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Low Reverse T3

This is my lab results:
TSH      = 2.91 (0.45 - 4.5)
T4         = 3.0   (4.5 - 12.0) -- low
Free T4 = 1.05 (0.82 - 1.77)
Free T3 = 2.6  (2.0 - 4.4)
Rev  T3 = 8.2 (9.2 - 24.1)

I have all the hypothyroidism symptoms like fatigue, cold hands & feet, losing hair & eyebrow, brain fog.  I was tested for thyroid antibodies (TBA & TPO), and they are all negative. Recently I have increased my carbs intake and felt much better.  I believe I also have adrenal fatigue as my daily cortisol cycle are inverted so I wake up several times during sleep.
My question is do I have subclinical hypothyroidism?  Why my reverse T3 is low?  Or I have iodide deficiency?
Thanks so much.
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649848 tn?1534633700
COMMUNITY LEADER
You have to be careful what you read... There is really no condition called "adrenal fatigue" that's recognized by the medical community.  There "is" a condition called adrenal insufficiency, otherwise known as Addison's disease.  

I also can't find any scientific studies, directly linking insulin to the conversion of FT4 to the active FT3.  If you can link actual scientific studies, I'd be glad to read them.

The article you linked is not suggesting a high carb diet; it's suggesting moderate carbs, which is about 30% of calories being carbs.  It's also suggesting that you speak with a dietician who can help you with this.  Carbs should be paired with foods that will slow their conversion to sugar and absorption into the blood stream, as this spikes blood sugar levels, which in turn spikes insulin levels.  Over a period of time, this can cause insulin resistance and/or type II diabetes.  
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649848 tn?1534633700
COMMUNITY LEADER
Your thyroid antibodies do not indicate that you have Hashimoto's... You should ask for a thyroid ultrasound. Some people have been diagnosed with thyroiditis based on the characteristics of the tissue of their thyroid gland.  

High carb diet, such as one that consists of a lot of rice is not good.  Rice is a simple carb that breaks down quickly into sugar in your body and if not used right away for energy will goes straight into fat cells to be stored for later use.  This is what causes us to gain weight.  Heart palpitations can be caused by other things; just eating rice will not cause your thyroid to switch to hyper... in fact, heart palpitations are often present in those of us who are hypo.

The type of carbs you need are complex carbs, such as those found in vegetables - better known a fiber.  It isn't necessary to eliminate dairy or gluten from your diet, unless you have a sensitivity or intolerance to them, but you should eliminate sugar and processed foods.  If you're going to eat rice, make it brown rice, which is whole grain vs white rice, which is processed.

Are you supplementing vitamin D?  Vitamin D deficiency can cause a lot of hypo-like symptoms.  What about the low testosterone?  That can also cause many adverse symptoms.
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1 Comments
Barb, I was on low-carb diet for a long time, but recently I found out that for many people like me, eating a low-carb diet may weaken the thyroid or even cause hypothyroid.  If you google "low carb diet and low thyroid", you will see that eating "safe" carbs like sweet potatoes or rice will help out your thyroid a lot. http://chriskresser.com/is-a-low-carb-diet-ruining-your-health/

As for Vitamin D, I tried to supplement it at a high dose like 5000 iu per day and it give me so much side effects that I gave that up entirely.  The same thing with testosterone therapy. It seems many people have the same problem like mine: Vitamin D intorlerance.

I will ask my Dr. to have my thyroid scan soon.  I'm still reading more about central hypothyroidism as you mentioned above.

Thanks again.
Avatar universal
Check your iron, vitamin and mineral panel. Your iron or ferritin may be low. Its good that RT3 is low. If it is high you have to get on T3 medicine. Try changing your diet for brain fog. Eliminate sugar, dairy and gluten from your diet, include lots of fresh vegetables and fermented food. Take a good quality multivitamin, fish oil and probiotics. Try it for month, I'm sure you will see the difference.  



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1 Comments
Hi Emily, thanks for the comment. I have not checked out my iron & ferritin.  I will ask my Dr. to do that.  I avoid all sugary foods & caffeinated beverage.  But I found out that white rice just calm me down.  I guess maybe that's because I'm Asian :-)
649848 tn?1534633700
COMMUNITY LEADER
Your Free T4 and Free T3 are way too low in the ranges, which definitely indicates hypothyroidism.

Rule of thumb is for FT4 to be about mid range; yours is only at 24% of the range.  Rule of thumb for FT3 is upper half of range and yours is only at 25% of range, so you have a long way to go.  

It's hard to say exactly what's going on... what were the exact levels of your antibodies, do you know?  It's possible they just haven't ramped up or you could have Central hypothyroidism, which is a pituitary/hypothalamus issue, not a thyroid problem.  

Hypothyroidism is hypothyroidism and needs to be treated with replacement thyroid hormones, whatever the cause.

Free T4 is converted to either Free T3 or Reverse T3.   With your Free T4 as low as it is, most likely, it's being converted to Free T3, which is what your body uses.  rT3 is inert.
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1 Comments
Thanks for your reply, Barb.  These are my thyroid antibody results: ATA = <1.0 (0.0 - 0.9) TPO = 6 (0-34).  Lately, I ate a high-carb diet (mostly rice) and felt like my thyroid is switching to hyper mode (heart palpitation).  I think I have Hashimotto, though my labs have not shown up yet.  Also, my free testosterone is low: 341 (348-1197) and my Vitamin D is also low: 24 (30-100).
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