# High RT3 and sick all the time



## jmichaels (Jun 17, 2011)

Hi all. I'm new here, and seeking some input on my lab results. First, a bit of background: Male, 40yo. I've been feeling less than healthy for a few years now, with fatigue, brain fog, low libido and occasional e.d., frequent colds. Except for the rapidly increasing dark puffy bags under my eyes, I look healthy enough. I'm a healthy enough weight, and exercise when I'm feeling good. Though, I've gotten "doughy" (not overweight though) the past few years, and losing it is extremely difficult; strenuous exercise 3x a week has done nothing for that or my overall energy level. Now, I'm quite functional, only sleep 8 hours a day, and keep my head above water. But I know that I don't feel as good as I should considering my diet, physical fitness, and lifestyle.

I've seen a few doctors about this the past few years, and nothing has come of it. Most of them are very conservative, and my current doc is the sort that only tests TSH when looking for thyroid issues. I've looked at anything I can find that might be a culprit for my diminished health, including sex and thyroid hormones. I have tested low normal for Testosterone and high normal for Estrogen. Lowering the Estrogen with Arimidex helped things a bit, and last year supplemented Testosterone. That was good for the sex drive, but didn't help much else, so discontinued use; didn't seem worth injecting myself every week for life for minimal results. My recent trips have been because I've spent the majority of 2011 actively fighting colds, or recovering from them. I've had 3 colds that were pretty severe and lasted for nearly 3 weeks each. One of those I came down with after being recovered from another for only a few days. Very frustrating, and depressing. And I've been getting more colds than anyone else I know for years. When I'm not sick, I feel reasonably good, staying active enough and mentally well.

Past week I've tested for Hepatitis, HIV, Lupus, EBV, and thyroid hormones. The only thing that showed up as abnormal was my Reverse T3. The FT3/RT3 ratio is about 7, which would be much too low from what I've read. My questions for the experienced here are: Could this and thyroid issues be the root of my troubles? Or is it more likely that the elevated RT3 is just a symptom of something else that is causing my problems? About the only thing I can think of that hasn't been checked are food allergies; can those (like gluten intolerance) cause elevated rt3?

My recent test results:

*TSH 0.947 uIU/ML (0.45 - 4.5)
FT4 1.48 ng/dL (0.82 - 1.77)
FT3 3 pg/ml (2.0 - 4.4)
RT3 403 pg/ml (90 - 350)*

Thyroid Peroxidase antibodies 7 iu/ml (0-34)
Antithyroglobulin antibodies <20 iu/ml (0-40)

If anyone has any input, I'd be extremely happy to hear it. Mostly wondering if this is something I should focus on or not, and if so, where to go next. Thanks!


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## Andros (Aug 26, 2009)

jmichaels said:


> Hi all. I'm new here, and seeking some input on my lab results. First, a bit of background: Male, 40yo. I've been feeling less than healthy for a few years now, with fatigue, brain fog, low libido and occasional e.d., frequent colds. Except for the rapidly increasing dark puffy bags under my eyes, I look healthy enough. I'm a healthy enough weight, and exercise when I'm feeling good. Though, I've gotten "doughy" (not overweight though) the past few years, and losing it is extremely difficult; strenuous exercise 3x a week has done nothing for that or my overall energy level. Now, I'm quite functional, only sleep 8 hours a day, and keep my head above water. But I know that I don't feel as good as I should considering my diet, physical fitness, and lifestyle.
> 
> I've seen a few doctors about this the past few years, and nothing has come of it. Most of them are very conservative, and my current doc is the sort that only tests TSH when looking for thyroid issues. I've looked at anything I can find that might be a culprit for my diminished health, including sex and thyroid hormones. I have tested low normal for Testosterone and high normal for Estrogen. Lowering the Estrogen with Arimidex helped things a bit, and last year supplemented Testosterone. That was good for the sex drive, but didn't help much else, so discontinued use; didn't seem worth injecting myself every week for life for minimal results. My recent trips have been because I've spent the majority of 2011 actively fighting colds, or recovering from them. I've had 3 colds that were pretty severe and lasted for nearly 3 weeks each. One of those I came down with after being recovered from another for only a few days. Very frustrating, and depressing. And I've been getting more colds than anyone else I know for years. When I'm not sick, I feel reasonably good, staying active enough and mentally well.
> 
> ...


Hi there and welcome to the board.

Interesting.

This study showed that increased T4 and RT3 levels and decreased T3 levels are associated with hypothyroidism at the tissue level with diminished physicial functioning and the presence of a catabolic state (breakdown of the body).

This is why your muscles are non-responsive.
http://www.holtorfmed.com/index.php?section=downloads&file_id=12

I actually think you may be hyperthyroid.

There are antibodies and immunoglobulins that block the receptor sites forcing the T4 to convert to rT3 instead of T3 which is your active hormone in order to keep you from feeling the symptoms of hyper. The body has amazing ways of protecting it's self.

Here is a good source for rT3 info.
http://thyroid-rt3.com/whatare1.htm

And I personally feel that you should have the following tests.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.

http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Your Free T3 is much too low. It is below the mid-range of your labs range. Ideally it should be around 75% of the range given by your lab.

