RE: reverse t3 test on NHS?

June 19, 2010

Fliss, the following information might be of help

" -

Cortisol from a salivary adrenal stress test. Blood TSH, T4, and T3 may be

fine. But if there are symptoms, cortisol may be high because of stress or

excess carbohydrates in the diet. If the cortisol is high, the patient is

almost certainly making reverse T3 instead of real T3. Reverse T3 is not a

functional hormone but it looks like normal T3 on a blood test. This is often

treated with T3 and T3 may relieve symptoms. But it may be better treated as a

high cortisol issue. At least half of adrenal issues are excess cortisol

output! "

Read more about rT3 and testing here http://curezone.com/forums/fm.asp?i=1563809

.. Wait until you get your

24 hour salivary results to see what your cortisol output is. Read the rest of

the information on this thread also.

Sheila

can you do a saliva test for reverse t3 or do

you have to do blood? my dr won't do one, at least he says you can't do it on

nhs...is this true or has anyone had one via GP? where can i get one that i

don't need blood for?

fliss

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18:35:00

June 19, 2010

Hi Sheila,

Sorry for butting in,but does that mean that people with low cortisol levels dont have a problem with RT3? If RT3 looks like T3 on a blood test,surely that means gp's would think that their patients are fine,when really their T3 levels are low.I didnt know carbohydrates had such an effect on cortisol levels either.

From: Sheila <sheila@...>Subject: RE: reverse t3 test on NHS?thyroid treatment Date: Saturday, June 19, 2010, 7:58 AM

Fliss, the following information might be of help

" - Cortisol from a salivary adrenal stress test. Blood TSH, T4, and T3 may be fine. But if there are symptoms, cortisol may be high because of stress or excess carbohydrates in the diet. If the cortisol is high, the patient is almost certainly making reverse T3 instead of real T3. Reverse T3 is not a functional hormone but it looks like normal T3 on a blood test.

June 19, 2010

Your

not butting in - the information on this forum is for everybody. Read the

following to help you understand about what causes reverse T3 (rT3)

http://www.custommedicine.com.au/blog/2007/04/17/reverse-t3-dominance Â Reverse T3 Dominance - A Thyroid Imbalance

The thyroid gland is located in the lower part of the neck near your Adamâ€™s

Apple. It secretes two essential thyroid hormones: triiodothyronine (T3) and

thyroxine (T4) which are responsible for regulating cell metabolism in every

cell in your body. They promote optimal growth, development, function and

maintenance of all body tissues. They are also critical for nervous, skeletal

and reproductive tissue as well as regulating body temperature, heart rate,

body weight and cholesterol.

In a healthy patient a normal thyroid gland secretes all of the circulating T4

(about 90 to 100mcg daily) and about 20% of the circulating T3. The T4 made by

the thyroid gland circulates throughout the body and is converted into roughly

equal amounts of T3 and reverse T3. Most of the biological activity of thyroid

hormones is due to T3. It has a higher affinity for thyroid receptors and is approximately

4 times more potent than T4. Because 80% of serum T3 is derived from T4 in

tissues such as the liver and kidney, T4 is considered a pro-hormone. No

receptors have ever been identified for T4. Normal physiological production

ratio of T4 to T3 is 3.3:1.

Reverse T3 is virtually inactive having only 1% the activity of T3 and being a

T3 antagonist binds to T3 receptors blocking the action of T3. Normal

metabolism of T4 requires the production of the appropriate ratio, or balance,

of T3 to rT3. If the proportion of rT3 dominates then it will antagonize T3

thus producing hypothyroid symptoms despite sufficient circulating levels of T4

and T3. Reverse T3 has the same molecular structure as T3 however its three

dimensional arrangement (stereochemistry) of atoms is a mirror image of T3 and

thus fits into the receptor upside down without causing a thyroid response and

thus preventing or antagonizing the active T3 from binding to the receptor

acting as a metabolic break.

Reverse T3 dominance or functional hypothyroidism is a condition that exhibits

most hypothyroid symptoms although circulating levels of T3 and T4 are within

normal test limits. The metabolism of T4 into rT3 is in excess when compared to

T3 therefore it is a T4 metabolism malfunction rather than a straight forward

thyroid deficiency. Periods of prolonged stress may cause an increase in

cortisol levels as the adrenal glands respond to the stress. The high cortisol

levels inhibit the conversion of T4 into T3 thus reducing active T3 levels. The

conversion of T4 is then shunted towards the production of the inactive reverse

T3. This reverse T3 dominance may persist even after the stress passes and

cortisol levels have returned to normal as the reverse T3 itself may also

inhibit the conversion of T4 to T3 thus perpetuating the production of the

inactive reverse T3 isomer. There is some argument to this last point with some

research indicating that the elevated rT3 is only temporary and not a permanent

condition. The medical authorities officially do not accept reverse T3

dominance theory and thus many doctors will refuse to treat this condition. We

have found prolonged elevated reverse T3 in many of our patients whom all

respond well to T3 therapy.

