Too much reverse T3 : My recent results show I... - Thyroid UK

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Too much reverse T3

Sineadkots profile image
11 Replies

My recent results show I have too much reserve T3 I'm taking 175 much of thyroxine & optimum vitamins etc , do I need separate T3 medication as I just keep gaining weight 4 stones since my thyroidectomy 9 years ago & I follow a Paleo diet & workout.

Any help please let me no, thank you :)))

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Sineadkots
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11 Replies
Jazzw profile image
Jazzw

What were the results? It'll help if you post them, with lab ranges.

Learner1 profile image
Learner1

Levothyroxine converts to T3, which is active, or to reverse T3, which is inactive.

Your labs would be helpful. How high, exactly is rT3? It would give you an idea of the size of the problem. And how low is free T3? If low, and rT3 is very high, then likely your T4 isn't helping much at all, and the answer would be to take all T3, at least for awhile.

If free T3 and T4 are at the higher quarter of the normal range, do you have high thyroid antibodies? How is your adrenal function?

RT3 is generally produced at times of stress, sickness, infection, lack of sleep, poor diet, etc. so being nice to your adrenals and fixing any problems there is a key to fixing thyroid issues.

Reducing whatever causing the stress on your body, supporting adrenal function, and taking T3 may help. But do look at the entire picture...share your labs if you want help here...

Sineadkots profile image
Sineadkots in reply toLearner1

Thank you for your reply, yes my adrenals are terrible, my inactive T3 is very high hence my question.

I'm really struggling to lose even 1lb !

I'm currently taking supplements to help with the T3 convert, the Adrenals & my diet is 95% Paleo & I exercise.

So I'm doing all the right stuff, I just wonder if only by supplements will these help me ?? :)))

whispers60 profile image
whispers60 in reply toSineadkots

unfortunately working out will deplete any t3 you have very quickly, you need to stop that until you have sorted out the rt3 problem , has as been mentioned, without your results posted people will struggle to give you the correct help

kpl110 profile image
kpl110

I have the same problem. ☹️ I now take a combination T4/T3 pill, Naturethroid. I overall feel better on it than Synthroid only, but also still have weight issues. 😭

silverfox7 profile image
silverfox7 in reply tokpl110

Could you start a new thread and like as advised above post somecresultsxand ranges and tell us how you feel. The more info the easier it is to comment.

humanbean profile image
humanbean

If people have a healthy thyroid and their thyroid hormone gets used up, the body can create more.

But without a functioning thyroid the amount of thyroid hormone you have is fixed by the dose of meds you take.

T3 gets used up by normal everyday living - keeping the heart pumping, the lungs breathing, the liver working etc.

T3 also gets used up by exercise.

With too little T3 available for normal living the metabolism slows down and people put on weight.

Instead of punishing yourself with more and harder workouts, stop doing them, and switch to gentle walking and/or swimming and/or yoga. Your body will have more T3 available for normal living, your metabolism will speed up, and you will feel better, more energetic, and may even lose weight.

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There are other factors to consider...

Have you been trying to lose weight by restricting your calories?

Unfortunately, this doesn't really work long-term. If the body thinks there is a famine it will try to save itself by reducing energy expenditure, thus trying to keep you alive until the famine is over.

One of the ways it does this is to reduce your metabolism. And the way it does that is to create less T3 and more reverse T3, thus setting up the conditions necessary for laying down more fat whenever it can.

If your diet is a high fat, low carb one, then it sounds good to me. You might just have to eat more of it to keep your body's production of T3 to an optimum.

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There are lots of factors involved in determining what proportion of T3 and rT3 the body creates.

High levels of Inflammation is a common problem and will lead to reduced T3 and increased rT3.

Inflammation occurs commonly in the gut in people who are hypo. Many of us take probiotics, make fermented foods such as kefir, sauerkraut, try to get the gut flora as healthy as possible, eat the healthiest diet we can. There are loads of posts on the subject of improving gut health on this forum and on the web.

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Another major factor is cortisol. Too high or too low causes havoc and increases the chance of too little T3 and too much rT3 being made. Unfortunately for us all doctors think there are only three states that can occur in connection with cortisol :

1) Having Addison's Disease

2) Having Cushing's Syndrome or Disease

3) Anyone who does not have one of the above conditions has completely "normal" cortisol levels.

Patients would disagree. (What a surprise!) They generally find that being low in the doctors' "normal" range or being high in the doctors' "normal" range will have major effects on health.

If you look at the two lists of symptoms (for high and low cortisol) at the bottom of this page :

adrenalfatigue.org/cortisol...

you'll notice that both lists have a lot in common. It isn't possible to guess which problem you have (assuming you have a cortisol problem at all).

