Ok, so having done some Googling I am conscious that there is some skepticism on here as to the relevance of Reverse T3, however I've also read several accounts which suggest it CAN be a very real problem (or at least an indicator of one), so I'd appreciate some open discussion on the matter. Some links supporting the concept of RT3 being problematic:
I'm not your typical thyroid patient. For a start I'm male, and secondly I was relatively young and fit, 32, when I began exhibiting symptoms of hypothyroidism in 2017. These symptoms have become increasingly agonising and debilitating, to the point that I've been driven to the brink of suicide despite increasing (self-earned) wealth and a beautiful wife and two young kids. It's been absolutely gruelling.
I've spent thousands of pounds seeing private specialists of various specialisms and slowly buy surely, virtually EVERYTHING has been ruled out. Eventually, I found an endocrinologist who was willing to attempt treating what was diagnosed as sub-clinical hypothyroidism (TSH was just over 5, FT4 good, FT3 a little bit low).
That treatment has ultimately done nothing for my symptoms, almost a year in now, despite my levels being almost text book. No change whatsoever. And then recently I came across some old medical notes which shows my TSH was over 4 years before these symptoms even started, and then back down again a couple of years later, which has really made me begin to doubt whether my issue is one of typical hypothyroidism.
So here's the thing. Between February 2016 and the summer of 2017, I lost around 6.5 stone having been advised to lose weight by my doctor (from 17 stone to 10.5). I went from a body fat of around 30% to around 10% through a combination of intermittent fasting, improved diet and rigorous exercise.
That said, eventually I did find keeping in shape increasingly difficult. And then I'd cut the calories a bit more. And then a bit more. And then some more again. To the point that I'd be training twice a day, six days a week on little more than a 1,000 calories a day - largely protein. With hindsight, I got suckered into incrementally reducing my calorie intake by changes in my metabolism that I was not fully aware of in the moment, and I hold my hands up and say that I messed up, but I'm paying the price and ultimately I am where I am.
Pretty much every source I've read on RT3 quotes 'starvation / severe calorie restriction' - that's definitely where I was at one point, as mad as that was, looking back. With that in mind, I recently took a Reverse T3 blood test, and the result came back on Friday showing me to be way, way above range. My result was 70 ng/dL, with a quoted range of 8 - 31, however reading up it seems that anything north of 10 - 15 is considered problematic.
For me, this was a bit of a lightbulb moment. For any RT3 skeptics out there, please consider for a second:
- My symptoms began a few months after introducing a significant daily calorie deficit in order to lose weight, and doing so accordingly
- My symptoms are absolutely crippling, and absolutely consistent with severe hypothyroidism despite having, at worst, 'sub-clinical' bloods
- Getting my bloods to completely normal levels has had no effect on my health whatsoever, if anything I'm worse than ever now
- I've already ruled out virtually everything - some kind of thyroid issue was my last roll of the dice
- My RT3 is exceptionally high
All things considered, I can't walk away from such a hypothesis with little more than a "RT3 is a myth that's been debunked" quote on a forum as the reason - I'm quite literally losing the will to live here and I owe it to my family and myself to dig deeper. At the very least, I'd want to see my RT3 in optimal range to at least rule it out as I continue to search for answers.
So with that in mind, does anyone know where I might be able to find specialist support for this particular issues? Many endocrinologists I've spoken to in the past seem dismissive, but then I don't think my unique circumstances are typical of your average thyroid patient.
The consensus seems to be that the answer, in addition to addressing the original cause, is to dose with T3 only medication in order to suppress TSH and T4, in turn preventing the production of excess RT3 (as it requires T4 to exist in the first place). However, I can't find much online in terms of dosing guidance .
Any advice genuinely greatly appreciated!