# dr. oz on reverse t3



## smelliebellie (Oct 14, 2012)

just saw a clip of dr oz's show today on how important getting reverse t3 done on your labs! im not crazy! maybe all i really need is t3 or t3/t4 to help solve my hypo issues ! slowly getting better but not optimally there yet.

"slow and steady wins the race"
thanks for your advice and support, thyroidboard members!


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## Octavia (Aug 1, 2011)

I'm glad you're getting better. And I'm glad you're not crazy.


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## allowingtoo (Mar 31, 2012)

Huh. Never heard of that. Had to Google it.

http://www.stopthethyroidmadness.com/reverse-t3/


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## smelliebellie (Oct 14, 2012)

exactly - allowingtoo.

not a lot of people know of this test. and usually its high stemming from change in metabolism, infection, gut issues, etc.

im only on t4 medication and im planning on either switching to t3/t4 or adding some t3 to my med to see if it will help clear my High rt3 level. it all depends on my bloodwork due in 6 weeks.


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## lainey (Aug 26, 2010)

When you find a study from a recognized source regarding reverse T3, its importance, consequence, or the usefulness of "treating" it (however that may be) please post the link.

Reverse T3 can also be high when there is rapid conversion of T4 to T3, as is found in hyperthyroidism--as a protective measure, the body produces an inert form of T3. As you can see, there is more than one way to look at it.

In general, the whole "reverse T3 hypothesis", and any suggested treatement to address it, is considered dubious, at best. I have known of several past posters in other forums who have tried the T3 only "treatment", with no success.

Dr. Oz got his start with Oprah.

*sigh*

He probably helped her with her "thyroid" problem.


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## Andros (Aug 26, 2009)

lainey said:


> When you find a study from a recognized source regarding reverse T3, its importance, consequence, or the usefulness of "treating" it (however that may be) please post the link.
> 
> Reverse T3 can also be high when there is rapid conversion of T4 to T3, as is found in hyperthyroidism--as a protective measure, the body produces an inert form of T3. As you can see, there is more than one way to look at it.
> 
> ...


And that last sentence deserves a double sigh!

Anyway, as you no doubt know, the body needs some precursor molecule T4 to initiate peripheral deoiodination.


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## smelliebellie (Oct 14, 2012)

Never said I was only going to use t3. either add t3 to my t4 med or start a
combo of both. My ND recommends I try the combo but is being very patient with me because I want to see if t4 alone will help. However adding more t4 can ramp up my rt3 even higher so I need to decide soon. Gonna wait on my labs next month.


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## lainey (Aug 26, 2010)

The "treatment" for high rT3 is a short course (about 6 weeks) of T3 only medication, with a pause, and then the resumption of T4 medication.

In your last labs, if memory serves, you had free T3 that was already high in the range--that, as well as the exogenous T4, is likely the source of your high rT3. The first "experiment" would actually be to go off T4 medication, to see if the labs "right" themselves on their own. Then, add back T3 only as said above, and once again wait to see if the labs "right" themselves on their own.

That is, of course, if you give credence to the "rT3 hypothesis" to begin with. Just because something is discussed in books or the media does not mean that it has support in clinical practice or research.

Once again, I will suggest that a high free T3 does not make you a good candidate for T3 therapy of most types, as it will likely make you easily clinically hyper.


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## smelliebellie (Oct 14, 2012)

like i said, not going to try t3 alone. and can i add that there are people out there who are on t3 alone who have solved their rt3 issues with success. "recovering with t3" is a great example. theres just a mix of opinions out there. based on my next lab work, i will decide to add a small dose of t3. maybe thats all i need to correct my remaining aches. no feeling hyper over here! those issues resolved two months ago. honestly, im happier being hypo than hyper. and if a small dose of t3 makes me hyper, then either i have adrenal issues or i may not need it after all. You just never know til you try and see what works right for you. trial and error.


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## smelliebellie (Oct 14, 2012)

also, heres a "recognized" source i came across from a wonderful book i read weeks ago.

Mary Shomon's, The Thyroid Diet,
"a high rt3 demonstrates that there is either an inhibition of rt3 uptake into the cell and/or there is increased t4 to reverse t3 formation.. reverse t3 is an excellent marker for reduced cellular t4 and t3 levels not detected by TSH or serum t4 and t3 levels.. high or high normal rt3 is not only an indicator of tissue hypothyroidism but also that t4 only replacement would not be considered optimal in such cases and would be expected to have inadequate or suboptimal results"

not everyone can believe it, but ive read this numerous times from credible sources via books and not so much on the internet.


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## CA-Lynn (Apr 29, 2010)

Dr. Oz.......not a high opinion of him in my house.

The test is antiquated and I haven't had one in 20+ years. But if you feel you have nothing better to do and want to run the labs know that the test has to be done at the same time you do the free T3. Then measure the ratio between the two by dividing the RT3 into the Free T3. The body produces the benign RT3 naturally to rid itself of excess of T4, but in some cases, such as high or low cortisol, it's made in excess and that excess clogs your cell receptors from receiving regular T3.

Here are some credible articles on elevated rT3:

http://www.temple.edu/imreports/Reading/Endo - Non-thyroidal illness.pdf

http://www.healthscopepathology.com.au/index.php/functional-pathology/tests/reverse-t3-rt3/

http://labtestsonline.org/understanding/analytes/t3/tab/test

Oh yes, if you're taking hormones or birth control pills, NSAIDS, or aspirin, forget taking the test as the results will be skewed.


