Meaning of High Reverse T3

[pemone]

I was reading on a web site about "Wilson's Syndrome", which apparently is diagnosed by hypometabolism (temperature below 98.2) together with high reverse T3. The site describes the condition as:

"The thyroid gland makes T3 and T4. T3 is the active thyroid hormone and every cell in the body has molecular docking stations for T3. T4 is made by the thyroid, circulates and eventually ends up in the liver where it is converted to T3 and a tiny amount of a substance called Reverse T3 (RT3). RT3 has no action on the cell, except that it binds with the receptor sites, the tiny docking stations, and blocks the action of T3. However, in the normal situation, T3 dominates and RT3 is no problem.

However, when a person experiences prolonged stress, the adrenal glands respond by manufacturing a large amount of cortisol. Cortisol inhibits the conversion of T4 to T3 and favors the conversion of T4 to RT3. If stress is prolonged, a condition called Reverse T3 Dominance occurs and persists even after the stress passes and cortisol levels fall. Apparently, RT3 itself acts like cortisol and blocks the conversion of T4 to T3.

Reverse T3 Dominance is the cause of hypometabolism because too many receptor sites are blocked by RT3 and the chemical reactions of life slow down. These reactions give off heat and are the source of heat in the body. They make us warm blooded. When those reactions slow down, our temperature drops. This drop in temperature slows down enzymes in every cell of the body causing a condition of Multiple Enzyme Dysfunction which is the heart of hypometabolism."

My question is what does it mean when you have normal thyroid levels, and high RT3, but do NOT have low temperature? In this case the body is able to run its function with the amount of thyroid receptors that RT3 has not blocked? You are effectively "normal" for thyroid purposes?

 

[MCRobbie]

Hi Pemone, I have a couple thoughts which may be of interest. There have been a number of examples within the Paleo community of people experiencing high Rt3 on low carb and or ketogenic diets. Its now well understood within the Paleo/Ketogenic Diet communities that when you restrict carbohydrate intake and to some degree protein intake, or a combination of the two which I think its the hypothalamus deems insufficient for optimal energy production, it (again I think its the hypothalamus in this case but I could be mistaken) produces RT3 for the express purpose of down regulating T3 produced by the thyroid primarily as a conservation measure. Its essentially a 'starvation' response. The hypothalamus detects a deficiency of incoming resources and wants to down regulate T3 and to some extent T4 to conserve energy because it thinks youre starving. The result of high RT3 and resulting low T3 is decreased metabolic rate, lower body temperature, because the body is now trying to conserve resources. This is what your passage describes as hypometabolism. Dr Ron Rosedale who is a proponent of Ketogenic Diets claims all of his patients who he puts on Ketogenic diets develop high RT3 and low T3 and he argues this conservation state promotes longevity. Paul Jaminet who has debated the health effects of ketogenic low carb diets with DR Rosedale argues that these diets put a strain on the body over the long term and high RT3 and low T3 is evidence of this and should not be equated with a health promoting state. If Paul's argument is the right one and low carb ketogenic diets put a stress on the body, a starvation mode as he calls it, it would make sense possibly that you would see a rise in cortisol which may be the link between his theory and what you read about 'hypo' metabolism. This is just one reason for high RT3. There may be others I am unaware of. Im curious, if you have high RT3, are your t3 and t4 levels in the normal range?

 

[pemone]

Hi Pemone, I have a couple thoughts which may be of interest. There have been a number of examples within the Paleo community of people experiencing high Rt3 on low carb and or ketogenic diets. Its now well understood within the Paleo/Ketogenic Diet communities that when you restrict carbohydrate intake and to some degree protein intake, or a combination of the two which I think its the hypothalamus deems insufficient for optimal energy production, it (again I think its the hypothalamus in this case but I could be mistaken) produces RT3 for the express purpose of down regulating T3 produced by the thyroid primarily as a conservation measure. Its essentially a 'starvation' response. The hypothalamus detects a deficiency of incoming resources and wants to down regulate T3 and to some extent T4 to conserve energy because it thinks youre starving. The result of high RT3 and resulting low T3 is decreased metabolic rate, lower body temperature, because the body is now trying to conserve resources because it thinks you might be in starvation/famine mode. This is what your passage describes as hypometabolism. Dr Ron Rosedale who is a proponent of Ketogenic Diets claims all of his patients who he puts on Ketogenic diets develop high RT3 and low T3 and he argues this conservation state promotes longevity. Paul Jaminet who has debated the health effects of ketogenic low carb diets with DR Rosedale argues that these diets put a strain on the body over the long term and high RT3 and low T3 is evidence of this and should not be equated with a health promoting state. If Paul's argument is the right one and low carb ketogenic diets put a stress on the body, a starvation mode as he calls it, it would make sense possibly that you would see a rise in cortisol which may be the link between his theory and what you read about 'hypo' metabolism. This is just one reason for high RT3. There may be others I am unaware of. Im curious, if you have high RT3, are your t3 and t4 levels in the normal range?