To test cortisol levels the best test is a saliva test done at four points throughout the day. The most popular saliva test for cortisol on this forum is the one by Genova Diagnostics UK :

gdx.net/uk/product/adrenal-...

Read the various tabs - description, analytes etc, and also read the things listed under Additional Resources down the right hand side of the page.

For more info on how to order, how to get a discount on the price, and how to get your results :

thyroiduk.org.uk/tuk/testin...

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Even when you've got everything working as well as you can you still might be producing too much rT3 and not enough T3.

One way of getting rid of rT3 is to gradually switch from taking T4 to T3. Without any T4 your body has no way of making rT3 (or T3) and eventually, when all the T4 in your body is gone you will only have what is coming from your T3 tablets. It is a sledgehammer solution. Some people do very well on T3 only, some people don't. The ones who don't must have some T4 in order to feel well.

Once rT3 has been mostly eliminated, you could add back some T4 and reduce your T3. Make all changes fairly slowly and when you get a combo of T4 and T3 that suits you, stop there. Easier said than done though...

Bear in mind that there is lots of advice on the web about starting T3 terribly slowly. There are references to taking only 1/4 tablet etc. That might be great for people with a thyroid that still has some function, but just remember that you have no thyroid. You must always make sure you are always taking enough thyroid hormone (of whatever kind) to keep you alive. So, use small reductions in T4 when adding in small amounts of T3. Don't give up T4 altogether and then start with small amounts of T3. You would be in trouble in no time flat.

I have a thyroid and it still works - just not very well. I stopped taking T4 and started on tiny amounts of T3. (I was a novice and didn't know what I was doing.) I started falling over, could hardly walk, my memory vanished, my vocabulary vanished, I almost forgot how to speak. The only way I coped was by increasing my T3 dose very quickly indeed. The number of things I did wrong is enormous. But I was protected (sort of) by the fact I still had a thyroid. You don't. Be careful.

For future reference, based on patient experience, T3 is roughly three times as potent as T4.

So, if you switched from T4 to T3 in slow stages, you would have to reduce your T4 in 25mcg stages and replace each 25mcg T4 with (25 divided by 3) = 8.3 mcg T3.

Obviously, T3 tablets come in 20mcg or 25mcg tablets so you will have to cut T3 tablets up and use approximate doses of T3 to replace your T4.

But if you were to, eventually, replace all your T4 with T3 you could expect to be on a dose of approximately 60mcg T3. But it could be more, it could be less. These approximations are never exact.

Sineadkots profile image
Sineadkots in reply tohumanbean

Thank you very very much for all your advice, yes I had the saliva test & I produce really high cortisol at night which is terrible & the weight gain might be a factor ?

I'm taking Adrenal supplements for 4 days now & hoping for some results soon 😔

Your advice has been very helpful thank you :)))))

sue_b profile image
sue_b in reply toSineadkots

Hi Sinead, which adrenal supplement are you taking?

Learner1 profile image
Learner1

Humanbean had some good advice.

Sounds like your body needs T3, not T4. Take T3, not T4, then. All this slowly switching just makes it more challenging. My doctor has had me switch back and forth from T3 to T4 to T3&4 doses over the years, without doing anything slowly, and uts been fine, as long as the dose is right.

Maybe cut your T4 dose to 75 or 100 and replace the rest with T3 for 3 or 4 days, then go to all T3. Or just go to T3.

As for weight loss, you won't be able to lose weight if your hormones are a mess. Period. Get all hormones measured - pregnenolone, cortisol, DHEA, testosterone, estrone, estradiol, and estriol. A DUTCH test, dried urine test of comprehensive hormones, is the best test I've seen for this.

Figure out if your female hormones are balanced, and whether you might benefit from testosterone or DHEA or progesterone.

Next, look for why your body is inflamed? Food allergy (nightshades?)? Chronic infection? Autoimmune (test ANA antibodies)? Toxicity?

You might try Interplexus Seriphos for your adrenals. I've seen it work wonders for people with different cortisol problems. And Vital Nutrients Adrenal Support has the strongest combined glandular and adaptogenic herbal formula I've seen.

And try a Thorne Research multivitamin, a Stress B Complex, and additional vitamin C and B5.

Don't overdo exercise, keep it moderate. Be religious about sleep. Keep your good diet and keep coffee and alcohol to a minimum. Add one thing at a time from the above, and gradually things should start to improve and you will begin to lose weight.

Sineadkots profile image
Sineadkots in reply toLearner1

I have to take T4 I had total thyroidectomy 9 years ago , yes thank you for your advise I just hope a little T3 added to my Levo will help with the weight loss 😔

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