# 23 year old girl, reverse T3 syndrome



## cookfan56 (Oct 26, 2011)

Hi. I am a very concerned mother of a 23 year old daughter. She recently, in the last six months, put on about 40 lbs and *was overweight before that.* She also started having severe cystic acne covering at least half her face. Before that, nothing more than occasional pimples. She saw a D.O. rather than an M.D. We don't live near her and she goes by our health insurnace list. I begged to get her into a real endo appt. *which I did myself* and she is seeing them next week.

In the meantime, she was prescribed oral steroid for the acne, which has mostly cleared up, and a time release T3 preparation from a compound pharmacy for the reverse T3. It seems little is known about reverse T3 and also odd, but lucky, that doc ran that test because other thyroids were "normal".

But since then, I have spoken to my own endo here (we live in cities 5 hous apart), and told that what my daughter has is called "sick euthyroid" and is normally seen in hospital patients who are very sick! I personally am emotionally sick because I can't attend do appts. with her, she is passive in personality, and she *looked sick and very unwell the last time we saw her.

Anyone know anything about "sick euthyroid", reverse T3, or Wilson's as it is sometimes called?

As for her, she takes oral contraceptives, has for several years, takes Zoloft, does not smoke, does not eat particularly healthy, and tends to binge drink at times with her boyfriend, but takes no illegal drugs.

Signed, Very Worried mom.


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## lainey (Aug 26, 2010)

Can you report lab results with ranges?

Were antibodies tests run? If so, what were the results?

What is the name and dosage of the medication she is taking?

I am confused regarding your endo's comment, because what they are referring to is usually seen in patients that have another underlying condition for which they are hospitalized for. See:

http://emedicine.medscape.com/article/118651-overview

I will say that the reverse T3/Wilson's syndrome is considered in most circles to be a spurious diagnosis. In any case, the only "solution" for that is short term therapy with T3 only medication.


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## cookfan56 (Oct 26, 2011)

lainey said:


> Can you report lab results with ranges?
> 
> Were antibodies tests run? If so, what were the results?
> 
> ...


Lainey,

Her results from her DO read exactly as: (and note he does not put in ranges -- sigh)

AntithyroglobulinAb 20
Candida Antibodies, ual Negative
Iron Bind Cap 388
Iron Saturation 55
Iron serum 212
Reverse T3 298
T4, Free 1.09
Thyroid Peroxidase (TPO) Ab 7
T3 164
TSH 3.210
UIBC 176

I am aware, because I have hashi's myself, that you should supposedly have no TPO antibodies (mine are around 400). I don't know if the fact that she has even 7 is significant. The DO claims that only her Reverse T3 is abnormal. However, I also know that some docs consider the range for TSH to be suspect if it is over 2.5, although the range for some books goes to 4.0 for the TSH. Personally I feel unwell if my TSH is not under 1.0

These are the only tests he ran. No CBC, no liver profile, no glucose tolerance, no check for prediabetes (even though diabetes runs in our family). She sees an actual endocrinologist next Mon. so I am hopeful.

I do not know the doseage of the time release T3 prescribed. She works many hours and goes to school at night and communication isn't easy with her (also compounded by how lousy she feels.) I do feel she may have adrenal fatigue (also not checked for) which may have led to the reverse T3.

Also, I'm still trying to find out the role of the severe cystic acne, which occured exactly at the time of the severe weight gain.

I know this isn't as much info as you hoped for, but all I have. I also truly appreciate your response. I can't tell you how many hours I have spent in recent days researching this diagnosis. Howver, I also know that Rt3 can be a "spurious) diagnosis, however, some docs are still convinced it is real and can mean there is an underlying systemic disease. Which worries me, since I have hashis, which is autoimmune, and I worry that she may have an autoimmune disease.

Thanks.


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## lainey (Aug 26, 2010)

It is not true that you should have no thyroid antibodies. They do occur in the general population and they do occur in the presence of no thyroid dysfunction. Her levels of antibodies at the moment are very low.

Iron results, once again without ranges (you need these because each lab is different!) do not look horribly low.

TSH is only slightly elevated using the newer ranges up to 3.0 and free T4, lacking lab ranges, looks like it would fall within the normal range. Thyroid-wise, TSI and free T3 are the only things missing. You might find a doc that would trial her on T4 based on that.

As for the acne, look carefully at the birth control she is using. In women, this is often a hormonal issue. Testing for PCOS may be in order, as well as adrenal issues--all of which could be causing her symptoms.


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## cookfan56 (Oct 26, 2011)

lainey said:


> Can you report lab results with ranges?
> 
> Were antibodies tests run? If so, what were the results?
> 
> ...


When refering to *myself*, not my daughter (I have hashis) I meant to modify my last post that my own Tsh is all over the map: when I felt worst it was .32 (I got the numbers reversed, I feel worse the lower it is). Even at 2.0, I don't feel good. I don't know what number my TSH should be at to feel well. Currently I take synthroid 112 with 5 mcg cytomel each day. I am being changed to 75(?) armour thyroid today. I don't know if the 75 is mg or mcg, or grains, which also confuses me. My own doc has been dealing with me by phone so my details aren't good.

