Endo has told me today and I have also come across this information that taking too much T3 either at once or in separate doses makes the body raise reverse T3 as a defense mechanism.
Is this true?
What's your experience?
T3 raising reverse T3: Endo has told me today and... - Thyroid UK
T3 raising reverse T3
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YulianaRossenova
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Not sure if thats true, but all the information I have read about says T3 actually decrease reverse T3
YulianaRossenova,
Medicating T3 will NOT raise RT3 but reduces it. Reverse T3 is only covered from T4, NOT T3.
We all need a little reverse T3 to balance T3, preventing us from having periods of feeling hypo and helping clear unused T4 from the body. Elevated RT3 is created from low cortisol, low iron and elevated oestrogen & other sex hormones, blood sugar imbalances, nutritional deficiencies, etc ....
In emotional, psychological or physiological stress, the body will convert excess T4 to reverse T3 (rT3) as a means of conserving energy for healing and repair. T4 is converted by the 5-deiodinase enzymes (Type 1 & 2 ) into T3 or via the 5-deiodinase enzymes (Type 3) into RT3.
Your endo does not understand thyroid psychology as the underlying causes must be addressed first or will just continue to perpetuate further RT3 production. Most doctors (& even endos) will not understand the free T3/RT3 ratio or a thyroid physiology that includes the deiodinases’ activation and deactivation. D1, D2, and D3 vary in different tissues among different individuals and the amount of medicated T4 and T3 must be considered as they have different half lives.
The prime diagnostic for RT3 issues is the ratio of Free T3 to Reverse T3. Your problem is finding an endo who not only can interpret RT3 test results but knows how to treat it.
Medicating too much T3 will mess up your sex hormones as encourages higher levels of protein carriers that hormones will bind to, so becoming inactive.
radd,
There is, though, an argument that the presence of sufficient (or excess) T3 will push any conversion of T4 towards rT3.
This would not occur if there is no source of T4 - whether your own thyroid or taken as levothyroxine or desiccated thyroid. Assuming there is some T4 available, it does seem feasible.
Just because there is an argument doesn't make it a proved case!
helvella,
So you are saying there is the possibility that the OP is producing some T4 of his own and converting enough T3 to make the further medicating of T3 too much ? ? ....
Uummm .. . .. I am too wrapped up in my own issues where I have absolutely no thyroid activity but guess this to be possible but only proven if FT4/FT3 levels were to be tested and all symptoms, deficiencies, etc, considered ....
Good argument ... and one I had forgotten to consider ! ! ! ... ;o)) ...
Thank you....
helvella,
Do you have any available literature on this argument please ? ? .
Sorry - I haven't. Have read it a few times around the place, including in posts/responses here.
Makes sense as a thought experiment (up to a point) but I too would like to see proof it really happens.
This is from Dr Lowe re RT3 and go to the date March 24, 1999
Ohh, I am getting more and more lost. It seems to me I will never get better. I am on 75 mcg T3 and still hypo, although about 70% better. In the last two days I have started experiencing very short episodes (5 min) of elevated heart rate (90-100) 3-4 hours after taking my morning T3 dose, which is weird as I am still hypo. I have a very slow heart rate due to hypothyroidism - in the 50s, 60s and have forgotten what it is like to have a normal heart rate. I also suffer from horrible skipped beats (my most pronounced and first ever hypo symptom) which really greatly lessened on 75 mcg T3.
"Elevated RT3 is created from low cortisol, low iron and elevated oestrogen & other sex hormones, blood sugar imbalances, nutritional deficiencies, etc .... "
I am going to get a 24-hour saliva test. I know my iron is good, top 1/3 of the range, but my ferritin is low, I have estrogen dominance due to progesterone deficiency right now which can be caused by my low thyroid actually...
"Medicating too much T3 will mess up your sex hormones as encourages higher levels of protein carriers that hormones will bind to, so becoming inactive."
