On syn. 50 mcg labs are: TSH 4.45; rt3 23.3; T4 10.4; t3uptake 30; free T3 3.1; triiodothyronine T3 121. Increase synthroid (thyroxine)? Don't sleep, fast heart.

See your doctor. If you are having issues with sleep and a fast pulse, you should see your family practice physician. Think of TSH like a flagpole. If it is high, you may need more thyroid hormone. If it is low, you may need less thyroid hormone.
RT3 high? RT3 looks high, but need units to confirm. Must calculate FT3/RT3 ratio. More info on: http://sufairchild.com/ENDO/thyroid.htm But increasing synthroid (thyroxine) would probably be the wrong thing to do if RT3 is already high.