Thanks and sorry for confusion.


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## cookfan56 (Oct 26, 2011)

lainey said:


> It is not true that you should have no thyroid antibodies. They do occur in the general population and they do occur in the presence of no thyroid dysfunction. Her levels of antibodies at the moment are very low.
> 
> Iron results, once again without ranges (you need these because each lab is different!) do not look horribly low.
> 
> ...


Sorry about the antibody confusion. On some boards I have read you should have no antibodies. Confusion abounds :sad0049:

I know her TSh could be elevated, although doc said not. As for acne, I also was very aware that birth control pills influence this however, she is adament about not going off any form of BC at this time. I've asked her about Yaz (not what she takes) and she told me that is worse for acne (whether true or not I don't know.)

I also want her checkked for PCOS because I am very aware that acne and thyroid issues are highly indicative of that. She has not been seen yet by an ob/gyn for that.

She is overwhelmed! Working fulltime as well as going to school with all this. Grad school at that.

Also, could any form of binge drinking be causing thyroid issues? I don't think she drinks often, but when she does I'm afraid it's too much. She refuses to be forthcoming on this issue.:sad0049:


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## Andros (Aug 26, 2009)

cookfan56 said:


> Lainey,
> 
> Her results from her DO read exactly as: (and note he does not put in ranges -- sigh)
> 
> ...


What a shame you can't get the ranges. I wonder if you call the lab if they would send you out a copy w/ the ranges? Different labs use different ranges so anything we would comment on would only be a guess and when it comes to someone's well-being, I defer.

Now..................please allow me to welcome you to the board. You are in the right place for sure. I am positive we will all rally 'round and help you as best we can.

Here is some info on rT3 which you may find helpful.

rT3
http://thyroid-rt3.com/whatis.htm

And, sometimes folks find that alcohol makes them feel better (temporarily, of course) and it helps them sleep when they cannot due to illness. I think ultimately this will turn out alright when your daughter gets the medical attention she needs.










It's hard to be a mom when your children are of legal age. Boy, is it!


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## cookfan56 (Oct 26, 2011)

Andros and Lainey, thanks for the welcomes! Very nice being here. Andros, I don't know any folks on armour so it will be good to report to you how it goes since i just started today. I am the one with hashis, my daughter is the one with the reverse T3. Just to be clear. I originally came on to post about her but did mention myself in the process so thought i better add a signature!

And yes, what's harder than being the mom of an adult with health issues is being 5 hours away and the flights costing $300! I also have a younger one at home so my time is also limited, even if I could easily do the drive alone.


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## Andros (Aug 26, 2009)

cookfan56 said:


> Andros and Lainey, thanks for the welcomes! Very nice being here. Andros, I don't know any folks on armour so it will be good to report to you how it goes since i just started today. I am the one with hashis, my daughter is the one with the reverse T3. Just to be clear. I originally came on to post about her but did mention myself in the process so thought i better add a signature!
> 
> And yes, what's harder than being the mom of an adult with health issues is being 5 hours away and the flights costing $300! I also have a younger one at home so my time is also limited, even if I could easily do the drive alone.


I think you will love the Armour! I hope so, anyway.

You made it clear that you needed some support on behalf of your daughter. Hope the info on rT3 is helpful. Hopefully the doc will start her on a low dose of Cytomel (5 mcg.) and see how it goes?


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## lainey (Aug 26, 2010)

The weight gain and acne could also be tied to the antidepressant. There really are several moving parts here.

There are many types of oral birth control, however, and it doesn't have to be about stopping it but rather, as you already suggested, trying something different.



> Also, could any form of binge drinking be causing thyroid issues? I don't think she drinks often, but when she does I'm afraid it's too much. She refuses to be forthcoming on this issue.


Lifestyle issues such as these have their own consequences. Perhaps they look like thyroid issues when in fact they are not. Poor habits, nutrition and sleep patterns are going to result in health affects such as weight gain, fatigue and other problems. Before assuming a physical problem, your daughter would do better to correct for the effects of these first.

Please don't take this personally, but if she admits to the drinking, there could easily be other recreational drugs--even "mild" ones that she thinks will cause no harm--that could be behind some of the changes. We were all young people, and we don't always tell everything to our parents.

How distressing as a parent, because you really have no control over this, and are in the bad position of having to point out that her behavior could be a good part of the problem.

Keep the discussion open and hopefully she will get further testing to see if there is anything else going on.


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## cookfan56 (Oct 26, 2011)

Andros said:


> I think you will love the Armour! I hope so, anyway.
> 
> You made it clear that you needed some support on behalf of your daughter. Hope the info on rT3 is helpful. Hopefully the doc will start her on a low dose of Cytomel (5 mcg.) and see how it goes?