Sorry you are having such a hard time of it; I hope we can help!


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## lainey (Aug 26, 2010)

I think your thyroid concerning TSH, FT4 and FT3 results are fairly good actually. Your Ft4 especially is high enough in the range that it would be difficult to convince a doctor to give you thyroid replacement medication.

The use of the RT3 test is debatable, and most docs consider it outdated.

You may benefit from further antibodies testing, but the tests that you have had are also not particularly elevated.

Have you been tested for insulin resistance/type 2 diabetes?


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## jmichaels (Jun 17, 2011)

Andros said:


> And I personally feel that you should have the following tests.
> 
> TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.
> 
> ...


Thanks for the reply and links Andros, it's much appreciated! I actually read that Holtorf Med link last night, was thinking of sending it to my doctor. They always love when you try to educate them.....

I already got the TPO and Thyroglobulin Ab tests:

*Thyroid Peroxidase antibodies 7 iu/ml (0-34)
Antithyroglobulin antibodies <20 iu/ml (0-40)*

I assume having a low TPO reading is good, but perhaps having any at all is some sort of red flag? I also had some other general, non-specific immunoglobin tests done. Not sure if they help in this situation, and I wasn't able to find much about what they do indicate:

*Immunoglobin G 1488 (700 - 1600)
Immunoglobin A 383 (70 - 400)
Immunoglobin M 112 (40 - 230)*

I'll see what luck I have getting my doctor to run some more thyroid tests; he's very by the book, and apparently that book is fairly old and mainstream.


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## jmichaels (Jun 17, 2011)

lainey said:


> Have you been tested for insulin resistance/type 2 diabetes?


I've had fasting glucose levels taken (always under 100), and fasting insulin (low end of normal). I'm pretty sure from what I've read that I don't have diabetes, but certainly would seem to have reactive hypoglycemia, which could lead there. I plan on pushing my doc for some of the more aggressive tests in this area. Unfortunately, last time I mentioned my hypoglycemic episodes, he just looked at me and said "Hmmm, that's interesting", without further comment or action. yeah, my doctor sucks..... unfortunately, none of the others I've seen through my provider are any better. They get you in, get you out, run a few of the most basic tests, and tell you nothing's wrong with you. My Neurologist was the exception, but he probably wouldn't see me for thyroid issues.


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## jmichaels (Jun 17, 2011)

I just remembered, I did also just have an ANA test, for Lupus, that was negative. So really, TSI and Cortisol are the important ones that I have left, and maybe ferritin.


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## lainey (Aug 26, 2010)

Even if you have TSI, unless it is very high, your numbers are not showing a treatable thyroid problem at the moment.

If you have tested low for testosterone, you should be monitoring those levels. You did the shots/hormone treatments so if that is still low or now lower it could be part of the issue.

Has anyone checked your vitamin D levels? Low vitamin D can cause a lot of the symptoms you describe.


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## Andros (Aug 26, 2009)

jmichaels said:


> Thanks for the reply and links Andros, it's much appreciated! I actually read that Holtorf Med link last night, was thinking of sending it to my doctor. They always love when you try to educate them.....
> 
> I already got the TPO and Thyroglobulin Ab tests:
> 
> ...


I love it when I find things. LOL!

Here............

The five major types of antibodies are:

IgA. IgA antibodies are found in areas of the body such the nose, breathing passages, digestive tract, ears, eyes, and vagina. IgA antibodies protect body surfaces that are exposed to outside foreign substances. This type of antibody is also found in saliva, tears, and blood. About 10% to 15% of the antibodies present in the body are IgA antibodies. A small number of people do not make IgA antibodies.

IgG. IgG antibodies are found in all body fluids. They are the smallest but most common antibody (75% to 80%) of all the antibodies in the body. IgG antibodies are very important in fighting bacterial and viral infections. IgG antibodies are the only type of antibody that can cross the placenta in a pregnant woman to help protect her baby (fetus).

IgM. IgM antibodies are the largest antibody. They are found in blood and lymph fluid and are the first type of antibody made in response to an infection. They also cause other immune system cells to destroy foreign substances. IgM antibodies are about 5% to 10% of all the antibodies in the body.

IgE. IgE antibodies are found in the lungs, skin, and mucous membranes. They cause the body to react against foreign substances such as pollen, fungus spores, and animal dander. They may occur in allergic reactions to milk, some medicines, and some poisons. IgE antibody levels are often high in people with allergies.

IgD. IgD antibodies are found in small amounts in the tissues that line the belly or chest. How they work is not clear.

http://www.webmd.com/a-to-z-guides/immunoglobulins

Low TPO is good but it does indicate that something is afoot. Antibodies do wax and wane and sometimes it is tricky to catch when they are raising their ugly heads.

ANA is suggestive of many many things. The down and dirty test for Lupus is Anti-DNA, C3 and C4. You could NOT have ANA but still test positive for Lupus.

Look this stuff up here..........
http://www.labtestsonline.org/


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## 8889 (Jul 28, 2012)

jmichaels

I was curious what you decided to do about your high RT3? Did your doctor ever consider trying low dose T3 therapy?


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