Reverse T3 (also called Reverse Triiodothyronine)

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.