I am one of a few outliers here, not hashi, but some classic low thyroid symptoms eg loss of eyebrows, leg hair, and in bloods, poor converter and not high t3, and for me most telling, low temperature and heart rate. (i am not posting results today)
People have suggested it is central hypothyroidism but i cant quite get to grips with what that is or how to help.
From the posts I have seen on here, most do not rate RT3 as a tool to measure anything useful. But i have been coming across others stating that RT3 is the body's way of slowing down the metabolism, particularly when there is chronic stress (I have a lifetime of it), or worse, nasty illnesses, and when it is high then metabolism slows, hence low temperature etc and risk of other illness.
I have also been taken by the works of Ray Peat, Broda barnes ideas etc
I came across a Wilson temperature protocol that suggests that in this situation the only way to improve metabolism, temperature etc is to stop T4 (it just goes to RT3), and take not usual or daily t3 but take it in a slow release form as the t3 stays in the system for such a short time, and the claim is that this will improve the symptoms. You need a GP who will prescribe this, private I imagine.
As there is so much expertise on here, i wonder if anyone has any thoughts on this protocol?
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PaulRobinson still takes RT3 into consideration, although, like you I see the views on the Forum seem to be different. Never seen a recommendation anywhere about stopping T4 or indeed recall seeing slow release T3 getting a good press either.
I like Broda Barnes but my recollection of his is pretty small doses, whereas people seem to take much higher doses today - although not as high as was recommended by other practitioners in his time.
Sorry no help at all but intrigued as to the source of your info. When one is grasping at straws (me) I am very interested in alternate views.
i know, it might be clutching at straws. Here is the Wilson website , its controversial I suspect. wilsonssyndrome.com/ .. I know Ray Peat believed in taking nibbles of thyroid hormone through the day (but ndt i think) , perhaps his equivalent to the slow release. wilson argued that the slow release was the only way he found to get temperatures up
Thanks. I am going to read that. Ray Peat is only online? Crikey I so need stuff in book form. I have trouble collating Ray Peat info in my head and you have now highlighted something I ought to look at more closely. Again sorry no help to you but could certainly help me! Thanks again.
It is always difficult discussing people who are outside the mainstream in medicine. Some will, of course, be outright charlatans. But others might be well-meaning and could be right OR wrong. Whichever it turns out to be, those being treated need to have been fully informed and aware of the status of the treatment.
And this is an interview with WIlson:
Denis Wilson, md: Low Body Temperature as an Indicator for Poor Expression of Thyroid Hormone
thanks so much, and very interesting interview. I know its controversial and he had one bad outcome that raised controversy, but there seems to be a logic to what he suggests? He also talks about how certain herbs etc can enhance conversion of t4 to t3 .. i would be interested in hearing more about that
OK I see what Wilson might be getting at. Whilst I did not get on well with T3 (SVT). I definitely felt better until it went haywire and even after stopping, some things stayed improved for weeks or even months after. I was never quite able to understand the possible ‘why’s’ behind that.
It seemed to me (reports on the Forum) that most people experience the ‘magic bullet’ effect of T3 or not. For me it was a bit of both.
Wilson’s method lends some credence to my experience. That would also explain Broda Barnes experience too but all his patients seemed to do well on his regime of low doses. It’s confusing isn’t it. How much might be PR and how much truth? Still I will think some more.
interesting. I am pretty ignorant and just worry that my low temperature, which is getting worse, signifies worsening health. I love Ray Peat, he did have newsletters and also is on a gazillion podcasts but he knew so much and was also going off in different directions. I wish it was bottled. I do think he was a genius!
The stopping of meds to reduce elevated RT3 levels is outdated. RT3 it is a contentious subject with many not understanding the physiology of how it becomes elevated. A further layer is latest research has now proven it is not the RT3 that causes the issues but an up regulated thyroid enzyme (DIO3) that drives the RT3. This has now lead to people saying elevated RT3 doesn’t matter but its presence is indicative of things not working well so should always be addressed.
Your early posts state low thyroid hormones but also TSH that was not responding indicating central hypothyroidism. TSH is a pituitary hormone that should rise to encourage further thyroid hormones when levels dip. TSH remains the gold standard for thyroid hormone level assessment but the medical fraternity still has yet to catch on that is it in fact a poor and inappropriate measure for a number of people.
The only treatment for central hypothyrodism is to replace those missing thyroid hormones with meds, eg Levothyroxine. However your endos trial of 20 mcg T3 with 75 of levo for 2 months was setting you up to fail. Initially the replacement of thyroid hormones should be only with levothyroxine so assessment of conversion abilities can be made after several months.
Living long term with inadequate thyroid hormones slows metabolism in every area so eventually the hormones you have will have troubles working effectively and efficiently, eg conversion will be impaired, excretion will be slowed, etc. This can takes many months to reverse and should be done slowly. How did a starting dose of 20mcg T3 + 75 Levo thyroxine make you feel? Are you still medicating?
Thanks for the reply. I took the 20 and 75 then he reduced it to 10 and 100 because of, guess what, low TSH.. i dont think the t4 does much as I convert poorly so i suspect i am back to square one yet again and feel pretty hopeless .
The temperature thing has always made sense to me. Unlike many on here, i am lucky that I can exercise and generally have energy, i think this though is the adrenaline compensating for a shot cortisol system and my thyroid is just not delivering, and whether Rt3 is the cause or an effect, it seems linked. I am nearly 67 so whether I can turn around my stress system now after a lifetime of it I am not sure but with high Rt3 and not converting i am not sure if there is any alternative other than T3 .. i wish there was!
You can’t know how well you convert T4 because firstly you had insufficient thyroid hormones and then were dosed a T4 and T3 combo meds. You need to dose only Levothyroxine with all nutrients optimised to allow best opportunity to convert. Then assessments can be done by symptoms and labs.
Elevated RT3 is created for a whole host of reasons including nutrient deficiencies, adrenal stress, chronic illness/inflammation, and also incorrect thyroid hormone medication. Contrary to belief you can end up with elevated RT3 with excess T3 as it’s the up-regulated DIO3 enzyme that will drive both FT4 & FT3 congruently (T4 to RT3 and T3 to inactive T2).
Many people do well on levothyroxine mono-therapy and if you continue taking T3 meds before knowing if you ever actually required it, it risks preventing wellbeing. If I was you I would stop the T3 meds, dose 125mcg T4, address any nutrient deficiencies and assess the situation in 3 months. Some members have received higher levels of T3 by reducing meds (myself included).
I have been here quite a few times. I tried 125 levo. I tend not to feel many effects but all the classic symptoms did not budge one iota and the RT3 was high and people, including on here, said I was not converting well.
I take some B's and D and K and quite a few supplements and eat well, so i doubt it is nutrient deficiencies unless my gut is bad, which in fact I have not tested.
So basically it is going round in circles. I will know if anything is of help if my temperature and heart rate increase, some hairs grow back and other infections go.
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A ramble concerning Reverse T3 ratio/ DIO2 polymorphism and dosing. 
High T3 low Reverse T3? Pooling or normal? 
Reverse T3 testing?
Reverse T3
Low BPM and Body Temperature.. with Cytomel?