Well,, the D.O. already started her on a time released compound form of T3 which was just started. When she sees the actual endo next Monday, I'm hoping the endo will run blood tests (extensive ones) and then retest in a month after being on the compounded T3 to see what that did. Apparently the D.O., anyway, feels that you need a special time releaase T3 rather than cytomel. What I'm really hoping against is that the endo totally dismisses the diagnosis of reverse T3 (which she may) and send us in another direction entirely. I don't mind being told she may have other things in addition to reverse T3, but I also want it taken into account. Does that make sense? I am trying to get airline tickets now to go with her to that appt. That was my own former endo before we moved, and she treated me for two years, so knows the history.

Thanks again.


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## Andros (Aug 26, 2009)

cookfan56 said:


> Well,, the D.O. already started her on a time released compound form of T3 which was just started. When she sees the actual endo next Monday, I'm hoping the endo will run blood tests (extensive ones) and then retest in a month after being on the compounded T3 to see what that did. Apparently the D.O., anyway, feels that you need a special time releaase T3 rather than cytomel. What I'm really hoping against is that the endo totally dismisses the diagnosis of reverse T3 (which she may) and send us in another direction entirely. I don't mind being told she may have other things in addition to reverse T3, but I also want it taken into account. Does that make sense? I am trying to get airline tickets now to go with her to that appt. That was my own former endo before we moved, and she treated me for two years, so knows the history.
> 
> Thanks again.


That is awesome that you are able to accompany your daughter to the endo! 2 heads are always better than one!

I think timed release is better for the rT3 protocul. At least that is what I have read. We will soon know, won't we?

Wonder if your daughter's adrenals are functioning well because we often find those in trouble also w/ rT3...................or so I have read as well.


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## cookfan56 (Oct 26, 2011)

lainey said:


> The weight gain and acne could also be tied to the antidepressant. There really are several moving parts here.
> 
> There are many types of oral birth control, however, and it doesn't have to be about stopping it but rather, as you already suggested, trying something different.
> 
> ...


I don't take it personally. She is very secretive, always has been. I thought by her mid 20's that would let up, but it hasn't. So I have no idea what else she does besides some drinking. However, she holds down a job and goes to grad school with good grades, so with only seeing her every few months there's not much more I can do to monitor her.

About the birth control, I would love for her to approach her doc and say "look, I've gained 40 lbs in 6 months. I weigh close to 200. I've never been obese in my life. My face was covered with cystic acne until being put on these temporary steroids. What kind of birth control can I go on instead?" But she's stubborn, doesn't want more doc appts. on top of the ones she already has and just leaves it. sigh. You can lead a horse to water .... You would think that pride in her looks alone would really motivate her but I don't know that it does.

But thanks for the advice. It is appreciated.


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## cookfan56 (Oct 26, 2011)

Andros said:


> That is awesome that you are able to accompany your daughter to the endo! 2 heads are always better than one!
> 
> I think timed release is better for the rT3 protocul. At least that is what I have read. We will soon know, won't we?
> 
> Wonder if your daughter's adrenals are functioning well because we often find those in trouble also w/ rT3...................or so I have read as well.


It turns out now she doesn't want me at her appt. Oh well, as I said before, having a very loving, informed mom can only help if you let her help. Luckily for me I have loving people in my life who see how much I'm trying to help her, and tell me that and also tell me that stubborn *adults* cannot be forced to be helped (by otherrs who have information and wisdom they do not.)

But I am very curious about the adrenals. I'll be typing up a list of questions for her to ask. That is one at the top.


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## Octavia (Aug 1, 2011)

cookfan, even though you're 5 hours away, would it be possible for you to make a trip to accompany her to one or two doc appointments, to be her advocate and spokesperson? Some people have a hard time talking to doctors, especially doctors who are quick to dismiss symptoms. Your daughter might benefit from having you in the room with her. (My husband went to all but one of my pre- and post-surgery appointments, and he AND my mother were in the waiting area at the hospital during the surgeries. Okay, that's partly because my mother is an RN, but still...even though I'm 42, it was nice to have mom's love and support.)

Edit...oh, shoot...I just read your new post. Ugh.


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## cookfan56 (Oct 26, 2011)

Octavia said:


> cookfan, even though you're 5 hours away, would it be possible for you to make a trip to accompany her to one or two doc appointments, to be her advocate and spokesperson? Some people have a hard time talking to doctors, especially doctors who are quick to dismiss symptoms. Your daughter might benefit from having you in the room with her. (My husband went to all but one of my pre- and post-surgery appointments, and he AND my mother were in the waiting area at the hospital during the surgeries. Okay, that's partly because my mother is an RN, but still...even though I'm 42, it was nice to have mom's love and support.)
> 
> Edit...oh, shoot...I just read your new post. Ugh.


It's okay. Some people, i guess, are very secretive by nature and don't want overt help. I know that's hard to understand. My other child, thank God, is not like that.


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