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## lainey (Aug 26, 2010)

> credible sources via books


Just because it is in a book, or written in print vs. online, from a famous "advocate", even, does not make it credible. It would be in this case and in many others, the evidence that is being used to back up their assertions lacks the form and substance of clinical evidence to back it --no different than mine, I suppose (other than other internet posters have gone down this road, and I have researched it on their behalf, and have yet to find anything that isn't heresy to support the idea). So then it becomes, what reliable research has been used to make these determinations--replicable studies, etc. When you find these studies, government or otherwise, even that support the idea that the addition of T3, or the resultant reduction of rT3 has a positive clinical impact on patients, please do share them.

Most who examine the influence of elevated rT3, and tissue hypothyroidism, do so from the standpoint that for some reason the patient has an impaired T4/T3 conversion axis, as further evidenced by low free T3 lab values. Once again, I fail to see how this applies when the free T3 lab values are high in the range.

At some point, you have to ask yourself, if this is such a problem, how come EVERYONE is so stupid as not to know it--that in and of itself, if it does not ring alarm bells as making the idea suspect, I don't know what does.

There is nothing wrong with trial and error. On the internet especially, it is what ever the thyroid patient "thinks" will work that may.


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## smelliebellie (Oct 14, 2012)

thank you CA-Lynn for posting credible "links".

1) doctor requested the test, its not that i dont have anything better to do. i actually see a doctor who is well versed in hashimotos disease because she has hashimotos herself.
2) currently dont take any birth control, nsaids, or aspirin so theres no problem there.


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## smelliebellie (Oct 14, 2012)

my ft3 was 3.15 and rt3 was 364. (these were drawn at the same time) which leaves me with a ratio of 8.7 
http://www.stopthethyroidmadness.com/rt3-ratio/


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## CA-Lynn (Apr 29, 2010)

I think you're grasping at straws. Sometimes you just have to ask yourself, "If this test is so wonderful, why is it that few people use it anymore?"

Reverse triiodothyronine, also known as reverse T3 or rT3, is one of the hormones produced by the thyroid gland. The thyroid gland's function is to regulate metabolism, and it mainly secretes the hormones T4, or thyroxine, and T3, or triiodothyronine, but reverse T3 is also produced in small amounts. Triiodothyronine is the active thyroid hormone and, when circulating thyroxine reaches the body's tissues, a proportion of it is converted into triiodothyronine. Reverse triiodothyronine, which is inactive, is a byproduct of this conversion process, and most of it is produced in this way. Increased levels of reverse triiodothyronine are *sometimes* found in patients who have serious illnesses.

The reverse triiodothyronine molecule is an example of what is known as an isomer of triiodothyronine, which means it is a molecule containing all the same atoms as triiodothyronine but has those atoms arranged in a different structure. Around 95 percent of reverse triiodothyronine in the circulation is created during the conversion of T4 to T3 by deiodinase enzymes. The remaining five percent is produced by the thyroid gland.

Read more at http://www.wisegeek.com/what-is-reverse-triiodothyronine.htm


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## CA-Lynn (Apr 29, 2010)

You asked for scholarly and credible publications about rT3, so here you go:

http://scholar.google.com/scholar?q...a=X&ei=i54WUf6aA-aA2wWdyIHADQ&ved=0CC4QgQMwAA

You'll notice that most of them are pretty old........which typically means they've found a better method for diagnostics.


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## lainey (Aug 26, 2010)

There is a difference between the "sick euthyroid syndrome"--a known phenomenon at times of physical stress such as surgery as presented by CA-Lynn--and the implications by Mary Shomon, Dr. Oz, STTM, et al, that high rT3 may in some way be a treatable malady. Sure studies have noted the presence of rT3, but once again, I have yet to find anything that discusses correcting it, or even the significance of doing so. Ergo, the idea, as CA-Lynn also said, that one is really grasping at straws when you start to calculate "ratios" on this.

Even the STTM website ultimately goes from high rT3 to stress reduction via adrenal support (aka adrenal fatigue).

Smelliebellie, based on your recent labs from other posts, I am really not convinced that the answer to your problems lies in more or different thyroid medication. You had good numbers without medication, and slightly better numbers with a trial dose. If that is not doing the trick, it might be more productive to focus on other possibilities.


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## smelliebellie (Oct 14, 2012)

Ive done every test under the sun. Stool, saliva cortisol, numerous blood tests and rheumatological ANA CRP tests coming back normal or low normal. I am very early in my stages of Hashis, im suspecting my thyroid gland is putting out some type of hormone still. Also, even at 50mcg of t4, in feeling better than I did in October. Not sure if you or Ca-Lynn are on t4 alone but I might just have to give the t4 a little more time to work.


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## CA-Lynn (Apr 29, 2010)

Focus on other areas. I think you're spinning your wheels.

Suggestion: Go outside and play rather than masticate on this.


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## smelliebellie (Oct 14, 2012)

Sorry, not masticating on anything. Until my thyroid levels are under control, ill be roaming around here for answers/advice. Thanks and have a fantastic day!


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## iroczinoz (Aug 15, 2011)

Did you ever get your progesterone and estradiol tests done?


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## smelliebellie (Oct 14, 2012)

nope, still havent gotten around to doing that because I just barely got my period after two months without it. I have irregular cycles


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## iroczinoz (Aug 15, 2011)

Well that is another symptom of estrogen dominance. Best day for bloods is day 18.


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## Danniswirl (Feb 23, 2013)

PCOS, Celiac Disease, and hashimotos unfortunately go hand in hand. It does seem likely you have Pcos too.


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## smelliebellie (Oct 14, 2012)

danniswirl - just saw a new obgyn doctor last week and had blood work done. I dont meet criteria for pcos, nor do i have the symptoms. I do have endometriosis.


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