How to understand and treating reverse T3 - Thyroid UK

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How to understand and treating reverse T3

Sazzle1969 profile image
17 Replies

Sorry, another post from me today! I have high levels of reverse T3, which I've been told can be caused by extreme stress, but I've also read that severe dieting/reduced carb intake can cause it. Does anyone on here know about reverse T3 and how to deal with it? My nutritionist says it can take a long time to get it right and there doesn't seem to be any clear guidance on medication treatment that I can find - some point to taking pure T3 others a combination of T4 and T3 treatment. Does anyone know if severe dieting can cause it (I lost a lot of weight 3 years ago on a diet then it suddenly piled back on and more about 6 months later and I am now much heavier than I was before I dieted). I have had a long period of stress too, which I am treating now, but would welcome any advice/info about reverse T3 causes and treatment. Many thanks

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Sazzle1969
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17 Replies
greygoose profile image
greygoose

The 'treatment' for high rT3 is to reverse the condition that caused it. And, there can be many, many causes.

One of them is low-calorie diets, but if that's the cause, rT3 should go back into range when you start eating more calories.

If it was caused by low iron, increase iron/ferritin levels.

High cortisol? Lower cortisol levels. Etc. Etc. Etc.

There is no universal pill that can 'cure' high rT3 - which isn't even a disease. It's a safety mechanism. It protects the body when the body is suffering in some way and needs to conserve energy. The body does that by reducing conversion of T4 to T3, and it does that by converting more T4 to rT3, the rT3 is then converted to T2 after a couple of hours, then to T1, and then the components are recycled. Nothing wasted.

rT3 is therefore not the problem some people make it out to be. It doesn't cause poor conversion, it is the result of poor conversion. It doesn't block T3 receptors, it has its own receptors. It doesn't cause symptoms because it is inert.

As for using T3 to 'treat' it. That will only help if the cause of your high rT3 is high levels of unconverted T4. You reduce the dose of levo and add in T3, and the rT3 level will drop. But, if your high rT3 is caused by taking beta blockers long-term, when you stop taking the T3 the high rT3 will just come back.

So, my advice would be to look to your general health: do you have an infection? Are you eating enough calories? Do you have chronic inflammation or Lyme Disease? Take care of these health problems and the rT3 will take care of itself. :)

Sazzle1969 profile image
Sazzle1969 in reply togreygoose

Many thanks greygoose, I don't think I have any infections but I have been restricting calories as terrified about gaining more weight! I have just sent off for a full medichecks thyroid test to see what is going on currently with my thyroid hormones and iron levels - once that is in will post them up here and see where to go next. I think a chain reaction happened in me after severe dieting followed by a big personal shock and stress/and an operation - I think my body nosedived after that - I'm working on the health front to improve things and once the test results are in will see what next steps can be. Thanks for all the help and info - it is demystifying it all a bit for me!

greygoose profile image
greygoose in reply toSazzle1969

You're welcome. :)

mandyjane profile image
mandyjane

Hi Sazzle. Extreme dieting and that would in my book include weight watchers and slimming world can really mess up you body and metabolism in so many ways that can be very difficault to fix. It sounds like you are also undereating again which will only add to the problem long term.You may have to cope with putting on weight to help you body repair so you are in a better place to lose it. I would suggest the first port of call is to normalise your eating. I hope you dont mind a list,

1) Measure height and weight and use one of the online calories counting apps, groups such as weight loss resources to calculate your daily needs. Aim to then eat the same amount of calories as needed to maintain the same weight rather than lose. Once you weight is stable for three months you can then reduce the calories very slightly to aim to lose one or two pounds a month. I know this sounds laborious, like it is going to take a lot longer than you would like to lose weight but the weight loss will be permentant and benefit your health rather than damage it.

2) Practice mindfulness. Jon Kabot Zin does some good led CDs or local Buddhist groups can teach. It will help reduce any inflammation and stress as well as help deal with any compulsions to over eat, binge, snack.

3) avoid as much as possible refined sugar.

4) Post all your latest bloods and symptoms on this forum so we can make sure your thyroid treatment is optimal.

5) Gentle exercise.

You might want to consider joining overeaters anonymous for extra support.

