High Reverse T3 (Thyroid)

ChrisD

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Does anyone else have High Reverse T3 and poor conversion of RT3 back to T3? As in the T3:RT3 ratio that labs such as Medichecks in the UK calculate?

And has anyone with this benefitted from treating with T3 Liothyronine or NDT?
 

BeADocToGoTo1

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Hi @ChrisD,

No personal experience help, but I do remember the following book which mentioned a lot of good info on reverse T3. It was written by someone who suffered and overcame, called Paleo Thyroid Solution by Elle Russ.
 

pattismith

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High reverse T3 is a feature of Low T3 Syndrome (LTS)

A subset of ME/CFS patients have this problem.

Iron deficiency (with or without anemia) can cause this syndrome, especially when combined with Selenium and iodine deficiency.

You can fix this syndrome if you manage to raise your ferritine level .

If you take iodine/selenium before fixing the iron issue, you will end with auto-immune thyroiditis , as iron deficiency is known to be often associated with it.

All these problems happened to me before I understood iron deficiency was my main issue.
Eftekharifinal (psu.edu)

Our study provides support for the contention that an increase in rT3 is related to changes in iron status and that the increased level of rT3 is inversely correlated with changes in plasma ferritin concentration.

Iron deficiency decreased plasma concentrations of T3 and T4 and increased in vitro hepatic rT3 deiodination, suggesting that iron-deficient animals tend to metabolize thyroid hormone via a deactivating pathway.
 

pattismith

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@pattismith..what are you doing to fix this? Greg JOnes would tell u u need iodine, selenium b2 to metabolise iron correctly.


If you take iodine/selenium before fixing the iron issue, you will end with auto-immune thyroiditis , as iron deficiency is known to be often associated with it. i got the Hyperthyroid form.

I fixed my autoimmune hyperthyroidism with a low iodine diet:
Every days I was eating some red meat, which was good for my iron issue as well, even though I was not aware of this issue at that time.

I fixed my thyroid problem within 6 months, then I stopped the low iodine diet progressively...

Then my ferritin dropped again, but I was still not aware I had an iron deficiency.

It took me again lots of time and suffering before a neuropsy diagnosed me with with a kind of iron deficiency without anemia...
 

Shanti1

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rT3 increases either when the body perceives there is a need to conserve energy/slow down metabolism or if there is too much T4 (from medication or hyperthyroid) and the body is trying to protect us from hyperthyroid.

Stress (mental/emotional/physical) and calorie restriction are often cited as causes. The info from @pattismith is interesting, iron deficiency could also be perceived by the body as a reason to slow metabolism.

In ME/CFS, where we seem to have hypometabolism/energy, it wouldn't surprise me if higher than optimal rT3 is common. Although not in the literature, I've seen docs report high rT3 as a finding in sleep apnea (a definite physical stress), which makes me think that low oxygen states/perfusion might also cause it.

In a small study in individuals with CHF, ginseng helped increase T3 and lower rT3, https://pubmed.ncbi.nlm.nih.gov/11783267/. Using prescription T3 makes sense to me, but if your ferritin is low, it seems that would be the place to start.
 

pattismith

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@Shanti1

there is a study showing low fT3 and iodine in a subset of ME/CFS

Higher prevalence of ‘low T3 syndrome’ in patients with CFS: A case-control study | Phoenix Rising ME/CFS Forums

"FT3 below the reference range, consistent with the 'low T3 syndrome', was found in 16/98 CFS patients vs. 7/99 controls "

So 16.3% of CFS patients of this group had fT3 below the normal range and were considered affected by the Low T3 syndrome.

16.3% is not the majority of CFS patients, but it is all the same a rather important subgroup of patients, so I think it is important to screen it from the begining when the disease just starts.
The study also says, "Additional analyses indicated that CFS patients had a lower urinary iodine status..."

Could a simple remedy for some here be increasing iodine intake?
In this subset, the problem may be nutritional, with iodine/Selenium and Iron deficiency
 

Learner1

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Does anyone else have High Reverse T3 and poor conversion of RT3 back to T3? As in the T3:RT3 ratio that labs such as Medichecks in the UK calculate?

And has anyone with this benefitted from treating with T3 Liothyronine or NDT?
At one point, my rT3 was 450 when normal was something like 4-25. I was out in liothyronine and have been on it for 12 years, though I added levothyroxine 3 years ago. My rT3 runs around 8 these days. I didn't find that selenium or iodine levels have had much to do with it.

You might find this helpful:

"Do you have a Reverse T3 problem? – Thyroid Patients Canada" https://thyroidpatients.ca/2018/07/29/do-you-have-reverse-t3/amp/
 

pattismith

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At one point, my rT3 was 450 when normal was something like 4-25. I was out in liothyronine and have been on it for 12 years, though I added levothyroxine 3 years ago. My rT3 runs around 8 these days. I didn't find that selenium or iodine levels have had much to do with it.
It has much to do with it only if you have low iron and iodine , which are common issues. :)
In my case, there was no need to supplement with thyroid meds, my thyroid hormones now are just fine.

People with low iron often have nutritional problem related to poor non hemic iron absorption that correlates with some digestive issue (gut or stomach inflammation).
Gastric acid is required for inorganic iron absorption, because " it is absorbed mostly in the duodenum and in the proximal ileum mainly due to the low pH, which keeps iron soluble."
 

Learner1

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It has much to do with it only if you have low iron and iodine , which are common issues. :)
In my case, there was no need to supplement with thyroid meds, my thyroid hormones now are just fine.

People with low iron often have nutritional problem related to poor non hemic iron absorption that correlates with some digestive issue (gut or stomach inflammation).
Gastric acid is required for inorganic iron absorption, because " it is absorbed mostly in the duodenum and in the proximal ileum mainly due to the low pH, which keeps iron soluble."
You might read the article that I posted.

Significant illness can drive high RT3.

As for iron, people with hemochromatosis, genetic iron overload, can have high RT3.

My point in posting the article was to provide a good overview of the problem.
 

Shanti1

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In this subset, the problem may be nutritional, with iodine/Selenium and Iron deficiency
Thanks for posting. As you say, it is a possible subset. When trying to figure out the cause of something, it is good to make a list of known possible causes and then to try to rule them in or out. In the case of rT3 in ME/CFS, the same method would apply.