What if medicating too much T3 is not enough and the person is still hypothyroid. In this case does too much T3 (but not enough for the person) mess up sex hormones?
I have been synthetic T4 free for 2 weeks now, but my own gland is still producing quite an amount, enough to even keep my FT4 in reference range.
My endo was talking about D1, D2, and D3 today. That is the best endo I have been able to find, compared with the rest of them.
I hope I don't have some sort of resistance, although I might since 75 mcg T3 is not a small amount and I definitely need more...
"Elevated RT3 is created from low cortisol, low iron and elevated oestrogen & other sex hormones, blood sugar imbalances, nutritional deficiencies, etc .... "
rT3 isn't 'created' from these things - how can you create anything from low iron? But these things are factors in the conversion of rT3, rather than FT3.
shawsAdministrator
No is my answer. In fact as he is an Endocrinologist he should know the answer himself and as he is ignorant and tries to frighten patients due to the present cost of T3 they want to stick to levothyroxine which, in my case, is absolutely useless.
I take my T3 in one dose and I am well and energetic. Not bedridden as I was at one time.
web.archive.org/web/2010103...
It's almost a certainty Endo doesn't know that T4 converts to RT3 and then into T3.
This is a link which is now archived as Dr Lowe died but the information is excellent. He himself took 150mcg of T3 daily and he was fit and well.
web.archive.org/web/2010103...
Go to the date March 24, 1999 on the following:-
web.archive.org/web/2010103...
Some of the other topics might be unavailable.
Shaws, thank you!
I have acquainted myself with Dr Lowe's work, have read everything you have given me. I feel inclined to try taking T3 in one dose but I am scared since my morning 25 mcg dose has started elevating my heart rate. Weirdest thing is my afternoon and evening doses do not produce that effect. They all are of same amount - 25 mcg X 3 times a day.
How much T3 do you take? What has made you decide to take it in one go?
My endo told me not to take T4, she wants me on T3 only, however she stated that 75 mcg T3 is a rather hefty dose. I am still hypo...
Maybe 25mcg is too low dose and why your heart is playing up.
I had all those symptoms on levothyroxine but not on T3. Sometimes it could be fillers/binders in the product which is the problem.
I am not medically qualified and my dose is between 45 and 50mcg. It is a daily dose but suits my body.
Now that you mentioned I had those symptoms on levothyroxine but only for a month. My heart would play up terribly 2 hours after taking T4 and I would get sweaty all over. And I was still hypo (despite the racing heart)!
Also I get daily shakes (mainly in hands). I have been getting those for over a month now, long before I ever started T3, actually I started getting the shakes when I was on no medication for thyroid. I am wondering if this is another symptom of hypo.
Shaws, you are lucky to have such a small dose heal your symptoms.
Hoe long have you been on it before the symptoms went completely away?
Hasn't multi-dosing worked for you?
Or you just didn't like the idea of taking a medication more than once a day?
For me, T3 was instant. Palpitations were my worst experionce (before T3) and they calmed immediately on the additon of T3 to T4. Endocrinologist didn't like my blood test and told me to stop T3. I said 'no' so she said reduce T4 which I did but decided to go my own way with the help of TUK (no forum then).
Try taking an antihistamine 1 hour before you take T3. If you don't have that reaction then you'll have to change the T3 as you are sensitive to somethng in it. Our heart needs thyroid hormones and mine struggled before being diagnosed (TSH was 100) then on T4 (except I wasn't aware why it was happening).
I started on half a tablet of T3 and about every week added 1/4 until I then stated having unpleasant sensations, then dropped back to the previous dose. I only have a yearly blood test now.
I haven't split doses as I would be unaware (I believe) of my body's response as I titrated up.
Also, as you know, some people's cells are resistant.
Do you refer to skipped beats when you say palpitations?
Where can I buy T3 online?
What unpleasant sensations did you experience when upping T3?
My skipped beats are still there, although greatly reduced in number. However I had almost 20000 per day, now having about 100-200 feels like heaven.
