum (IMO) needs to come up. It's at 36% of its range value. Again, upper end would be the ticket, and it will be somewhat necessary to get your ferritin up. My suggestion is to make sure you're supplementing plenty of quality elemental iron. Talk with your physician about the best options (ferrous sulfate, gluconate, ...). It will take some time; possibly 8 weeks or more. Divide it up 2x or 3x day, Most importantly, make sure you take it with plenty of Vitamin C to ensure optimal absorption.

Lastly, the iron/ferritin side of things can also be problematic on the adrenals. If possible, I would encourage you to get a 4x saliva kit going. I'm 'waiting' on my current results with Canary Club/ZRT Labs. Don't feel alone, I'm having a pooling issue just the same right now, and more than likely I'm leaning towards cortisol (which obviously prompted the labs). So, we're in the same boat pal, and it will be best to get everything sorted out before jumping into thyroid meds. Hopefully some/most of this makes sense. Plenty of info if anything that you and your physician can research. There could be other factors that I'm overlooking just as well, so I'm more than open for other comments and perspectives ...

 

[Nelson Vergel]

What do you guys think of this?

https://www.excelmale.com/forum/thr...agnosis-and-Treatment-Algorithm-Dr-Rothenberg

 

[Bass]

Bass, I have just a little bit, so I'll cover a few things that I see from your labs.

Yes, your FT4 and FT3 exhibits hypothyroidism. Your FT4 is at 42% of the lab reference value, your FT3 is to the left of it at 29%. As mentioned in other threads, in ideal situations you would like to see these labs at the 50% to 80% (upper end). IMO, I think your thyroid is under-active no matter how you slice it, but you have a underlying issue that might make it difficult to treat this effectively with NDT medication(s) ...

Your Reverse T3 is high as you can tell, and I highly suspect your low ferritin to be a factor, if not "the" factor. I know you donate blood frequently, and that's no doubt one of the contributors to a lower ferritin score. I do it for necessity of controlling my ferritin, which will be off the charts high without donating. The short and simple is that ferritin is needed in the transport process of getting T3 to the cells. When low, T3 isn't working at the cellular level, it begins to pool. The body will offset by producing more RT3 (negative charge) until the improvement begins.

Many in the STTM group, including myself, would like to see a FT3: RT3 ratio that is > 20:1. Yours is at 9.9:1. Your iron serum (IMO) needs to come up. It's at 36% of its range value. Again, upper end would be the ticket, and it will be somewhat necessary to get your ferritin up. My suggestion is to make sure you're supplementing plenty of quality elemental iron. Talk with your physician about the best options (ferrous sulfate, gluconate, ...). It will take some time; possibly 8 weeks or more. Divide it up 2x or 3x day, Most importantly, make sure you take it with plenty of Vitamin C to ensure optimal absorption.

Lastly, the iron/ferritin side of things can also be problematic on the adrenals. If possible, I would encourage you to get a 4x saliva kit going. I'm 'waiting' on my current results with Canary Club/ZRT Labs. Don't feel alone, I'm having a pooling issue just the same right now, and more than likely I'm leaning towards cortisol (which obviously prompted the labs). So, we're in the same boat pal, and it will be best to get everything sorted out before jumping into thyroid meds. Hopefully some/most of this makes sense. Plenty of info if anything that you and your physician can research. There could be other factors that I'm overlooking just as well, so I'm more than open for other comments and perspectives ...

Chris I can't thank you enough. this info definitely will be shown to my physician, hopefully he'll read with an open mind, do more tests to diagnose and treat properly. your feedback is always appreciated, and thank you again.

 

[Vettester Chris]

What do you guys think of this?

https://www.excelmale.com/forum/thr...agnosis-and-Treatment-Algorithm-Dr-Rothenberg

Nelson, I like the flow chart! IMO, it's spot-on! The only thing that I would add to it is taking a different pathway option "if" RT3 is not where it should be, which is what Bass and I are going through. If T3 is low, but it will struggle to reach the cell receptors, then adding thyroid medication might be counterproductive. I actually love visualization methods to learn. Maybe Janie at STTM will make a video to compliment her site and book. LOL, I would stand in line all night waiting for the release!

Chris I can't thank you enough. this info definitely will be shown to my physician, hopefully he'll read with an open mind, do more tests to diagnose and treat properly. your feedback is always appreciated, and thank you again.

Bass, you're quite welcome, and I'm sure everything will workout just fine! Yes, hoping your physician will be open to at least explore a few angles that are being discussed. My GP and I actually will pull some time aside during my check-ups to talk about stuff just like this. It's just a case of mutual respect and willingness to progress.

There's a million things these men and women had to learn in med school, and it's not like they will have all the facts on Reverse T3 at the tip of their tongue. Most are initially trained with providing the TSH only and Total T4; maybe Total T3 thyroid lab panel, or even that T3 uptake routine. It sounds like your doctor is a good guy, I'm sure he will do some research. The best I can suggest on your end is doing your homework as well. If supporting facts on your conversations are reinforced with the likes of experts, i.e., Dr. Rind, Dr. Lam, Dr. Crisler, etc., then it 'should' help your partnership expand with your doctor. Here's a link on STTM, with letters and such from patients to doctors about thyroid diagnosis and/or treatment http://www.stopthethyroidmadness.com/2014/02/18/open-letter-to-physicians/ .... Not that I suggest you C&P this in your presentation lol.

Keep me posted, and I'll do the same with you Bass!! Also, thanks for being an awesome member. Your contributions are greatly appreciated!

 

[Bass]

thanks again Chris, definitely will keep you posted.