Diagnosis

In addition to considering T3 levels we also need to consider rT3 because if it

is too high it will block the effects of T3 thus producing hypothyroid

symptoms. If this is the case the TSH, T4 and T3 tests will give a false

impression of true thyroid function. To overcome this diagnostic problem there

is a special test that specifically measures reverse T3 and should be requested

to rule out reverse T3 dominance. Ideally the ratio of T3/rT3 multiplied by 100

should be between 1.06 to 1.13. If this ratio is below 1 then reverse T3

dominance is present and slow release T3 therapy needs to be initiated once

adrenal exhaustion, hypoglycemia, nutritional deficiencies and/or low sex

hormone levels have been ruled out and/or treated. In addition nutrients such

as selenium, zinc, Vit B6, B12 and E, iron and iodine should be supplemented as

they are necessary cofactors for the proper conversion of T4 into T3.

It is also very important that if elevated levels of cortisol are found (stage

1 adrenal exhaustion) it should be treated first because if it is left elevated

it will only continue to inhibit the conversion of T4 into T3 and thus continue

reverse T3 production and thus reduce the effectiveness of this treatment. Low

cortisol levels should also be treated because low cortsiol will reduce the

number of T3 receptors and also prevent T3 transport within the cell. In

addition some patients respond poorly to thyroid medication if adrenal fatigue

is present. Therefore we recommend you test adrenal function and correct it

before commencing this treatment.

Treatment

It is important that no T4 (thyroxine), including Armour Thyroid, is used for

this condition as a portion of the supplemented T4 will only be converted into

reverse T3 and keep this cycle going. The idea is to use slow release T3 to

provide the active thyroid hormone to alleviate hypothyroid symptoms and to

rebalance the T3/rT3 ratio without the risk of increasing rT3 production. This

will allow rT3 levels to diminish over time and thus for T3 to be able to bind

to its receptors and thus be effective. It is critical that rT3 levels are

reduced in order to achieve a positive therapeutic outcome.

Dr developed a protocol using cycled doses of slow release T3 based on

body temperature. A major problem with this protocol is that in many cases very

high doses of T3 are required (90 to 120mcg daily) before a normal body

temperature is obtained. In addition it is a complicated protocol that many

patients find confusing. High dose T3 will suppress TSH causing a reduction in

T4 production. With little or no T4 left in the system reverse T3 can no longer

be produced and eventually whatever is already present in the body will be

eliminated thus reducing overall reverse T3 levels. The conversion of T4 into

T3 will then no longer be inhibited by the reverse T3 allowing the appropriate

activation of T4 into the active T3 form to occur once the dose of T3 has

ceased and thyroid production has recommensed. Unfortunately the risk of high

dose T3 causing hyperthyoid symptoms is high and should be avoided.

Our preference is to supplement with a combination capsule (thyroid conversion

capsules) which contains selenium, zinc, Vit B6 and B12, iron, Vit D and iodine

as they are all required by the 5-deiodinase enzyme responsible for proper T3

production. In addition slow release T3 is also used to obtain an appropriate

T3:rT3 balance. Slow release capsules work best as they prevent peak

concentrations of T3 after 1 to 2hrs often observed with tablets which are

responsible for the side effects associated with T3. Begin by taking 10mcg T3

SR daily. Doses above 15mcg daily should not be used to avoid endogenous

suppression, except in cases were autoimmune reactions and toxicities occur.

Symptoms should be monitored for improvement in energy levels and an increase

in body temperature (ideally underarm temperature above 36.5C). The dose should

be gradually adjusted until levels are adequate and balanced.

Symptoms for hyperthyroid such as sweating, anxiety, palpitations, etc must

also be monitored for and doses reduced at the first sign of these symptoms

appearing. Care should be taken not to allow the pulse rate to remain above 100

beats / minute, or more than about 20 beats / minute faster than before

treatment.

We have found that by using a consistent low dose of T3 over two to three

months without the need of cycling the dose, as described by Dr , in

addition to addressing the causes of improper T4 metabolism, many patients have

responded favorably with improved symptoms and a reduction in reverse T3

levels.

------------------------------------------------------

There

are several causes for this ratio getting disturbed, the principal ones that we

know of are:-

Extreme

dieting, the RT3 increases to slow the metabolism and make better use of

the available food

Low

Ferritin

High

cortisol, this disturbs the balance of the thyroid hormones

Low

cortisol, this again disturbs the balance of the thyroid hormones

Insulin

dependent Diabetes

Low

Vitamin B12 levels

In addition

to these there are a large list of causes which I have copied from here

Aging

Burns/thermal injury

Caloric restriction and fasting

Chemical exposure

Cold exposure

Chronic alcohol intake

Free radical load

Hemorrhagic shock

Insulin-dependent diabetes mellitus

Liver disease

Kidney disease

Severe or systemic illness

Severe injury

Stress

Surgery

Toxic metal exposure

http://thyroid-rt3.com/whatare1.htm

Sheila

From: thyroid treatment