• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

High Reverse T3 (rT3)

Messages
23
Hi all.

I have longstanding CFS with Gut/Brain/nervous system symptoms and osteopenia.
I have recently had my Reverse T3 tested as well as the standard Thyroid blood tests.
The results came back with elevated Reverse T3 above reference range and my Doctor prescribed T3 only (Tertroxin). Apparently Reverse T3 is inactive form and while it is normal for the body to produce RT3, when elevated it blocks the cells and tissue from receiving the active T3 hormone. This means your blood tests can show normal thyroid function but your body is actually hypo-thyroid.

However I'm so fed up with taking things and finding some things making me worse, but the Doctor is adamant that I should stay on this. I'm wondering has anyone else on here had RT3 tested, tried T3 only or got anything to share regarding their own experience with high RT3? I'm interested to hear whether it was helpful, whether you had any issues while taking it and whether anything else helped treat this and the underlying cause of the high RT3.

Many thanks!
 

August59

Daughters High School Graduation
Messages
1,617
Location
Upstate SC, USA
Just be patient as there are some very knowledgeable people on this forum that can maybe guide you in the right direction. Some of it may come across as medical advice, which we try very hard not to do because we are not physicians and cannot give medical advice. I'm not real knowledgeable on RevT3 as mine has always been normal, but there is a website called "StoptheThyroidMadness.com". The is some good stuff on there, but there are things I don't agree with. However it may work just fine for you and answer some of your questions

Someone will be along to help you on here before long and welcome to the forum!!
 

Helen

Senior Member
Messages
2,243
Hi all.

I have longstanding CFS with Gut/Brain/nervous system symptoms and osteopenia.
I have recently had my Reverse T3 tested as well as the standard Thyroid blood tests.
The results came back with elevated Reverse T3 above reference range and my Doctor prescribed T3 only (Tertroxin). Apparently Reverse T3 is inactive form and while it is normal for the body to produce RT3, when elevated it blocks the cells and tissue from receiving the active T3 hormone. This means your blood tests can show normal thyroid function but your body is actually hypo-thyroid.

However I'm so fed up with taking things and finding some things making me worse, but the Doctor is adamant that I should stay on this. I'm wondering has anyone else on here had RT3 tested, tried T3 only or got anything to share regarding their own experience with high RT3? I'm interested to hear whether it was helpful, whether you had any issues while taking it and whether anything else helped treat this and the underlying cause of the high RT3.

Many thanks!

Hi 2012,

I have gone through all stages of hypothyroidism and tried all treatments so I think at least I can share experiences and what I have learnt from studying hypothyroidism for a long time.

I think your doctor is quite right prescribing the bioactive T3 for you. Just be aware of the half-life for T3. It is very short. In cooperation with a doctor who has hypo.. herself we found out that T3 should be taken around 8, 12. 16 and maybe an evening dose too. Take the hormone before meal for the best absorbtion.

You might feel a peek in energy 2.5-3 hours after intake, maybe with some palpitations. The palpitations will (probably) stop later and when you are on a full dose a day you will not feel ups and downs. At least that is my and many others experience. The full dose usually is between 45-60 mg a day, but there are of course exeptions.

Start with low doses each time and rise slowly. Keep track of and write down your puls and body temperature and other hypo-symptoms. As @August59 says you should read www-stopthethyroidmadness.com. You will probably feel vey much better soon. Congratulations to having this doctor and best of luck!
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
I did the T3 only protocol for over a year and briefly moderated on the Yahoo group. I think it's fair to say I know a lot about it.

I no longer believe in those protocols for the most part (except in rare cases of thyroid hormone resistance). I don't think RT3 can block receptor sites and the idea it takes 12 weeks to fall out of said sites seems ludicrous to me now.

I can't type much now as I am on my phone but start here:

http://tiredthyroid.com/rt3.html

What were your actual free T4 and T3 labs? Have you taken a combo T4/T3 med in the past?
 
Messages
80
Location
South Dakota
I was on 5 mcg Cytomel (Liothyronine) per day for 4 mo. in 2010 for high reverse T3. I took 1/2 of my dose 1st thing in the morning and the other 1/2, 4 hr. later. When high T3 came down in test I was taken off of it. Had so much going on then after an energy crash in 8/2008. Looking back, adrenal treatment seemed most helpful in getting more energy & recovering. I'm not on any thyroid directed treatment now. But I do put Lugol's 2% on my skin as a source of iodine. Blessings to you.
 
Messages
23
Thanks for the replies and links.

I was prescribed 20mcg Tertroxin (Once daily first thing in the morning) No other doses.

I also have a tendency towards iodine deficiency even though I supplement liquid iodine and add kelp to food.

