Reverse T3? Please help

[Garz]

Would that mean we all likely have high RT3 if we are bedbound/housebound with gut issues that are unknown/ANS dysautonomia related

fair question

i would say that i think there will be a tendency towards high RT3 in this case but that there is likely a large amount of individual variability.
it may depend on a persons makeup - or how much and what type of inflammation is present

 

[JasonPerth]

fair question

i would say that i think there will be a tendency towards high RT3 in this case but that there is likely a large amount of individual variability.
it may depend on a persons makeup - or how much and what type of inflammation is present

Hopefully we can get a single biomarker and not a “pattern” so to speak biomarker that ive been reading about recently.

 

[Nanni]

Hi everyone, im currently doing a protocol which i dont think is working at all. Anyway, months ago when seeing my doctor he looked into my thyroid which seemed normal besides Reverse T3
There was alot of skepticism online about Reverse T3 so i was super unsure

I had 795 pmol/L when normal range is 140-540

Im just wondering if it could have anything to do with my post viral MECFS? And if taking supplementation to supposedly improve my Rt3 levels can indeed make my health better?

I was prescribed 1 tablet per day and after 2 days i was waking up and vomiting alot at night and put it down to the thyroid drug. And i havnt tried it since after another doctor told me to stop (the doctor that has me on a protocol thats doing nothing for me)

I dealt with very severe low t3 back in 1994. Way before I got me/cfs. I was told low t3 is usually brought on by extreme stress, mostly physical. My 2 difficult pregnancies were a last straw for my body. It took years to get under control and then changed again after I got sick.Every time I thought I had the right medication and dosage it would change.

Taking only t3 wasn’t helpful in the long run. Just taking synthroid was the worst. Getting all my hormones balanced was most important as was having a nurse practitioner that listened to me and not just test results.

Today I take .25 grains of a t3 and t4 combination from Walgreens. I’m down from 2.5 grains. For awhile I have been taking a supplement for my stomach that is basically DGL licorice. Before I treated myself for SIBO my stomach had been getting really bad so I was eating the licorice like candy. Licorice is also helpful for the thyroid and I think over the last few years it has helped to heal my thyroid.

I also feel a little stomach discomfort from the thyroid medication but doable these days.I used to have a compounding pharmacy make it up which really worked the best but it’s a lot more costly.

Getting my hormones figured out was one of the most important things that helped my mecfs . Good luck!!

 

[Wishful]

I honestly cant recall! Im assuming it was just before bed or early morning.

I strongly recommend keeping a food(and drugs, supplements)/activity/symptoms journal, as detailed as you are comfortable with. This can help identify correlations, such as "this food past noon causes insomnia". Some ME responses are time-of-day dependent, and some have cofactors, so maybe "T3 doesn't work unless I also eat ruminant fat with it". Human memory is just not reliable enough for this sort of correlation identification.

I don't know if it would work for you, but there's also T2 (3-5 diiodothyronine). It has some similar effects as T3, and suppresses (I forget whether it's suppressing T4 or T3). T2 worked very well for my ME, whereas T4 and T3 had no noticeable effect. I think T2 is one of those things that you won't know how it will affect you until you actually try it. Amazon had a T2 product available last time I checked (a year or more ago).

 

[Garz]

I strongly recommend keeping a food(and drugs, supplements)/activity/symptoms journal, as detailed as you are comfortable with. This can help identify correlations, such as "this food past noon causes insomnia". Some ME responses are time-of-day dependent, and some have cofactors.......,

i think this is very good advice

trying to navigate diagnosis and treatment of such a complex illness as CFS/ ME - or in fact any chronic illness - without the benefit of real objective data points organised in some form of chronologic record is likely to be a merry-go-round of bewildering rabbit holes subject to and likely driven by all the normal human cognitive biases that, whether we recognise it or not, we all have.

i have lost count of the number of conversations I have had with people who firmly believe in some cause and effect relationship relating to their illness - often including detailed mechanisms they believe are at work - but that are based on only the most ambiguous of clues - like " my pee smelled funny - so it means....." or "My heart rate went high and i started sweating so that means ....." but where anyone looking in from the outside can clearly see such events could have many alternative explanations.

even with careful records - association (in time for instance) is not causation - but it will at least give you something to start with.

