I just got the rT3 numbers -- rT3 is 217 pg/mL, T3 was 2.4 pg/mL. That gives T3/rT3 of 0.011. Um, yep. I would say .01 is less than .2. :-)

The T3 & rT3 were measured about 3 weeks apart. I had added more carbs to my diet in the meantime & my cholesterol had dropped from 460 to 407.

That looks like it. Whew!

In the meantime, I had *totally* freaked out. I was very sick some years ago & I think it has made me very jumpy. I was pregnant & had both very serious pre-enclampsia & placenta previa. It would have ended with me bleeding to death, except that I was in the hospital with a nurse standing next to me when it all went south (and baby did die). My head knows that cholesterol isn't that big a deal, but my emotions seem to still have some residual stuff hanging about.

In the meantime, I did have a heart scan, which came back with a score of 0. That is a big relief. I'm also now sensitized to heart disease, which isn't necessarily a bad thing. It's on my radar to figure out how to keep my risk low, which is way easier than fixing problems.

Thanks much for your help, Lisa & everyone ...

Beth

Beth,

Couple of things. First, it's not T3/rT3 -- as I said in my first post it's FREE T3/rT3. Do you have something on your report that says FT3? If so, what's the number. Also, for the FT3 (if you have it) there should be a 'range' listed. What is the range? You should also have FT4 listed, and a range. If so, please post here.

Second, rT3 of 217 is high. That is, not good, and even without knowing the actual ratio I believe my suspicion of rT3 hypo is confirmed, and indeed is the cause of your high cholesterol. Nice that it dropped a bit, but you will need thyroid medication to get it down another 200 points.

Third, as to the ratio itself, if your FT3 number were to also be 2.4 (for example), you would do the ratio like this: 2400/217 = 11.05 (or, converted to your lab number, that .1 you mention). This is just a bit more than half of what it needs to be. It should be 20, or .2.

This positively means hypo, and given your temps, specifically Wilson's Temperature Syndrome. The bad news is, this is bad news. The good news is -- it's easily treated, depending on your ferritin and cortisol levels. Did you have both of those tested as well? If not, head right back to the doc to have them done.



I'm not in the least surprised, but I'm very happy for you.

Now, let's get you on track to fix the thyroid problem. I'll look here for your reply/numbers.

Lisa

Hi Lisa,

Sorry I was gone so long, I was waiting for more info, which I now kinda have.

I had posted free T3, I don't have total T3. On the rT3, the lab report says that the reference range is 90 to 350 pg/mL, so it is within the reference range and even close to the middle, which is probably close to the mean. [The ratio is pg/mL is 0.01, 10 x less than 0.1, but if you multiply the T3 by 1000, it would come out to 11.]

The new information I have is that the endo I went to has not the slightest clue what the problem is. I had come up with a theory that it was the amount of cholesterol I was eating, but he said that only about 1/3 is absorbed (which begs the question of why people are advised to avoid eating cholesterol, but that's not the issue here).

He thinks it is the amount of saturated fat, but I looked that up & eating up to 25% of calories in butter causes perhaps a rise of 40 mg/dL, not a rise of 200. Also, my TC had dropped by 50 between one test & the next & I had eaten less sat fat and cholesterol (from 29% to 25% maybe) on the day before only, if I am reading my food log correctly. I doubt it is plausible to me that a change of one day would cause that large a drop.

In the meantime, I have been reading about heart disease & the main thing I have gotten is that it is an inflammatory disease & that low fat increases inflammation. It appears that if you were to think of the fat/carb balance as being a slider, when it is set all the way to low fat then inflammation goes up the most & when it is set all the way over to low carb, it goes down the most. There isn't enough research yet to provide a definitive answer (insert snarky comment here), but what there is points in that direction. The evidence is strong enough that the AHA is recommending a "moderate fat" diet ...

Moderate-Fat Diet May Be Better at Reducing Heart Risks

I don't really want to argue with my doctor about the amount of fat in my diet. He doesn't know what is causing this, thus he has no clue how to fix it. If the fat/carb balance were simply a matter of trying to lose weight, I would follow his advice, but it is much more important than that -- chronic inflammation seems to lie at the center of most of the major diseases that we are at risk of getting. The research is pointing to the idea that low carb is the best way to lower that risk (and besides, I like this WOE), thus I am unwilling to follow his advice.

I saw on the TSH of 9! thread that there is someone with a list of doctors that treat the adrenals. I have not yet gotten those cortisol or ferritin tests. I ran out of courage when talking to my nurse practitioner -- she is a nice person, but doctors scare me, with perhaps some reason. They are capable of doing harm with the best intentions, which is why I'm doing so much work to understand this situation myself.

My doctor suggested that I get a new cholesterol test & also a test for apoB (measures the number, and hence the size, of LDL) and also a test for Lp(a) (which is strongly correlated to heart disease). Then he would like me to get retested in late Jan & see him again near the beginning of Feb. I think I'll also try to get the cortisol & ferritin test from my nurse (who I am seeing for my annual). If the trend line on my TC is down, I may ask the endo for a course of Cytomel, to see what it does.

