How to avoid reverse T3?

Is it possible to avoid too much reverse T3? I've been on T3 only for 4 months, and maybe changing to either T4 only or T4 and T3 combination.

History; I was only on Levothyroxine for 5 weeks as it gave me acne I stopped. I was on 75mcg and my FT4 was 16.9 (11-24) and FT3 was low at 4.4 (3.-6.5). My FT3 before thyroid medication is always in the 4's. My FT4 was 12.

I'm wondering whether I should have kept on it, as T3 gave me acne too! I'm not getting better on T3 only. I thought if I add some T4 it might help, but I don't want to have a problem with too much RT3.

5 Replies

  • I think reverse T3 may be rare. This is an extract from Dr Lowe:-

    During one year, I tested 50 fibromyalgia patients to see if they had laboratory values that would suggest that they had impaired conversion of T4 to T3 with elevated reverse-T3. I've also tested other patients since 1994. However, I have not found laboratory evidence of impaired T4 to T3 conversion in a single patient.

    Also, if impaired conversion was the source of the problem in my fibromyalgia patients, they would respond to a normal physiologic dosage of T3. However, most euthyroid fibromyalgia patients require far more than normal physiologic dosages to overcome their thyroid hormone resistance.

    Finally I decided that if some patients' fibromyalgia symptoms do indeed result from impaired conversion of T4 to T3, it is a rare phenomenon. I could no longer justify charging patients for the laboratory tests that would identify impaired conversion. As a result, I don't even bother ordering the tests any longer. This is the reason that you haven't read about impaired conversion of T4 to T3 and elevated reverse-T3 at this Web site or in more of our published articles.

    T3 is the active hormone which goes directly into our cells in a few hours but then sends out 'waves' which effect lasts up to 4 or 5 days. T4 is the inactive hormone and has to convert to enough T3. One dose today takes about 6 weeks to to disappear by gradually reducing each day.

  • Thanks Shaws for the info.

  • It is possible that your symptoms indicate that your dose of Levothyroxine and then T3 were both too low. Your basal temperature is the best indicator of this.

  • Hi Sandy. I'm having problems with my basal body temp. As I'm using a digital thermometers. I have 2 and they have completely different readings! Which is right?!

  • This is from a link which was previously posted, but I've lost the link.

    To do a basal temperature test, it should be done as soon as you wake up and before you get out of bed. In women who are menstruating, their body temperature varies with the cycle; creating errors which can be avoided if the basal temperature is taken on days 2, 3, 4 and 5 of the cycle. Men and non-menstruating women may take their temperature on any day.

    It doesn't really matter which kind of thermometer you use when doing the basal temperature test, although it is important to be consistent in how you do it:

    If using a digital thermometer you should place it under your tongue not your arm – a digital thermometer is not to be relied upon if placed under the arm due to the speed of the reading. Place it under your tongue until the thermometer beeps or buzzes, or for the length of time suggested in the instructions.

    Note the reading, and do it for several mornings so the results can be averaged out, since they may vary slightly day by day.

    If you have taken your temperature under the arm, the normal temperature is:

    36.6ºC - 36.8ºC (97.8ºF - 98.2ºF)

    If your temperature is below 36.6ºC (97.8ºF) then hypothyroidism should be considered if you have symptoms.

    If your temperature is above 37.0ºC (98.4ºF), hyperthyroidism is possible if symptoms are present and if there is no other illness present to cause a fever.

    If you have taken your temperature under the tongue, the normal temperature is:

    Normal temperature is 36.5ºC - 37.2ºC (97.7ºF – 99.0ºF)

    If your temperature is below 36.5ºC (97.7ºF), hypothyroidism should be considered if symptoms are present.

    If your temperature is above 37.4ºC (99.2ºF), hyperthyroidism is possible if symptoms are present and if there is no other illness present to cause a fever.

    This test is a guide only as some temperature variations could be due to infection, virus, etc. This test, used in conjunction with the Thyroid UK Signs and Symptoms Lists, can be helpful.

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