this will help you identify patterns - show up what other confounding factors also changed and may be involved - help you organise trials changing only one thing at a time ( its surprising how hard this is to do if you actually start listing all the things that change from day to do even when you are trying to keep things stable - and change only one factor at a time)and also provide historical records where you can check for similar reactions in the past.

if we hand our care over to a practitioner - then we forgo the need for this by stepping back and allowing them to take control and guide our care based on their experience over 1000's of patients

in the absence of such expert care - and instead operating in the world of N=1 trials ( trials where we experiment on ourselves) - the human mind is a meaning generating machine - designed primarily for navigating much simpler systems than the inner workings of human health - for example - situations where there is a simple choice to make - between two discrete options - Option A or Option B where the case and effect are known - but is not so good at evaluation the probabilistic likelihoods of 10 or 20 options with little understanding of the mechanisms and only ambiguous clues to work with.
When fed sparse or noisy data on such complex systems, the human brain will reliably "see" patterns and generate unreliable "meanings". But the brain generating them will usually be satisfied with its explanation and blind to the assumptions and gaps that may exist.

as a result we really have to be very careful and systematic to prevent bias, unconscious assumptions, and unknown unknowns, from leading us a long way down the garden path.

 

[Wishful]

if we hand our care over to a practitioner - then we forgo the need for this

Well, if you have a good practitioner, having a record of "whenever I do <this>, I get <this response> 17.5 hrs later", and I have recorded 28 incidents of this over the last 6 months." might be useful. I expect that doctors are very aware of the "unreliable meanings" people generate when something is wrong with their bodies, supported by unreliable memories of one or two events, so a detailed record is more likely to be accepted.

However, I suggest not shoving a pile of messy records at a doctor. That might be taken as signs of obsession. Just offer the important fact (This does this reliably) and say that you keep detailed records.

 

[Davsey27]

I'm curious what the optimal rt3 looks like in health controls

Generally I functional medicine it seems <15 levels are suggested and I'm curious if folks that report good general well being fall within optimal ranges

Perhaps it may be naturally high as there may be root causes driving the iinflammations others have suggested which can often be tricky

 

[Garz]

as far as i can see - under 15ng/dl

is the optimal ratio - in healthy controls "normal range" which is typically just 2 standard deviations around the mean of all tests - is much wider

Complete Lab Test	Abbreviation (Commonly referred to as)	Normal Range (Reference range on labs)	Optimal Range (Based on healthy adults)

Reverse T3, Reverse Triiodothyronine

RT3

9.2 – 24.1 ng/dL

Less than 15.0 ng/dL

from https://www.restartmed.com/normal-thyroid-levels/

 

[Shanti1]

Generally I functional medicine it seems <15 levels are suggested and I'm curious if folks that report good general well being fall within optimal ranges

Although not validated in studies as being linked to greater health, some functional medicine institutions have proposed that the optimal rT3 level is dependent on free T3 levels with a proposed optimal ratio around 20:1 fT3 to rT3.

To me, an optimal ratio makes more sense than an optimal level because, if your T4 was really high, either due to hyperthyroid or excessive thyroid medication, your body would convert it to rT3 and to T3. It would then be appropriate for your rT3 to be high since it blocks active T3 to minimize hyperthyroid symptoms. Similarly, maybe someone's rT3 is lowish because they are hypothyroid, but relative to their T3 or fT3, it is too high, exacerbating the hypothyroid.

 

[Garz]

To me, an optimal ratio makes more sense than an optimal level because, if your T4 was really high, either due to hyperthyroid or excessive thyroid medication, your body would convert it to rT3 and to T3. It would then be appropriate for your rT3 to be high since it blocks active T3 to minimize hyperthyroid symptoms. Similarly, maybe someone's rT3 is lowish because they are hypothyroid, but relative to their T3 or fT3, it is too high, exacerbating the hypothyroid.

i agree with the logic here - as the issue with RT3 seems to be that it binds to but does not activate T3 receptors - effectively blocking T3 function - and normally antagonists like this are concentration dependent.
i haven't seen any data on the relative affinity of RT3 vs T3 for the binding sites - which might come int play if RT3 had super strong binding vs T3.

In practice it may be something of a moot point as the range for optimum T3 ( according to functional thyroid doctors ) is pretty narrow - which would mean when defining target Rt3 levels - a ratio vs T3 or a just aiming for RT3 under a fixed value might, in practice, give a person much the same general result.

perhaps the exceptions being if someone has T3 high or low