I would like to find a doctor who has a clue here. So far, there have been 5 people with decades of experience who have all said that they have never seen this happen before. That is some thousands of patients, so it must be somewhat rare. However, there are three people or so on the forum who have had it happen, so that strongly suggests it is a rare response to low carb. It might, maybe, be a response to heavy cream (which would be sad, because I like it), but even if so, it would still be rare.

The long and the short of it (long, mainly, in this post ) is that I think your idea is the most plausible I have heard yet. I was going to say that both T3 and rT3 are in the middle of the reference ranges, but not so, T3 is right at the bottom (ref range is 2.3 to 3.9, value is 2.4).

I think you said at some point that your doctor was giving you T3 and it should bring your TC down -- did that work (I hope)?

I shall keep digging, because it is the kind of person I am, but in the meantime, thank you VERY MUCH for the info you have provided. I would never have figured this out on my own, or even had a clue to look in the direction of thyroid.

Thanks again, Beth

Hello Beth, I just wanted to say I am sorry about your baby having died and the rough time involved with your health.

Good luck with your thyroid!

Hey, Beth -- I was getting kinda worried about you, so I'm glad to see you back.


Okay, then -- that means your FT3/rT3 ratio = 11. It should be at least 20. So yes, your high cholesterol is indeed being caused by a peripheral thyroid hormone problem. Your T4 should be converting to T3 via an iodine molecule on the enzyme. In addition to the newly created T3 entering your cells to regulate metabolism, it also signals to liver that there is sufficient cholesterol in your body. Since without enough cholesterol every cell in our body would loose coherence and we'd collapse into a puddle on the floor -- sufficient cholesterol is a priority for your body.

But instead of this healthy process, what's happening is the the T4 is converting to Reverse T3 instead, by using a mirror-image reverse iodine molecule. This molecule can NOT signal the liver that there's enough cholesterol, so more and more and more is made, even though it's not used. If you had enough T3 reaching your cells (doesn't matter what the 'range' says; if it doesn't reach your cells because the receptors are blocked it's as if you had none at all) your excess cholesterol would quickly be converted to bile and fatty acids that would excreted from the body. Instead, your body is storing it because it's not getting the signal it needs to do otherwise.


Which means zip. Nada. Nothing. Range only says how much there is in the bloodstream, and not what it is in relationship to T3. That's like saying you have sufficient insulin to handle any glucose you eat. If your cells are insulin resistant, all that energy goes back to the liver to be turned into stored adipose fat. What you need to do is either have the rT3 cut in half, or have your FT3 double.


You need a new doctor. Seriously. This person can do nothing for you. You now know far more than he does. And thus there's no point in 'arguing' with him, since he would have to actually get educated in order to understand what you say to him.


Unfortunately, you will need the results of both tests before you can begin treatment to clear our your rT3 and let the T3 reach your cells -- which will lower your TC.


Not necessary, though if he is willing to order your ferritin and SALIVA (not serum) Cortisol, then fine. The TC and APO will show what you already know,


I doubt you'll get it. Nor should you take it until you know what you're doing, how to take it -- and depending on the results of ferritin and cortisol -- that you can take it without harm. Getting the C without him will be no problem; write me privately, but only after you have the results of the two tests you need.


It's not rare at all. But you've just proven that even if hundreds of their patients did have the problem -- they wouldn't have recognized it. How do I know this? Your doctor didn't recognize it in you, even after looking at your blood test results! Hello....


Again, when you say "T3" do you really mean Free T3 or Total T3? If you mean Free T3, you have to write it like this: FT3 -- so folks will know what you mean.

So if you mean your FT3 is at the bottom range -- and it needs to be in the top third of the range for your cells to get it -- you have just demonstrated again why being 'in range' on these tests is a meaningless measurement, and what you need someone who understands this to interpret the tests and treat you properly.


*I* gave me T3, thank you. And I just took my blood tests this week. Should have the results two weeks from now, and although I've only been on T3 for a month, will be thrilled even if the TC hasn't gone up -- as it has on every single test for the last 3 years.

Beth, you definitely have a Reverse T3 problem, but as you can see you'll need to get some tests done before you can do anything about it, and you need to start getting educated about this specific problem. PM me for more info.

Also, you now need to do a temperature chart for a wide variety of reasons, also before you begin treatment, and then during. Here's what you do:

Take your temperature 3 hours AFTER waking. Take it 3 hours after that, and 3 hours after that. Do this for one week and post the results here, in F not C, like this:

Monday: 3-hr: 97.8 6-hr: 98.0 9-hr: 98.0 (avg: 97.9)
Tuesday: 3-hr: 97.6 6-hr: 98.2 9-hr: 98.0 (avg: 97.9)

Etc.

This will provide a LOT more information about what's going on.