Sazzle1969 profile image
Sazzle1969 in reply tomandyjane

many thanks, Mandyjane, I think the dieting etc did mess up my metabolism like you say. I am doing meditation now which is helping with my stress and taking herbs to help too. I think joining a group for support is a good idea. I'll get my test results posted once they come in. I will try meantime to eat healthily and avoid sugar. I know I sound like I am moaning again, but I really think my doctor has been awful in not treating me properly as it has pushed me down a road of serious undereating and anxiety when what I need is some proper medication and a bit of help. Have lost a lot of faith in the health service as a result of all this...

mandyjane profile image
mandyjane in reply toSazzle1969

I avoid doctors like the plague these days.

Bugbear123 profile image
Bugbear123

I had high levels of reverse T3 when I had glandular fever. It is well know that viruses can cause this or other types of illness. I am over EBV now and

slowly coming off it. The only way to treat it is with T3 as adding T4 made me feel so much worse

Sazzle1969 profile image
Sazzle1969 in reply toBugbear123

thank you Bugbear, glad you are getting better now.

HLAB35 profile image
HLAB35

Not a fan of calorie controlled diets. Our metabolism is way too smart to fool it into coping with less energy input.... it'll just put the brakes on and slow down our burn rate and stop us from exercising. The way I found was to eat MORE at breakfast - the minimum would be two eggs, scrambled, buttery toast and fruit and some green tea and an oat cake. We don't feel like snacking before lunch and if our lunch is fairly early (before 1.00) and limited on carbs - homemade lentil and vegetable / red pepper soup and crackers and salmon/soft cheese is filling and keeps us going until evening. Because the body has already been 'tricked' by the fact we ate a big breakfast we should be burning calories at a good rate for our afternoon 'fast'. A piece of fruit and some nuts and seeds around 4pm in the afternoon and an electrolyte drink (add mineral salts and Vitamin C to some water) can see us through to 6.30pm and home cooked balanced dinner with lots of extra veg and pulses - casseroles, curry, morrocan chicken.... just limit your carbs with evening meal (less rice and potatoes and keep away from pasta altogether for a while).

tattybogle profile image
tattybogle in reply toHLAB35

Your menu made my mouth water :) , which is good as i've just been told off (again ) for not eating enough. sometimes i just don't fancy anything.

I agree , metabolism's are very smart at compensating, it's their job.... to stop us collapsing from shock if we drink a can of coke full of sugar, or need to survive through a famine.

I think the same is true of the hypothalamus /pituitary/thyroid relationship , and why reactions to a dose change take many weeks to feel stable.

thank's for the inspiration, just off to pinch number one child's salmon and cream cheese from the fridge !

HLAB35 profile image
HLAB35 in reply totattybogle

I think artificially sweetened drinks are the worst of all.... I sometimes add d ribose (a real sugar) to a mint tea if I need a boost. The CFS doctor Dr Myhill recommends d ribose.

tattybogle profile image
tattybogle in reply toHLAB35

Agreed , my 'health rating' ?! for sugar has brown sticky unrefined forms, and fruit, or honey at the top, down to refined white stuff at the bottom , and aspartame and anything else from the 'chemist's' below that.

i'm not convinced that the recent change's in so many soft drinks due to 'sugar tax' will prove to be such a good thing in the long run.

I alway's told my kid's to avoid thing's with aspartame, and not drink too much pop anyway.

Showing them how effectively coca cola dissolves limescale in the loo overnight was fairly convincing.

Dont know if that trick still works with an artificially sweetened version though !

Sorry Sazzle, wandered off topic somewhat . x

HLAB35 profile image
HLAB35 in reply totattybogle

Years ago I put one of their baby teeth (recovered from tooth fairy lol) in some coke to convince them!

tattybogle profile image
tattybogle in reply toHLAB35

My other favourite 'test' , when they wanted me to buy 'Sunny-D' drink, was to say 'if you can't read the ingredient's list i'm not buying it for you.......

5-ethanohydroxyoxylenecarbogobubblebathgobbledegook .....etc !

I never had to buy it........ :)

Sazzle1969 profile image
Sazzle1969

many thanks, yes, I think low cal diets probably just mess you up long term. The diet industry has a lot to answer for! In the past when I ate a lot and exercised a lot I burned loads of fat easily and was really fit, never had to worry about my weight. Just goes to show...

LADYARWEN profile image
LADYARWEN

Why would you want a lower T3? It's your Active Thyroid hormone.

helvella profile image
helvellaAdministrator in reply toLADYARWEN

This post is about reverse T3 - not T3.

T4 has four iodine atoms. When one is removed (it is deiodinated), three remain. However, T3 is formed only when a particular one of those four atoms was removed. If different iodine atom was removed, that would form reverse T3.

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