Reverse T3 dominance

[Tallchad]

Hello. I hope someone can help.

I have the following numbers:

TSH 2.56miu/l (0.27-4.2) so middle

Free T3 4.1pmol/L (3.1-6.8) so low end

free T4 17.6 pmol/l (12-22) so middle

Reverse T3 25ng/dl (10-24) so high

T3/rT3 I calculated as 10.6 so VERY LOW (20 is supposed to be threshold)

Iron, folate, antibodies, Vit D all okay, and I have tried selenium, zinc supplementation.

I have low but very stable basal temps (96.1C)

My symptoms started 10+ years ago after a period of excessive marathon running and never got better. I believe I have RT3 dominance, and my body is stuck. I would like to try SRT3 approach where yo slowly build up, then slowly wean off to reset the system

I have tried the holistic approach, with an excellent nutritionist, gluten free, leaky gut etc, but it hasnt fixed the issue, I just feel tired, lack motivation and drive, feel down, no lust for life

[mourneadventurer]

Personally I’d increase the T3 slightly and focus on the reverse T3 and where the inflammation is coming from that is causing it to be so high.

CRP is also a useful marker to monitor.

Your T4 doesn’t appear to be swamping your system and thus converting to contributing/converting to reverse T3.

The Invivo GI Map Test I found to be most helpful in pinpointing the active foreign RNA in my GI tract which was causing untold inflammation havoc with me.

I am not medically trained just someone else on the journey... Best Wishes.

[SeasideSusie Remembering]

I agree with mourneadventurer.

It's not too much T4 making rT3 rather than FT3 that's causing your reverse T3.

High rT3 can be caused by many things, apart from poor conversion. You could have low FT4 and still have high rT3. It could be caused by low ferritin, or high cortisol, by an infection, by low-calorie diets, etc.

General information that may or may not apply to you but illustrates the many causes of rT3:

Conditions that contribute to increased Reverse T3 levels include: Chronic fatigue, Acute illness and injury, Chronic disease, Increased cortisol (stress), Low cortisol (adrenal fatigue), Low iron, Lyme disease, Chronic inflammation. Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Lyme disease. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.

I don't think that rT3 just 1 point over range is a particular problem. When I had very over range FT4, low in range FT3 - so an obvious conversion problem, my rT3 was 22 (10-24). I added T3 to a lower dose of Levo and when retested 6 months later - on 31.25mcg T3 with Levo - my rT3 was 29 (10-24) and my FT3 was 75% through it's range. So the addition of a decent amount of T3 didn't lower my rT3, whatever was causing it was still there.

As slow release T3 isn't available in the UK, and most members here are from the UK, you may not get much helpful information, unless there are any US members who respond who are more familiar with slow release T3.

[Tallchad in reply to SeasideSusie]

I have read that the ratio of FT3/RT3 is important. I calculated mine as 10.6 and healthy is 20 or above.

stopthethyroidmadness.com/r...

[SeasideSusie Remembering in reply to Tallchad]

How did you calculate it? Were the units of measurement the same?

I have seen articles about how to calculate the ratio and they never seem to work out and don't make a lot of sense. If you want a ratio then do a test where the ratio is given with the results, that's the only one you can rely on.

But it still doesn't tell you why you have very slightly raised rT3. It may resolve itself without any intervention depending on what the cause is.

[Tallchad in reply to SeasideSusie]

Hi they are different units, but I found a calculation converter, and its definitely correct (I have double checked). I wonder what the cause might be, I have tried selenium, zinc etc but hasnt helped. I wonder if it might be an iron issue so am thinking order the 4 tests for iron, and I know I have high evening cortisol.

[SeasideSusie Remembering in reply to Tallchad]

It could be anything in the long list of possibilities I posted before. Sometimes we just don't know and it resolves itself over time.

[greygoose]

I would like to try SRT3 approach where yo slowly build up, then slowly wean off to reset the system

I have never heard of such an approach - where did you hear that? And I cannot see how it would work. As far as I know, it is not possible to reset the system. I would appreciate more details.

[Tallchad in reply to greygoose]

Thanks for your replies. I am not on any thyroid medication at all. Greygoose its treatment for Wilsons Temperature Syndrome

wilsonssyndrome.com/restore...

[greygoose in reply to Tallchad]

Wilson's Temperature Syndrome has been called into question many times. Wilson appears to have had so very strange ideas - like resetting the system! Dubious, at best. Why do you think you have Wilson's Temperature Syndrome, and not hypo? Your TSH is too high, and your FT3 rather low. Start taking T3 and then trying to stop it could possibly leave you worse off.