My latest thyroid results are:

Free T4 = 13.9 pmol/L
Free T3 = 4.8 pmol/L

I was actually on the Tertroxin 20mcg for 6 months before I stopped taking it (despite the doctor wanting me to keep taking it). 3 months after stopping it I had my rT3 re-tested and it was even higher than before. The Doctor said because I have come off it... it has probably gone back up. He would like me to take it again and re-test after a few months while taking it.
 

Helen

Senior Member
Messages
2,243
Hi @2012 ,

Your dose, 20 mg, seem to be very low as a single thyroid treatment. The best way to evaluate this is to compare with symptoms that you still have - or not. Where you really free from thyroid symptoms on the 20 mg dose you took for a long time? Check with www.stopthethyroidmadness.com.

By definition of rT3 you can´t get a high rT3 without taking T4 medication as far as I can see. rT3 is sometimes questioned as it is said to change often during the day. The rT3 theory is also questioned and not studied scientifically, but at least a T3-only trial could be a great help to a trial with a bioactive treatment of your hypothyroidism. Later I would guess that you would get better help from e.g. Nature-throid.

About one intake a day, see my first post if Tertroxin isn´t a time-released product?

Did your doctor test your thyroid antibodies? It should have been tested. If you give us the reference range to the free T4 and T3 it is easier to evaluate your numbers. The symptoms are anyway often the best guide to how the treatment is working.
 
Messages
23
Hi and thanks again for your help.

I haven't taken any T4 medication. However I think I was taking liquid iodine prior to the first rT3 test, so maybe that triggered it. However my second rT3 test was even higher and I haven't been on Iodine for over 6 months. I'm deficient in Iodine now, so I'm back on liquid Iodine supplementation.

My latest thyroid results with reference ranges are:

Free T4 = 13.9 pmol/L (Ref: 9.0-19.0)
Free T3 = 4.8 pmol/L (Ref: 2.6-6.0)

Two reasons why I stopped the Tertroxin after 6 months - I was fed up taking stuff and I felt it was possibly causing head aches, head sensations and outbreak of spots on skin... however I can't be certain it was that and not something else causing it.

The doctor is adamant I should keep taking it... but I'm not so keen anymore!
 

brenda

Senior Member
Messages
2,266
Location
UK
Hi 2012

Are you taking selenium? It is common to be deficient and it is very important for thyroid function. I was eating sea vegetables but the iodine has really messed with my immune system - I have Hashimotos. Apparently this happens when selenium is deficient. Anyway this book "recovering With T3" by Paul Robinson is about metabolic dosing and I am working my way through it atm.
 
Messages
23
Thanks. I read just the other day about Selenium playing a part in thyroid and rT3. It is hard to take it all in though.
I'm not really taking most of my supplements at the moment. I have the following in the cupboard (but not taking at present) a heavy metal chelate capsules which has selenium in them and also a colostrum powder with selenium.

Do you have any idea how much you should take a day?

I'm not sure how you know if your deficient in selenium or whether symptoms and medical history is the best way to determine deficiency? My latest Hair Mineral analysis shows Selenium in the lower end of the reference range... what ever that means.
 

brenda

Senior Member
Messages
2,266
Location
UK
@2012

100mg is supposed to be the usual dosage. You can get it from brazil nuts. I would take a malfunctioning thyroid to be a sign.
 
Messages
23
@2012

100mg is supposed to be the usual dosage. You can get it from brazil nuts. I would take a malfunctioning thyroid to be a sign.

I have had a look at my supplements...

Heavy Metal Chelate Capsules:
Contains Selenium (as Selenomethionine) - approximately 33 mcg per capsule, with 2 capsules twice daily = 132 mcg

Colostrum Powder contains:
Selenium 26 mcg per tsp serve. Twice daily = 52 mcg

So if I start taking those 2 supplements again I will be getting about 185 mcg Selenium.

I'm assuming you meant mcg rather than mg?

So can you take iodine now you have addressed selenium deficiency, or does it still mess with your immune system? I have had thyroid anti-bodies tested (all clear) - however Hashimotos is in the family.

I really appreciate the helpful people on this forum. Many thanks again!
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
My latest thyroid results with reference ranges are:

Free T4 = 13.9 pmol/L (Ref: 9.0-19.0)
Free T3 = 4.8 pmol/L (Ref: 2.6-6.0)

So that's a FT4 of 1.08 and a FT3 of 3.1 in conventional units.

The FT4 is pretty low but the FT3 is lowish but could be OK depending on symptoms etc.

I agree with the others that taking 20 mcg of T3 all at once in the morning is a sure fire way to feel like crap. T3 has a really short half life and really needs to be dosed 3-4 times a day.

20 mcg is also a very low dose if you are aiming to suppress FT4 in order to drop RT3 down. Most people take about 50 mcg to accomplish this. I would say you would end up with LESS thyroid hormone overall than you were making on your own supplementing it in this manner and dose. I don't blame you for a second for dropping it.