I agree with 90% of this. But I think RT3 in general is a marker of stress. And ketogenic diet is certainly an enormous physiological stress for some people. But there could be other causes. I have seen some people claim high RT3 is a marker for heavy metals, but ultimately those compromise aerobic metabolism so it may just be another path to the same effect. The body is starving for energy.

All of my T3 T4 and TSH markers are perfect, consistently.

I interpret the high RT3 as a marker for the fact that I have been under enormous physiological stress because my aerobic metabolism is so highly compromised. And my general take is that I can probably ignore that since my body temperature and metabolism appear to be "normal" from a thyroid perspective.

I need to find the cause of the collapse of aerobic metabolism, but thyroid shortage is probably not that reason.

 

[MCRobbie]

Yes I think if your other thyroid hormones are consistently normal and youre not on a low carb/protein/ketogenic diet clearly there is another reason you have high RT3. Good luck in finding the source. Ill be curious to know if you come up with a concrete answer in time. Maybe its as you say, enormous stress from poor aerobic metabolism, that might be enough.

 

[MCRobbie]

I assumed you meant by compromised aerobic metabolism a deconditioned aerobic state brought on by inactivity. Did I understand you correctly? I think many of us are aerobically deconditioned but I doubt whether aerobic deconditioning would raise RT3 in the majority. It would be interesting to know this, again if I understood you correctly.

 

[pemone]

I assumed you meant by compromised aerobic metabolism a deconditioned aerobic state brought on by inactivity. Did I understand you correctly? I think many of us are aerobically deconditioned but I doubt whether aerobic deconditioning would raise RT3 in the majority. It would be interesting to know this, again if I understood you correctly.

No it was not lack of activity. Prior to Dec 2013 I was endurance trained and athletic enough. When I came down with chronic fatigue my aerobic metabolism collapsed and I was suddenly very glycolytic. This was confirmed with a VO2Max test that I graphed the result against a large population study. I was the single worst data point in the 200+ person study, and I suddenly had the aerobic metabolism of a 100 year old man. I like using VO2Max as a marker for aerobic metabolism. That result suggests either hypoxia or mitochondrial failure.

It's unlikely I have any kind of hypoxia: I have a great heart, very clean arteries, and no type 2 diabetes. I do get high adrenalin, and I read that epinephrine can dilate large vessels while clamping down small vessels in peripheral tissues. Perhaps that creates some hypoxia. I'm exploring this path.

I may have suffered some mitochondrial injury as well. I took a supplement - alpha lipoic acid - in high quantities from Nov 2013 through June 2014, that is known to metabolize to a two-thiol heavy metal chelator and cross the blood brain barrier and enter mitochondria. Hidden in the research literature are some good studies showing how ALA can greatly increase brain and tissue levels of mercury. When I discovered all of this research I stopped the ALA cold turkey in June 2014, and I get about 2% better every month since then. I was eating fish every day during this period and had reasonably high blood levels of mercury, so I may have just poisoned my electron transport chain. The fact that I very slowly get better might mean that my body is just painfully and slowly clearing things on its own. I will probably attempt the Cutler chelation protocol with DMSA and ALA shortly.

 

[MCRobbie]

I stopped ALA for the same concern. Well I wish you luck on finding the source and improving your health. Sounds like youre on the right tracks. Best. MR

 

[2Cor.12:9]

My question is what does it mean when you have normal thyroid levels, and high RT3, but do NOT have low temperature? In this case the body is able to run its function with the amount of thyroid receptors that RT3 has not blocked? You are effectively "normal" for thyroid purposes?

Hi pemone - I know this is an older post and you may have come up with answers by now. I'm battling high Reverse T3 levels too. I also have "normal" Ft3, Ft4, levels, and don't always have low body temp. I alternate between low grade fever/normal/subnormal.

Here's a couple of good articles on the problem of Thyroid Transport. Chronic illnesses such as CFS, stress, and a number of other factors can cause high Rt3 as well as an inability to convert t4 to t3. According to these thyroid experts high Rt3 = hypothyroidism even when all the other labs are normal. This is because the Rt3 is anti-thyroid and it inhibits t3 from penetrating at the tissue/cellular level. Fixing the problem is another issue. I'm still working on it. I've had a major relapse of CFS this year but suspect it may be due to the high Rt3 causing hypo. I have Hashimoto's.
Good luck.
https://www.holtorfmed.com/cfs-patients-and-low-thyroid/
https://www.holtorfmed.com/treating-thyroid-conversion-disorders-with-t3/
https://www.nahypothyroidism.org/thyroid-hormone-transport/