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660067 tn?1267114659

Difference between free T3 and reverse T3?

Hi, my health issues have been a bit complex for the past 10 years or so, but recently my Fibro doc said I have Reverse T3 at a level of 15.7. He ran calcs from the lab sheet and did a diagram showing the T3 comes from the liver...he says an active 20 -30 yr. old woman would be at a 2 - 4 and most Fibro patients range from 6 - 10 and that mine is very high. I am on Cytomel (10mcg in the morn and 10mcg in the eve) along with B-12 injections and D3 supplements. They also want me to start Plaquenil, which is for RA and Malaria; neither of which I have, although most days I do feel like I have arthritis...any comments or suggestions regarding the difference in RT3 and Free T3? It would be greatly appreciated!
Gidge
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314892 tn?1264623903
I am hypo with a low t3. I was also just diagnosed with Neuro Lyme 14 years after a bulls eye rash.

I wasn't a big fan of "t3 conversion" issues. But now, I have a t3 on the very lowest end of the range, a low-ish free t4 and a great (normal 1.1) TSH.

Before getting these latest results, I saw the Lyme specialist for the first time. He checked my reflexes and said he thought I was a bit low on thyroid hormone. I didn't but it, knowing my last TSH was perfect at 0.93.

I did tell him I was getting the t3 checked and he said he was talking about what was going on at the cellular level. Now I have to re-think what I once believed.

Apparently, according to the doctor and my reading, chronic illness, like Lyme, can decrease your bodies ability to convert t4 to t3. Treating the Lyme may correct this or I may decide to add Cytomel. My endo is willing to rx t3 when symptoms do not improve on t4 alone.
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Avatar universal
so confused been taking levothyroxin 100mcg for a while still feel like ****, hair shedding no energy slow matabloism> I just start seeing a new Dr and have an appointment to go over blood work which was reverse t3 38  thyroglobulin antibodies (20  thyroid peroxidase antiobodies 23  tsh 3rd generation .86   free43 249 and free t4 1.2
pls someone what does this mean?
Stephanie
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660067 tn?1267114659
Thanks Stella5349 (Love the cat face!).

In answer to a question I forgot from above, yep tested for RA and it was negative. One step at a time is good, but also having a different health plan has been so rewarding and finally getting answers!
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393685 tn?1425812522
Never a bother and I hope all gets worked out.

Let's look at one step at a time as said earlier

I hope all will be figured out soon for you
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660067 tn?1267114659
Hello all,
Thank you for your comments and info! I may rambIe on like a boring short novel, but here is some of my angst; I can only imagine most of you on this site can COMPLETELY RELATE and I truly appreciate all of your feedback! And yes, it does help!!!

I do not have the labs with me at the moment, but can get them in the next two weeks when I go back to the docs office and will post them then. For years now my T2 and T4 have always showed within normal range. One thing he mentioned was the reverse T3 is a "break" in the thyroid, thus needing the Cytomel to boost my metabolism. AR's last comment sounded about right. I just had not heard of the Free T3 before and was curious to whether they were different or not. I will take a look at the sites you all mentioed; it can't hurt, right!  ( o ;
I will be going in for a more extensive test for Lyme disease which makes alot of sense as I used to ride horses in the creek and do alot of camping/hiking and had one of those little suckers (literally) stuck in the back of my neck. They say that 50% of the tests are false negatives.

I thought I self diagnosed with Cushings disease and had my GP run the tests. When she got them back it did show HIGH cortisol levels and she sent me to an Endo doc who ran more tests (the 24 hour and others) and found I do spike twice a day, but said that it was not Cushings and stress can cause the peaks. He proceeded to tell me I have the "fat" gene and just need to live with it and do Botox (for the excessive perspiring). I have never been this heavy before, nor achy or exhausted. I usually run from 130 to 140 lbs.and am currently at 199 (after losing 15 lbs. since the Cytomel). I am typically very active (playing and coaching my boys soccer teams and adult co-ed, not to mention softball, yoga and walking four miles a day, quilt sew, camp etc., etc...) which has been nil in the past five years. While I know some of it goes hand in hand with depression (which unfortunately is in my face) just to do normal things, I.E. dishes, laundry, dinner putting make up on to try and look/feel better, it all seems nearly impossible, let alone excercise!  

I assume this hits home for some of you and you all must have some of these frustrating and annoying docs who blow you off, but it has been worth plugging along and finally getting answers.

In the past I had chronic endometriosis so in all I have had 10 abdominal surgeries (3 c-sections and total hysterctomy in '06 included )...the say being put under anesthesia that much can cause FM, not to mention five concussions from sports. So, who knows exactly what has caused the FM and Reverse T3, GERD and depression, but it is the world I live in and can't wait to get better.

Again any experiences and knowledge is happily rec'd and I hope this didn't come across as a whinny baby, but more of a frustated mom who wants to get her life back. Thanks so much and happy TGIF! + / +
Gidget                                           V




Helpful - 0
213044 tn?1236527460
After reading about fibromialgia, I don't think it is pertinent to request further test information from gidget. The tests are not going to look good anyway.

They don't pertain to her questions or her problem.

I was wrong with my initial theory, but I said it was just a guess and added I probably was mistaken.

She asked what the difference was between reverse T3 and free T3.

The answer is, they are the same chemical, but reverse T3 is a mirror image of Free T3. Reverse T3 attaches to T3 receptors in cells, upside down, and do nothing except block T3 receptors. We all produce a tiny amount of reverse T3, so normally this does not present a problem. If the amount of Reverse T3 rises high enough, it starts hogging most of the T3 receptors and then metabolic processes are interupted at the cellular level.

