I can't disagree with seeing Dr. Saya, as he is a great doctor. But - I hate the implication that a TSH of 2.7 is high, and you need a specialist to figure this out. I think any good doctor (primary or endocrine) would not put you on Synthroid with TSH of 2.7, and anti-TPO of 8 (<34). Also - improving your Vitamin D from 25, may improve your mid range TSH level. I'm not opposed to complete thyroid panel with reverse T3. But I think we are jumping ahead with suggesting he needs to see Dr. Saya to figure this out.
Ask your current doctor why they put you on Synthroid, without re-checking TSH first to see if the 2.7 TSH is always that high or if that was just a moment in time. TSH varies through the day.
Also ask your doctor for a referral to an endocrinologist if he/she is not experienced with treating thyroid related issues.
In some ways I'm impressed that your doctor is willing to treat you with TSH of just 2.7, as many doctors won't treat thyroid issues until it's double or triple that level. But force your doctor to explain his recommendation, or refer you to a specialist. No need to pay out-of-pocket, in this situation.
Chris - please answer my original question -
Will his Reverse T3 be impacted by taking Synthroid?
Would it be better to get off Synthroid for 2 weeks and then check Reverse T3 and everything else?
And Nosupermodel - I know this all make you nervous. Relax - you are in no way at risk of harm, using or not using Synthroid. I'm simply trying to emphasize that everything is ruled out appropriately. Stay positive!
First, throw out using that useless TSH lab as the 'Primary' marker for diagnosing thyroid issues. Use it as a 'Secondary' marker, along with the KEY labs of FT3, FT4, RT3, TPO & TgAb. Notice his doctor didn't check RT3 or the TgAb antibodies?? There's ONE (1) Great reason there to go see a specialist. I know WHY his doctor put him on T4, it was because he based it on the lower FT4 reading and probably the TSH (which IMO is about where it should be based on his FT4 (low) and FT3 (mid range) reading). Even his FT3 was sitting just mid-range, so it wasn't way up there, but the variance against FT4 should have prompted further investigation, and his doctor clearly isn't up to speed on that .. Thus, another GREAT reason to see a specialist!!
John - YES, on the T4 to RT3! Here's how it works ... T4 function as the Reserves ... Its primary duty is to convert down to T3 and Reverse T3 (Usually a ratio of 2:1 on conversion to T3 over RT3). However, once again when issues are evident that will affect FT3 with getting into the body, the T4 regulation process will UP the conversion significantly to RT3. So, to answer you, IF he's having an issue and seeing an increase in RT3, ADDING MORE T4 WILL ONLY END UP CONVERTING TO HIGHER AMOUNTS OF RT3, and the smaller amounts of T3-> FT3 conversion that make it through will only cause the 'POOLING' process to worsen "IF THAT'S OCCURRING??"
Lastly, here's a factual, 100% Real Life lab results of someone very close to me ... Female, Mid 40's, Peri-Meno
FT4 0.93........ Ref Range 0.82 - 1.77
FT3 1.7 ........................2.0 - 4.4
TSH 0.67 ..................... 0.450 - 4.50
(Hint: Estrogen Dominance)
I won't screw this thread up with getting too deep on these results, BUT I've seen many like it, and it makes all the sense in the world to me!! Most doctors might look at that TSH and presume she has Graves or leans towards hyper .. 180 from the facts!
NSM, for the life of it, get the missing labs and either take it to your doctor, or take it to someone like Dr. Saya, or a novel concept, take it to both and get two (2) opinions. Peace!