Can I take T3 at night?
It feel like when not taking T3 at night my body becomes too hypo again by morning. I can tell so by the skipped beats which are and have always been at their worst in the evening and in the morning, when FT3 levels are highest judging by its circadian rhythm.
I think you should have an ECG to make sure your heart is fine. My ECGs were always good as my palpitations had stopped by the time I got to hospital.
Palpitations are different from skipped beats.
Palpitations are continuous for a period. At times mine were 140+. An ambulance was called several times.
Skipped beats are not the same as palpitations.
If I were you I'd miss today's dose and start again from tomorrow at the very beginning.
I said I took 50mcg but it is actually 1/4 tablet less as my body reacts to 50mcg but not to the lower dose.
My heart reacted to levothyroxine with skipped beats/palpitations.
Read the two questions from June 11, 2002
web.archive.org/web/2010103...
Doses are very individual.
You would have to put up a new post asking for a Private Message to be sent to you with info of where to source T3.
My heart is fine. I have done thousands of ECGs and holters. I only experience skipped beats due to not enough hormone, not from medications. When taking T4 at the very beginning my skipped beats disappeared when I was on 50 mcg. Now, at 75 mcg T3 my skipped beats have been reduced by 70-80%. My skipped beats are just one of my many symptoms of hypothyroidism.
I see now. So I don't experience any palpitations. Yet.
I'm glad your heart is fine. The aim of replacement hormones is to relieve all of the clinical symptoms but that's easier said than done at times. I hope you achive that soon.
Shaws, Dr Lowe used to take his 150 mcg in the middle of the night. Do you happen to know whether he was using the CM?
The CT3M is an approach that was devised by Paul Robinson - a patient - originally just for himself, only a few years ago. Dr Lowe had been taking his at night for many years.
Thank you, Helvella. I have not made myself very clear. I meant to ask whether Dr Lowe took his T3 at the four-hour cortisol production window or at any other time?
I have had a look at FT3 circadian rhythm and FT3 peaks and then starts falling right before cortisol production begins.
Do you know by any chance?
Dr Lowe was Thyroid Hormone Resistance and these are two links which may be helpful.
Without more info on your levels n ranges, I'm guessing your increasing T3 as you seem to crash and need more every 1-3 months? If so you've got an adrenal problem, and the need to keep increasing is from the extra workload the adrenals are putting on the thyroid... So need either a 24hr saliva test, or at the very least a 9am cortisol test at that time you ought to be in the 3rd quarter of the range... Hope that helps...
Aren't cortisol levels lower when one is on T3?
I've not been on T3 myself but experienced the scenario above, but things need to be in balance via the HPA (hypothalamus pituitary adrenal) axis. And as explained to me is if your levels need to be constantly raised after a period of feeling better, it's a sign the adrenals are involved as the adrenal fatigue forces the thyroid to work harder. And since I've spent more time reading up on adrenals
I'm convinced that in at least 70% of hypothyroidism adrenal fatigue was/is the primary cause, and hypothyroidism secondary. It's just that the thyroid is checked for first without taking the adrenals into consideration, as the thyroid compensates for a while before it becomes fatigued because of the low adrenal function. Another indicator is a high RT3 to slow the body down to try and heal, it's one of the fail safes to keep us alive...
Thank you, Roadrunnergreg.
Ummm.... shaws "It's almost a certainty Endo doesn't know that T4 converts to RT3 and then into T3." I think, actually, the rT3 converts into T2, not T3. You can't stick an atom of iodine back on. 
Thanks Dr Lowe says very similar to you.
Most thyroid researchers today argue that T4 is a storage form of T3. We believe that T4 exerts metabolic effects only after the enzyme 5'-deiodinase removes the fourth iodine atom from the T4 molecule. Removing the iodine atom, of course, converts T4 to T3.