[Tallchad]

I think I have it because it was a major stress that started my hypo symptoms (Wilson refers to this). I am open to any other ideas on how to lower RT3, and raise T3 (i.e. improve conversion). Do you think my low T3 is causing the slightly raised TSH?

[greygoose in reply to Tallchad]

Obviously low T3 raises TSH. That is what TSH is for - Thyroid Stimulating Hormone, a pituitary hormone. When the pituitary senses that there is not enough thyroid hormone in the blood, it releases more TSH to stimulate the thyroid to make more thyroid hormone. When, the level of thyroid hormones rises, the TSH decreases.

But, your main concern should not be to lower rT3. The rT3 itself is not the problem. It is inert, and only stays in the body for a couple of hours before it is converted to T2 and then to T1, and the iodine recycled.

And, you cannot even know if you have a conversion problem at the moment because your TSH is too high. What you need to do is take levo (T4) to bring your TSH down to 1, and then see what your conversion looks like.

Your FT4 is not high enough for your conversion to be the cause of high rT3, it is caused by something else - low ferritin, high cortisol, whatever, there are many possible causes. Something is wrong and you need to find out what it is, because it has nothing to do with your conversion, therefore just taking T3 will not solve the problem. T3 is not a general cure-all, and you should only take it if you need it. So far, there is no proof that you do need it. And, it certainly won't 'reset your system'.

I'm afraid you're barking up the completely wrong tree.

[Tallchad in reply to greygoose]

Thanks Greygoose. My cortisol is bordeline high in the evenings and I always wake early (3am) and struggle to sleep more than 6 hours a night

. A possible cause do you think?

[greygoose in reply to Tallchad]

Definitely a possible cause. What is your cortisol like in the morning?

[Tallchad in reply to greygoose]

Hi Greygoose in the morning it is 12nmol/l (range 6-21) on waking then it is 4.0 at noon (range 1.5-7.6) then 4.2 at 4pm (0-5.5) and 2.0 before bed (0-2)

[greygoose in reply to Tallchad]

It is a little low in the morning - although not worryingly so - and it is only a little high at night. You would be better off trying to raise your morning cortisol, rather than trying to lower your bedtime cortisol. You can do that by having a high protein meal as soon as you get up. And, make sure you get plenty of vit C, B vits and salt.

MaisieGray has given you a brilliant response about the reason for waking at 3 am.

[MaisieGray in reply to Tallchad]

What can be going on with the 3am waking is that the brain is highly active at night, transforming short-term memory into long-term memory and carrying out repair and regeneration, and it depends on a steady supply of energy to do these tasks. When you sleep at night your body goes into a fasting state. In order not to deprive the brain of the food it needs for energy, the body compensates by gradually raising cortisol. Cortisol stimulates the body to release or create glucose to supply the brain with energy during the night-long fast. Chronic low blood sugar, however, throws a kink in this process. People with hypoglycemia tend to have difficulty making the right amount of cortisol at the right times of the day or night. They also have blood sugar levels that spike and then crash throughout the day. If they go too long without eating they experience lightheadedness, irritability, shakiness, a spacey feeling, and other symptoms that signify the brain is not getting enough glucose.

In these cases, not only does blood sugar drop too low during the night, but the adrenal glands don’t produce enough cortisol to keep the brain fueled. In response, the body sounds the emergency alarm by releasing "fight-or-flight" hormones. These stress hormones raise blood sugar back to a safer level. Unfortunately, they also raise stress, which can cause anxiety or panic in the middle of the night. Hence the waking up at 3 a.m. and not being able to fall back asleep. With Hashimoto’s, this situation can of course, also further imbalance an autoimmune condition and aggravate your thyroid condition.

A quick fix for waking up at 3 a.m. can be as simple as eating a small amount of protein, with perhaps some fat - a spoonful of nut butter, a little bit of meat, or a hard-boiled egg. For some people this raises blood sugar to a healthier level and sustains it so they can fall back asleep. It's best not to eat something sweet or starchy because this will just cause blood sugar to spike and crash again.

[Tallchad in reply to greygoose]

Hi I have just ordered an Iron test (all 4 tests). I had thought that although rT3 is inert, it binds to the same receptors as Free T3, therefore blocking Free T3's effect?

[greygoose in reply to Tallchad]

No, rT3 has it's own receptors. Before, we used to think that it blocked T3 receptors, now we know it doesn't.

[Tallchad in reply to greygoose]

Thats interesting. Can you send me a link to something on that Greygoose? I would like to read more

[greygoose in reply to Tallchad]

No, sorry, I don't have a link.

[Tallchad]

By the way, I have no inflamation (CRP very low)