What causes this? Elevated cortisol levels. Stress, chronic illness, or autoimmune diseases, which result in a temporarily elevated Cortisol level. In the liver, the excess cortisol interferes with conversion and T4 is converted to Reverse T3 in elevated quantities, as well as converting T4 to T3.

When the cortisol levels drop, the condition rectifies itself.

How is it treated? Many doctors do not treat it at all, because it often does not present a major problem and it self regulates.

In some patients, like fibromyalgia patients or those with chronic cortisol problems, treatment is required, and the treatment is T3. A slow release compounded T3 is preferable to Cytomel, because Cytomel is so short lived, and creates daily imbalances in the blood hormone levels. Treatment is continued until Reverse T3 levels are normal.

Fibromyalgia patients are often prone to developing autoimmune hypothyroidism, so that needs to be monitored.

From the reading I did, it seems there are not many labs in the country that can process a Reverse T3 test acurately. I don't know why that is. It was stated that there are dozens of labs that can process the test, but only four or so that are trustworthy. I have no idea of the validity of this claim, but it came from a fibromyalgia site that wasn't selling anything, so there may be something to it.

I hope this information helps gidget.

Laura, if you have other questions or opinions on the link I provided regarding Wilson's Syndrome, you can PM me or start another thread about it. I was correct in pointing out that the first link provided had too much misinformation to be taken seriously, and I did so as a public service. It was not an attack on anything or anyone. Simply the truth, which is what we all seek.
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499534 tn?1328704178
I agree Stella....test results first.
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393685 tn?1425812522
Gidget

Are you able to post the TSH - Free T3 and the Free T4 tests at all?

Also if you have the lab information on the ranges of everything that may also help out alot too.

Were you tested for RA?

Let's tackle one thing at a time and figure out why this RT3 is a problem and lets see if others can suggest what you and your doctor could look at.


I think looking at this simply first with your labs is best before opening up a ton of links on you that may not even be your situation.

Only suggestions.



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213044 tn?1236527460
"In 1992, the Florida Board of Medicine fined him $10,000, suspended his license for six months, and ordered him to undergo psychological testing. If his license is reinstated, he would also be required to take courses in endocrinology, the scientific method, and medical ethics."

It goes on with more details if you look at the link.

He no longer practices medicine.
He has an internet business that is making him money.
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213044 tn?1236527460
He had his license to practice revoked, and was ordered to undergo psychlogical evaluation.
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393685 tn?1425812522
I am really picking my brain here - but I do remember a study (or treatment)  or article ( whichever) done by Dr Wilson that during the course of treatment for RT3 with a dozen or so patients 2 people had passed away.

There was speculation that Dr. Wilson's T3 treatment was not safe - but I do not remember if anything was proven at all.  The medical profession will argue this as much as they argue on everything about thyroid disease. I lend towards Wilson Syndrome being a real situation for some people and they are completely ignored.

Again another sad move on the medical communities that should be looking out for every individuals welfare.

Yet also as I recall - the other patients recieveing the same T3 therapy recovered 100% from the RT3 pooling and was then able to recieve treatment for the hypothyroidism with T3/T4 medication.

Regardless the test of RT3 exsists,  As everyone posts to the individual asking the question. RT3 can not be even looked at without looking at the whole Free T3 and 4 tests together. It is impossible to think RT3 is a factor without proper tests along with it.

It's an altered conversion of hormones that binds the receptors to release T3.  It's very clear.
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213044 tn?1236527460
http://www.quackwatch.org/search/webglimpse.cgi?ID=1&query=wilson%27s+syndrome

This should answer all of your questions.
With extra links if you want to read more!
Helpful - 0
499534 tn?1328704178
That actually is a good article....it states that it is rare and complicated to diagnose without the reverse t3 test. Why do they have a reverse t3 test then??? Why did I have an endo who ran the reverse t3 if it is rejected??
Please show us the proof where drs have been taken to court for following Dr Wilson's teachings and therapies? What did they get in trouble for exactly? What therapies were they using? What exactly about wilson's syndrome was rejected by the medical community and who is the "medical community"? Are these just individual drs rejecting this? Is there a proper medical term name for the disorder of too much reverse T3?

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213044 tn?1236527460
Wilson's Syndrome has been rejected by the medical community.

The first five paragrphs may have some good information, but the rest of that link is highly questionable and doctors have been taken to court for following Dr. Dennis Wilson's teachings and therapies.
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499534 tn?1328704178
What was your last free t3 and free t4 levels with lab ranges?? List that along with the reverse T3. You need to see the free t3 and t4 with it in order to see the conversion.  T3 is the active hormone in your body....used for metabolism, brain, etc. Most of conversion takes place in liver, but also happens in other locations of the body as well. We really need to see all your thyroid lab values in order to comment.
AR is correct in that reverse t3 is a useless form....but....sometimes it is due to a diff type of conversion problem where free t3 is converted to reverse t3 rather than being used in the body. Those with this problem end up having to take a t3 only med for a while until the body corrects itself and is usually a temporary condition. Everyone is diff so there is other tests and levels to consider. Are you on Cytomel only without a T4 med?  
Need to see your other test results... :) :)
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Avatar universal
I hope this will help

http://www.knoxintegrativemed.com/wilson's%20syndrome.htm
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213044 tn?1236527460
Free T3 is the thyroid hormone that enters the cells of your body and regulates metabolism.

Reverse T3 is like anti-matter. It is T3, but sort of a negative T3 that is junk. It is not usable.

This is just a guess, but I am never afraid to guess. LOL!
Your body is producing enough Free T3 from the Free T4 your thyroid is providing. More to the point, the Cytomel you are taking is providing too much T3 and your body is converting T4 from your thyroid to Reverse T3 at a rate that is not healthy.

I'll stop right there, because I am not sure I know what I am talking about. In fact, I'm pretty sure I don't know what I am talking about.
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