Or, to rT3, if the wrong molecule is removed. But, what I'm saying is that rT3 cannot then become T3, as you said, because that would involve sticking the atom of iodine back on, and removing another one. And you just can't do that. I thick even modern thyroid researchers would agree with me on that one! lol
The raw material that is needed to make T3 and reverse T3 is T4.
If the body has plenty of T3 for any reason then any T4 in the body (produced naturally or from thyroid meds) is likely to be converted to reverse T3.
BUT - if T3 is taken in high enough quantities, and no T4 is taken in meds, then it will block the thyroid from producing T4, or T4 will be produced in tiny, tiny quantities, so in those circumstances there will be little or no raw material for producing reverse T3.
I take T3 only, no T4 or NDT. The lowest my Free T4 has ever been is 1.94 pmol/L with a reference range of (12 - 22). Despite this my Free T3 was only quarter of the way through the range. I didn't have Reverse T3 measured at the time I got these results but I'm betting it would have been very, very close to zero. There wasn't much of the raw ingredient (T4) around for my body to make reverse T3 out of.
So, I will not be able to get out of this hypo circle any time soon. My thyroid is still producing quite an amount of FT4... 
"BUT - if T3 is taken in high enough quantities"
What are considered high enough quantities, or it depends on the particular person?
Hi Yuliana,
Getting your T3 level right is, unfortunately, only one part of a complicated 3 sided equation involving ovaries and adrenal glands. All 3 are interconnected. Your adrenal glands have probably been causing your heart rate anomalies. Weird responses happen with adrenal fatigue and the symptoms have similarities with hypothyroid. Any idea of cortisol levels? I suspect they will be low.
Your T3 dose seems very high. I have no thyroid and take around 37 mcg T3 only. Everyone is different but excess T3 is toxic to the heart. You still appear to need more (going by your FT3 results) so it may be that you need to look at autoimmunity issues - many people seem to get good results from lowering their gluten intake. Sounds unlikely, but seems to work.
Don't get dispondant. You will solve this problem.
Sorry, I seem to have made an assumption about your FT3 levels. Do you have a figure?
And, yes you need T3 at night. As you are having difficulties and weird symptoms I would say it is better to split your dose into 3 or even 4. I have tried all different variations, but have settled on taking the largest bit in the morning, then an extra little bit around teatime, then the rest at bedtime. Taking too large a proportion before bed can be overstimulating. Your body is asking for lots of T3 overnight, but unless you are nocturnal bedtime is the closest you can get!
T3lover, I have never had my cortisol checked. In my country no one ever does that. I will get it checked next week or in January.
I think it doesn't matter what my FT3 level is, since I am still hypothyroid. Apparently my T3 does not reach my cells.
I found it best when one night I took 25 mcg T3 right before going to bed.
I take my T3 at 8 am,12 and 5 pm.
I am almost 100% positive that my skipped beats stem from too little FT3, since they were my first and foremost hypo symptom and they used to disappear on T4.
However my shaking hands can be related to adrenals.
I have never had a very high TSH, even when diagnosed my TSH was at 2.9.
I do have Hashimoto's. My B12 is above mid-range, Vitamin D is near 100, folate is above mid-range. Ferritin is bottom range though, my iron is high in range. I am 5 months post pregnancy and my iron used to be bottom range after I gave birth, now it has returned to upper range. I cannot take any iron since it will well overpass the upper range... I hope that my ferritin will come up a bit too.
Thyroid medications used to have an effect and remove my hypo symptoms even at lower D, B12, etc during pregnancy.
I have no antibodies.
Here's a link on iron for you, but seeing as some of your nutrients are low, stomach acid being low can be the cause of the problem...
No, don'tr see how that can be true as RT3 is made from T4 not T3. It is possible if you are taking too much T4 (as well) that it will raise RT3 as there is no need to turn the T4 into T3.
Thank you for your replies.
I've just read your first post where you gave lots of results : healthunlocked.com/thyroidu...
Your results are unusual. You often have very good levels of Free T3 and Free T4 and yet your TSH is surprisingly high.
