A healthy thyroid produces the following hormones: T4, T3, T2, T1 and calcitonin. T4, a storage hormone and the most abundant, is meant to convert to T3, the most active hormone. T3 is also produced directly by your thyroid, i.e. you get T3 from conversion, and you get it directly.
But there’s another substance produced by the thyroid called RT3, which means Reverse T3. It is also converted from T4.
Why does my body produce RT3 (Reverse T3)? In any situation where your body needs to conserve energy, such as emotional, physical, or biological stress, your thyroid will properly convert any excess T4 to the inactive Reverse T3 (RT3) as a way to clear out the extra T4. This can happen when you are chronically or acutely sick (such as having the flu, pneumonia, etc), after surgery, after a car accident, etc. It’s normal.
Can I as a thyroid patient make too much RT3? Definitely yes. Understand that this is not a problem for all thyroid patients. But for many, you can find yourself with excessive RT3 from three common conditions, which are either undiagnosed or undertreated and thus, are ongoing: low ferritin, and/or high or low cortisol, and is exacerbated by your private life stresses. This RT3 problem is sometimes referred to as Wilson’s Syndrome, though thyroid patients found information that went beyond what Dr. Wilson discovered (and named after himself), as explained below, i.e. it’s not a unique, unrelated condition. It’s explained by the below.
What specifically are the reasons I, as a thyroid patient, make too much RT3? On top of the common stresses of your lifes, there are three common biological reasons, with the first two related to your adrenals, and the third related to your storage iron levels.
When biological stress is excessive, such as being on the inadequate treatment of T4-only (Synthroid, Levoxyl, levothyroxine, Eltroxin), or being held hostage to the lousy TSH lab test which only serves to keep you underdosed, or having a myriad of conditions related to poor treatment (including gluten intolerance/Celiac, low B12, etc), your adrenal glands produce high amounts of cortisol to help you cope with ongoing hypothyroidism and lingering symptoms and conditions. The excess cortisol inhibits the conversion of T4 to T3, and instead produces even larger amounts of RT3, creating an RT3 problem.
When biological stress is ongoing, your adrenals will eventually become fatigued, dropping from high cortisol to low, and those low levels put you into the problematic state of adrenal fatigue, which causes chronic anxiety, poor coping skills, paranoia, easy nausea, sensitivity to light or sounds, psychological issues, etc. When you don’t make enough cortisol, thyroid hormones can pool high in your blood. So your body responds by converting the T4 to excess RT3.
When ferritin, aka storage iron, is low, which is quite common in thyroid patients, your red blood cells become less plentiful, and carrying thyroid hormones via your blood becomes inadequate, causing thyroid hormones to pool in your blood. The body responds by producing excessive amounts of RT3 to clear out the excess T4.
***Note that you can have either a ferritin problem, or a cortisol problem, or BOTH.
When I make too much RT3, what happens? An over-abundance of RT3 (RT3 dominance) blocks the ability of the cell receptors to receive T3, and hypothyroid symptoms are the result, including a lowered body temperature, fatigue, anxiety, weight gain, hair loss and more.
Can labwork help me discover this? Definitely. With labwork, you are not necessarily looking for a RT3 result high in the range. Instead, you are looking for a problem in the ratio between the RT3 and the Free T3. (See page 162-163 in the STTM book for further detail)
Can I order my own labwork for this, since I doubt my doctor will do this? To order your own labwork, go here. HealthcheckUSA requires a prescription for RT3 labwork, but you can use MyMedLab and Direct Sciences. Remember to order a free T3 at the same time for ratio comparison. All facilities can test your ferritin without a doctor’s prescription.
Where else can I read more info on this: To read about RT3 problems, you can read patient Nick Foote’s compilation of Questions and Answers gleaned from the RT3 Yahoo group. You can also glean good information from the STTM book which can be taken into group doctor’s office, since doctors tend to respect books more than websites.
Where can I talk to others about this?? An RT3/T3 group can be found on the Talk to Others page.