Lisa

Hi Lisa,



Thanks .:-)



Maybe. I think it is likely that it is more closely related to the amount of carbs I have been eating than to the amount of fat, though I have not yet reviewed my food log in detail. The TC went down by some 11% & I think the only major change was the amount of carbs (I compensated by drinking less wine in that period).



Yes ... well, I suspect the war on cholesterol is misguided. :-)



The next thing I would like to understand, if possible, is the relationship between carb metabolism, the feedback that sets the cholesterol level & thyroid signaling. I don't know if the info exists, but I can look.



Yes, I don't think he has much to offer besides repeated testing. It was worth a try though. Also, I don't know if I am likely to find a doctor that could actually help.



Ok, it'll be a few weeks.



They could not fail to recognize a jump from TC of 188 to 460. I believe them when they say they haven't seen that before. :-)



Yes, FT3.



Wow. Good luck!



I know my temp tends to be low, it has been for at least 5 years. It doesn't bother me, at least I don't feel cold or tired either one.

Thanks, Beth

[QUOTE=Beth1708]Hi Lisa,


Your high TC is related to neither carbs nor fat, though I can understand your reasoning.

However, eating lots of fat does not give you high cholesterol. Eating high cholesterol foods does not give you high cholesterol. Finally, eating lots of carbs does not give you high cholesterol --- though it does give you high TG's and very very bad LDL.

Sorry, but you're conflating concepts that have no biochemical relationship. A book that will at least teach you all about cholesterol in general, is Dr. Malcolm Kendrick's very excellent: "The Great Cholesterol Con" which you can get on Amazon. There's another book with the identical title, but it's Kendrick's book you want.


There's an enormous quantity of info out there about exactly that.


They could, and they do. My doc said exactly the same thing to me, in almost the exact words. They see the jumps all right (it's fairly common) -- but of course they, in their abysmal, uneducated ignorance and steadfast believe in Ancel Keyes' "Lipid Theory" -- think it's diet. Eating all that fat, doncha know. So when they see those people, they just put them all on statins. Far easier to treat a number than a patient.

And when, after a few years, the statins fail to work, they just blame "patient noncompliance. They've actually written papers on this in medical journals. I know, I've read them.


Then I have a piece of the original Brooklyn Bridge I'd love to sell you.



It should. It foreshadowed your TC rise, and is yet another biological marker that you are hypothyroid, even without any other symptoms. Deb had no symptoms at all -- and then got a TSH of over 9! Very hypo indeed.

In other words, Beth -- your metabolic system is ill. It will continue to get worse until you take steps to heal it.

Lisa

Hi all,

I got back a new set of cholesterol numbers. TC 299, LDL 177, HDL & TG basically unchanged. Being mathematically oriented, I plotted them & did a least squares fit -- it is pretty much a straight line drop in LDL which should cross 100 (if it gets that low) sometime in Jan. It will be retested at the end of Jan. If the LDL is in what they call the normal range (which seems to be 1/2 a standard deviation below the mean, absurd imho), I shall call this fixed.

In the meantime, I think medicine has painted itself into a corner. Their thoughts on lipids may be an interesting study in sociology for the ages, but very possibly dangerous for those alive today.

Beth

This is, unfortunately, true.

Patrick

Reading this thread makes me appreciate how knowlegeable we are here.

BTW, I went back & looked at my food logs. I was tested & got a high reading, then retested & go a 16% or so lower LDL reading. In the month between the tests I had added more carbs & lots of CoQ10 to my diet, so I conclude that one (or both) of those things is what is causing the LDL to come down.

It seems that there is some agreement that low carb can cause low T3 which can cause high cholesterol. I don't know if that is what has happened to me, but it is a possible explanation.

Beth

So Beth....exactly how many carbs are you having now? What sources are you getting them from? Have you found out whether you are going to be prescribed T3?

This has been the most informative thread I have ever read!

Angie

According to FitDay, about 175. I think this is way too much --- I intend to cut back after the next dr visit. I just don't want to change anything right now, so I can compare apples with apples for the next set of test results.

Vegetables, fruit & 1/2 cup of oatmeal a day. I'm going to drop the oatmeal though.

No. This problem seems to be fixed & in the process of resolving.

Thanks. [I think, I would rather be reading this thread than writing it. ]

I wrote a really long & detailed post on my blog , but here is the summary of what I have found out.



Also, from something I read on another blog, having one's cholesterol go through the roof is something that happens to a few people on low carb. I suspect there is some feedback mechanism that goes wonky. For example, here's a theory:
- Low carb pushes LDL towards pattern A (large, fluffy, good)
- Pattern A increases the need for CoQ10 (which is packaged with LDL)
- Increased need for CoQ10 increases mevalonate production, which is a precursor to both LDL & CoQ10.
- Increased mevalonate increases the amount of LDL.
- Increased LDL increases the need for CoQ10

Repeat the last two steps until there is enough CoQ10 & a LOT of LDL.

I'm not saying that is what did happen, just that it's an idea.

Beth