I can't tell you what your problem is, but I can make some suggestions that you could follow up or ignore as you choose.
1) Reverse T3 - I didn't see a result for you for reverse T3. From personal experience I know that Free T4 and Free T3 can appear to be good while reverse T3 is very high indeed, which will make you feel very hypothyroid. For one suggested treatment of very high reverse T3 (high doses of T3 only) I suggest you read this website - the website is amateurish but worth the effort.
2) Palpitations and fast heart rate can be caused by low iron and ferritin. In order for the body to use thyroid hormone properly (either produced naturally or taken in pill form), optimal levels of iron and ferritin are essential. It is also essential to have optimal levels of vitamin D, vitamin B12 and folate.
3) Adrenals - low cortisol or high cortisol will affect the thyroid and the body's use of thyroid hormones badly. Doctors usually test cortisol with a single blood test taken in the morning, or worse still at a random time throughout the day. Since cortisol production has a natural circadian rhythm a single result tells you very little. Also most of the body's cortisol is bound to transport proteins and it is unusable in that form. It is unbound cortisol that we need to know. To test unbound cortisol the best test is a saliva test which is carried out at 4 different times throughout the day. It tells you levels of unbound cortisol and also tells you something about how well the circadian rhythm is working. On the subject of low cortisol and reverse T3 this website is worth reading :
4) Sex hormones and the thyroid - the fact that you have severe endometriosis and PCOS suggests that your sex hormones are not at good levels. I don't know anything about sex hormones but there is a strong relationship between sex hormones, cortisol, and the thyroid.
You may find this video helpful. The voice-over is spoken terribly fast but the pictures are the best bit anyway.
5) Given that you have severe endometriosis and PCOS I assume you have severe chronic pain. That is likely to lead to high cortisol which screws the thyroid up as I previously mentioned.
6) If you want lots of clues about what affects the thyroid, then this is the post for you (it's from another forum) :
forums.phoenixrising.me/ind...
I hope you find something that helps.
I forgot to mention - for adrenal info read the STTM website :
stopthethyroidmadness.com/s...
Look at the articles under the heading "Adrenal related"
Thank you, Humanbean.
"Palpitations and fast heart rate can be caused by low iron and ferritin. In order for the body to use thyroid hormone properly (either produced naturally or taken in pill form), optimal levels of iron and ferritin are essential. It is also essential to have optimal levels of vitamin D, vitamin B12 and folate. "
Since English is not my mother tongue, I used to think that palpitations and skipped beats are one and the same thing.
I do not suffer from palpitations or fast heart rate. I endure terrible, numerous skipped beats due to my low thyroid. Skipped beats are one of my hypo symptoms. My heart rate is in the 50s, 60s due to this illness. When I was healthy it used to be in the 70s-80s.
I do not have PCOS, only endometriosis.
The weirdest thing is that my sex hormones have always been fine, regular periods, etc.. The only time they are not fine is when I experience a little progesterone deficiency due to my Hypothyroidism... Right now I am progesterone deficient as well. Progesterone is strongly related to FT3...
So, it's a vicious circle I don't seem to be able to get out of anytime soon.
I know sex hormones are strongly related to thyroid.
And I do suffer from chronic pain due to my endometriosis.
I know that my results for FT3 and FT4 have always been either mid-range or high in the range (although still hypo), whereas my TSH used to be about 3. The only conclusion I can come up with by looking at these results is that when healthy I used to function at very high levels of FT4 and FT3, top range, or even over range.
The other thing that springs to mind is that I have developed some form of resistance over the last 2 years. It must be some sort of resistance since 75 mcg T3 dose is not enough...
Palpitations and skipped beats often go together I think. Do you get chest pain?
Have you ever had the minerals and vitamins tested that I mentioned? If you have we could tell you whether or not they are optimal.
No, I don't get chest pain. I don't get palpitations, only skipped beats.
I had everything tested. B12 and D were not optimal, ferritin was also very low, but iron - high. I supplement.
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