If it were me and I felt hypothyroid, I would consider trialing a T4 med and see if I could bring my FT4 up to a better 1.3ish range and then see where my FT3 and RT3 fell out from there.
 

brenda

Senior Member
Messages
2,266
Location
UK
I have had a look at my supplements...

Heavy Metal Chelate Capsules:
Contains Selenium (as Selenomethionine) - approximately 33 mcg per capsule, with 2 capsules twice daily = 132 mcg

Colostrum Powder contains:
Selenium 26 mcg per tsp serve. Twice daily = 52 mcg

So if I start taking those 2 supplements again I will be getting about 185 mcg Selenium.

I'm assuming you meant mcg rather than mg?

So can you take iodine now you have addressed selenium deficiency, or does it still mess with your immune system? I have had thyroid anti-bodies tested (all clear) - however Hashimotos is in the family.

I really appreciate the helpful people on this forum. Many thanks again!

Hi you are right its mcg. 185 sounds reasonable. You do have to be careful not to take too much but some advise 200mcg. There is a lot of dispute over iodine and Hashis. I found that it did increase my antibodies. If I had Hashis in the family I would do a lot of research first before making your mind up over iodine.
 

Little Bluestem

All Good Things Must Come to an End
Messages
4,930
I had normal free T4, but low free T3 and high reverse T3, so I am on supplemental T3 (Liothyronine). I take 5 mcg twice a day. My thryroid ratios have improved on that dose. I don't feel much different, but that is probably because there is so much more wrong with me. (Although I do seem to notice when I forget a dose.)

My doctor says that free T3/reverse T3 should be greater than 20 and total T3/reverse T3 should be 10 - 14.


I think that the underlying cause of the high rT3 is the ME/CFS.

I agree that 20 mcg is too much to take at one time.

Another website you could check out is http://www.thyroid-rt3.com .
 
Messages
23
The Doctor also mentioned trying slow release - 20mcg as a slow release once daily first thing in the morning.
I'm also convinced the rT3 is caused by ME/CFS and being chronically sick. I'm just really struggling... I am at the point where I would prefer to take nothing than keep making myself even sicker trying all these things.

By the way - It seems sensitive teeth and receding gums is one symptom of hypothyroidism. When I started taking Tertroxin I got severe gum receding and teeth sensitivity. I couldn't eat, drink or clean my teeth without a lot of pain!
I'm wondering whether taking the Tertroxin dose was actually making me even more Hypothroid by lowering my T4 but not being enough to replace my body's own production of T3?
Or maybe receding gums is also a symptom of Hyperthyroid? I was also having lots of headaches and head sensations, as well as skin breaking out which seemed to relate to taking the Tertroxin - but who knows!

I just know my body seems to react badly to absolutely everything!
 
Messages
1
Hi all.

I have longstanding CFS with Gut/Brain/nervous system symptoms and osteopenia.
I have recently had my Reverse T3 tested as well as the standard Thyroid blood tests.
The results came back with elevated Reverse T3 above reference range and my Doctor prescribed T3 only (Tertroxin). Apparently Reverse T3 is inactive form and while it is normal for the body to produce RT3, when elevated it blocks the cells and tissue from receiving the active T3 hormone. This means your blood tests can show normal thyroid function but your body is actually hypo-thyroid.

However I'm so fed up with taking things and finding some things making me worse, but the Doctor is adamant that I should stay on this. I'm wondering has anyone else on here had RT3 tested, tried T3 only or got anything to share regarding their own experience with high RT3? I'm interested to hear whether it was helpful, whether you had any issues while taking it and whether anything else helped treat this and the underlying cause of the high RT3.

Many thanks!

Hi, your explanation in first paragraph is absolutely correct. Too much RT3 blocks T3 at the cell and that being the case, you will feel horrible.

I am diagnosed hypothyrod. While my thyroid panel test results now appear normal (TSH;T4;T3) I have still been feeling awful for a long time. So I have most of the symptoms of hypothyroidism including weight gain, lethargy, gut problems, due to lack of stomach acid etc..... My GP tested Reverse T3 (RT3). It was twice as high as it should be. Calculated RT3 Ratio came in at 6.9. To be feeling well it should be 20+ No wonder I am feeling so awful. My GP has since lowered T4 medication (Oroxin) and started me off on a small amount of synthetic slow release T3 (5mcg) per day made up by a compounding chemist. I am not feeling any better at this stage but I am deducing the amount of T3 is not enough. GP says this is a slow process and you can't be given too much too quick so must wait 6 weeks for next results. I am with your Doctor on this. I wish I had an answer for what was causing the high RT3. It is usually associated with long periods of stress. In my case that is certainly true and I may also have thyroid resistance. Good luck....
 
Last edited by a moderator: