Re: Dr. Holtorf's Comments

October 26, 2009

But I think, if I understand correctly, that if your rt3 is low but the ratio is

okay, then you are probably not converting too much of your t4 into rt3 -- and

may do fine on t4/t3 combo. And if your rt3 is high, you prbably do convert a

lot of t4 into rt3. So that would make sense that the higher the rt3 value, the

more likely you need straight t3, no? The only time my rt3 was low was when I

take enough t3 to lower t4 and hence lower the rt3. Which also improves my ratio

of course.

Kathleen

>

> Shomon: At what point do you consider reverse T3 too high and requiring

treatment?

>

> Kent Holtorf, MD: Like everything else in medicine it is a continuum, but

healthy individuals are usually below 250 pg/ml and should have a free

T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3

is in pg/ml.

>

> 1)- I wish Shomon would asked whether he thought someone can have a

healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's

interesting that tho he talks about the ratio- he doesn't neglect to speak

specifically about the importance of the RT3 level alone.

>

> Shomon: How do you typically treat elevated reverse T3 levels?

>

> Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only

preparations will be. T4/T3 combinations are significantly better than T4-only

preparations, such as Levoxyl and Synthroid, but for the higher levels straight

timed released T3 is optimal.

>

> 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the

higher the RT3 level-- This is a bit of a black hole for people for whom the

numerator of this ratio is the factor. In fact, he says T3 only is optimal for

" the higher " RT3 " levels. " THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST

IMPORTANT FACTOR - THE RT3 LEVEL IS

>

October 26, 2009

Actually, I am just so impressed with this guy and all the articles on his site

-- especially now that I have been diagnosed EBV virus, which they do believe is

a major factor in many people not getting well despite hormone therapy.

I did make an appoinment. I didn't ask to see Holtorf as I doubt he is taking

new patients, but there was another doctor that impressed me and worked with

" difficult " endocrine isses and was consulted by other doctors for that purpose.

He wasn't taking new patients, either, but he made an excepton for me, which I

thought was great!

Since they follow the Holtorf protocol, I wanted to give this a shot at least.

And have prescriptons!!

The articles on the site about using HC, t3, and many many others including sex

hormone, latent virus, blood coagulation (which allows virus to hide out) had

all been found in prior labs.

They even some articles on food intolerance/gluten intolence and food allergies

being major in some folks -- and I was just diagnosd with that recently, too! I

am hoping these are the missing pieces that taxed my adrenals and never allowed

me to heal them

My newest doctor can do the myer's cocktails (which help immenseley) as well as

helps with the gut issues, but I need Valtrex for the EBV and I don't think the

realy gets rt3 or even the (necessary) use of HC. She says she wants to heal my

adrenals, which is great, so do I! But I think I have to fix these other things

first and get optimized on t3 or at least clear out rt3, as the adrenal stress,

gut issues, virues and low ferritin may all have been reason for poor converson.

I am hopeful.

Kathleen

>

> Shomon: At what point do you consider reverse T3 too high and requiring

treatment?

>

> Kent Holtorf, MD: Like everything else in medicine it is a continuum, but

healthy individuals are usually below 250 pg/ml and should have a free

T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3

is in pg/ml.

>

> 1)- I wish Shomon would asked whether he thought someone can have a

healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's

interesting that tho he talks about the ratio- he doesn't neglect to speak

specifically about the importance of the RT3 level alone.

>

> Shomon: How do you typically treat elevated reverse T3 levels?

>

> Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only

preparations will be. T4/T3 combinations are significantly better than T4-only

preparations, such as Levoxyl and Synthroid, but for the higher levels straight

timed released T3 is optimal.

>

> 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the

higher the RT3 level-- This is a bit of a black hole for people for whom the

numerator of this ratio is the factor. In fact, he says T3 only is optimal for

" the higher " RT3 " levels. " THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST

IMPORTANT FACTOR - THE RT3 LEVEL IS

>

October 27, 2009

I asked him about this- he said if your ratio is low, but it's low because of

low FT3, not because you have low RT3 (that is, your RT3 is below 250) you can

take Armour or something with T4 in it and do fine. The interesting thing to me

is that he said it is the RT3 level that matters withhin the context of the

FT3/RT3 ratio, and that a low FT3 with a low RT3 implies that RT3 is not your

problem-

> >

> > Shomon: At what point do you consider reverse T3 too high and requiring

treatment?

> >

> > Kent Holtorf, MD: Like everything else in medicine it is a continuum, but

healthy individuals are usually below 250 pg/ml and should have a free

T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3

is in pg/ml.

> >

> > 1)- I wish Shomon would asked whether he thought someone can have a

healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's

interesting that tho he talks about the ratio- he doesn't neglect to speak

specifically about the importance of the RT3 level alone.

> >

> > Shomon: How do you typically treat elevated reverse T3 levels?

> >

> > Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only

preparations will be. T4/T3 combinations are significantly better than T4-only

preparations, such as Levoxyl and Synthroid, but for the higher levels straight

timed released T3 is optimal.

> >

> > 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the

higher the RT3 level-- This is a bit of a black hole for people for whom the

numerator of this ratio is the factor. In fact, he says T3 only is optimal for

" the higher " RT3 " levels. " THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST

IMPORTANT FACTOR - THE RT3 LEVEL IS

> >

>

October 27, 2009

I asked him about this- he said if your ratio is low, but it's low because of

low FT3, not because you have low RT3 (that is, your RT3 is below 250) you can

take Armour or something with T4 in it and do fine. The interesting thing to me

is that he said it is the RT3 level that matters withhin the context of the

FT3/RT3 ratio, and that a low FT3 with a low RT3 implies that RT3 is not your

problem-

> >

> > Shomon: At what point do you consider reverse T3 too high and requiring

treatment?

> >

> > Kent Holtorf, MD: Like everything else in medicine it is a continuum, but

healthy individuals are usually below 250 pg/ml and should have a free

T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3

is in pg/ml.

> >

> > 1)- I wish Shomon would asked whether he thought someone can have a

healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's

interesting that tho he talks about the ratio- he doesn't neglect to speak

specifically about the importance of the RT3 level alone.

> >

> > Shomon: How do you typically treat elevated reverse T3 levels?

> >

> > Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only

preparations will be. T4/T3 combinations are significantly better than T4-only

preparations, such as Levoxyl and Synthroid, but for the higher levels straight

timed released T3 is optimal.

> >

> > 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the

higher the RT3 level-- This is a bit of a black hole for people for whom the

numerator of this ratio is the factor. In fact, he says T3 only is optimal for

" the higher " RT3 " levels. " THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST

IMPORTANT FACTOR - THE RT3 LEVEL IS

> >

>

October 27, 2009

> The interesting thing to me is that he said it is the RT3 level that matters

withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3

implies that RT3 is not your problem-

Thanks, that makes sense, the question is whether the FT3 will come up

faster than the RT3 does.

Nick

October 27, 2009

> The interesting thing to me is that he said it is the RT3 level that matters

withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3

implies that RT3 is not your problem-

Thanks, that makes sense, the question is whether the FT3 will come up

faster than the RT3 does.

Nick

October 27, 2009

This is thing that I wanted to clear up, and it may not have been adequately

addressed here, but I think he cleared it up for me. If the RT3 is low - even if

the ratio is low -- it means that you are not converting or creating a lot of

RT3. Therefore, if you take Armour, you wouldn't have to worry about about the

T4 in it converting to RT3. In this case, you might do well on Cytomel, too, but

not because you have too much RT3.

>

> > The interesting thing to me is that he said it is the RT3 level that matters

withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3

implies that RT3 is not your problem-

>

> Thanks, that makes sense, the question is whether the FT3 will come up

> faster than the RT3 does.

>

> Nick

>

October 27, 2009

This is thing that I wanted to clear up, and it may not have been adequately

addressed here, but I think he cleared it up for me. If the RT3 is low - even if

the ratio is low -- it means that you are not converting or creating a lot of

RT3. Therefore, if you take Armour, you wouldn't have to worry about about the

T4 in it converting to RT3. In this case, you might do well on Cytomel, too, but

not because you have too much RT3.

>

> > The interesting thing to me is that he said it is the RT3 level that matters

withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3

implies that RT3 is not your problem-

>

> Thanks, that makes sense, the question is whether the FT3 will come up

> faster than the RT3 does.

>

> Nick

>

October 27, 2009

so help me here..if you have a low FT3 and a RT3 under 250 then RT3 is not your issue?? so maybe raising NT would help and addressing adrenal issues?? this scenario is one of my hashi daughters low FT3 and RT3 of 199 but cant raise NT cause seems to give no benefit...so could this imply cortisol issueTo: RT3_T3 Sent: Tuesday, October 27, 2009 11:50:10 AMSubject: Re: Dr. Holtorf's Comments

I asked him about this- he said if your ratio is low, but it's low because of low FT3, not because you have low RT3 (that is, your RT3 is below 250) you can take Armour or something with T4 in it and do fine. The interesting thing to me is that he said it is the RT3 level that matters withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3 implies that RT3 is not your problem-

> >

> > Shomon: At what point do you consider reverse T3 too high and requiring treatment?

> >

> > Kent Holtorf, MD: Like everything else in medicine it is a continuum, but healthy individuals are usually below 250 pg/ml and should have a free T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3 is in pg/ml.

> >

> > 1)- I wish Shomon would asked whether he thought someone can have a healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's interesting that tho he talks about the ratio- he doesn't neglect to speak specifically about the importance of the RT3 level alone.

> >

> > Shomon: How do you typically treat elevated reverse T3 levels?

> >

> > Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only preparations will be. T4/T3 combinations are significantly better than T4-only preparations, such as Levoxyl and Synthroid, but for the higher levels straight timed released T3 is optimal.

> >

> > 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the higher the RT3 level-- This is a bit of a black hole for people for whom the numerator of this ratio is the factor. In fact, he says T3 only is optimal for "the higher" RT3 "levels." THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST IMPORTANT FACTOR - THE RT3 LEVEL IS

> >

>

October 27, 2009

so help me here..if you have a low FT3 and a RT3 under 250 then RT3 is not your issue?? so maybe raising NT would help and addressing adrenal issues?? this scenario is one of my hashi daughters low FT3 and RT3 of 199 but cant raise NT cause seems to give no benefit...so could this imply cortisol issueTo: RT3_T3 Sent: Tuesday, October 27, 2009 11:50:10 AMSubject: Re: Dr. Holtorf's Comments

I asked him about this- he said if your ratio is low, but it's low because of low FT3, not because you have low RT3 (that is, your RT3 is below 250) you can take Armour or something with T4 in it and do fine. The interesting thing to me is that he said it is the RT3 level that matters withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3 implies that RT3 is not your problem-

> >

> > Shomon: At what point do you consider reverse T3 too high and requiring treatment?

> >

> > Kent Holtorf, MD: Like everything else in medicine it is a continuum, but healthy individuals are usually below 250 pg/ml and should have a free T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3 is in pg/ml.

> >

> > 1)- I wish Shomon would asked whether he thought someone can have a healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's interesting that tho he talks about the ratio- he doesn't neglect to speak specifically about the importance of the RT3 level alone.

> >

> > Shomon: How do you typically treat elevated reverse T3 levels?

> >

> > Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only preparations will be. T4/T3 combinations are significantly better than T4-only preparations, such as Levoxyl and Synthroid, but for the higher levels straight timed released T3 is optimal.

> >

> > 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the higher the RT3 level-- This is a bit of a black hole for people for whom the numerator of this ratio is the factor. In fact, he says T3 only is optimal for "the higher" RT3 "levels." THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST IMPORTANT FACTOR - THE RT3 LEVEL IS

> >

>

October 27, 2009

I have low FT3 (2.26) and RT3 under 250 (194), ratio 11. I'm using an over-the-counter natural thyroid. I had to dose 1/4 tablet 4 times a day for my temp to be even because my liver processes meds quickly, so I would get a surge in T3 and drop.

My dr told me to take 2/3 of the dose in the morning and 1/3 around 2pm, and when I dosed like this it was BAD. I crashed after 3 hours even with enough HC (which I had just taken 1 hr prior to the crash). I'm suspecting that it's the T4 not converting to T3. So I'm switching to Cytomel.

It could very well be a cortisol thing though, so it's worth a check.So I tend to think it's the ratio that matters more than the actual RT3 level... I mean, if your T3 is low, then your body is not producing enough and/or T4 is not getting converted. So if you have T4 to T3 conversion problem (due to vitamin/mineral deficiency or RT3), then taking more T4 would result in more RT3. That's just my guess.

Kate

so help me here..if you have a low FT3 and a RT3 under 250 then RT3 is not your issue?? so maybe raising NT would help and addressing adrenal issues?? this scenario is one of my hashi daughters low FT3 and RT3 of 199 but cant raise NT cause seems to give no benefit...so could this imply cortisol issue

To: RT3_T3

Sent: Tuesday, October 27, 2009 11:50:10 AMSubject: Re: Dr. Holtorf's Comments

I asked him about this- he said if your ratio is low, but it's low because of low FT3, not because you have low RT3 (that is, your RT3 is below 250) you can take Armour or something with T4 in it and do fine. The interesting thing to me is that he said it is the RT3 level that matters withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3 implies that RT3 is not your problem-

> >

> > Shomon: At what point do you consider reverse T3 too high and requiring treatment?

> >

> > Kent Holtorf, MD: Like everything else in medicine it is a continuum, but healthy individuals are usually below 250 pg/ml and should have a free T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3 is in pg/ml.

> >

> > 1)- I wish Shomon would asked whether he thought someone can have a healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's interesting that tho he talks about the ratio- he doesn't neglect to speak specifically about the importance of the RT3 level alone.

> >

> > Shomon: How do you typically treat elevated reverse T3 levels?

> >

> > Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only preparations will be. T4/T3 combinations are significantly better than T4-only preparations, such as Levoxyl and Synthroid, but for the higher levels straight timed released T3 is optimal.

> >

> > 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the higher the RT3 level-- This is a bit of a black hole for people for whom the numerator of this ratio is the factor. In fact, he says T3 only is optimal for " the higher " RT3 " levels. " THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST IMPORTANT FACTOR - THE RT3 LEVEL IS

> >

>

October 27, 2009

I have low FT3 (2.26) and RT3 under 250 (194), ratio 11. I'm using an over-the-counter natural thyroid. I had to dose 1/4 tablet 4 times a day for my temp to be even because my liver processes meds quickly, so I would get a surge in T3 and drop.

My dr told me to take 2/3 of the dose in the morning and 1/3 around 2pm, and when I dosed like this it was BAD. I crashed after 3 hours even with enough HC (which I had just taken 1 hr prior to the crash). I'm suspecting that it's the T4 not converting to T3. So I'm switching to Cytomel.

It could very well be a cortisol thing though, so it's worth a check.So I tend to think it's the ratio that matters more than the actual RT3 level... I mean, if your T3 is low, then your body is not producing enough and/or T4 is not getting converted. So if you have T4 to T3 conversion problem (due to vitamin/mineral deficiency or RT3), then taking more T4 would result in more RT3. That's just my guess.

Kate

so help me here..if you have a low FT3 and a RT3 under 250 then RT3 is not your issue?? so maybe raising NT would help and addressing adrenal issues?? this scenario is one of my hashi daughters low FT3 and RT3 of 199 but cant raise NT cause seems to give no benefit...so could this imply cortisol issue

To: RT3_T3

Sent: Tuesday, October 27, 2009 11:50:10 AMSubject: Re: Dr. Holtorf's Comments

I asked him about this- he said if your ratio is low, but it's low because of low FT3, not because you have low RT3 (that is, your RT3 is below 250) you can take Armour or something with T4 in it and do fine. The interesting thing to me is that he said it is the RT3 level that matters withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3 implies that RT3 is not your problem-

> >

> > Shomon: At what point do you consider reverse T3 too high and requiring treatment?

> >

> > Kent Holtorf, MD: Like everything else in medicine it is a continuum, but healthy individuals are usually below 250 pg/ml and should have a free T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3 is in pg/ml.

> >

> > 1)- I wish Shomon would asked whether he thought someone can have a healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's interesting that tho he talks about the ratio- he doesn't neglect to speak specifically about the importance of the RT3 level alone.

> >

> > Shomon: How do you typically treat elevated reverse T3 levels?

> >

> > Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only preparations will be. T4/T3 combinations are significantly better than T4-only preparations, such as Levoxyl and Synthroid, but for the higher levels straight timed released T3 is optimal.

> >

> > 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the higher the RT3 level-- This is a bit of a black hole for people for whom the numerator of this ratio is the factor. In fact, he says T3 only is optimal for " the higher " RT3 " levels. " THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST IMPORTANT FACTOR - THE RT3 LEVEL IS

> >

>

October 27, 2009

but if FT4 and FT3 are both low and an RT3 of 199 maybe then just an increase in meds and adrenal attention??To: RT3_T3 Sent: Tuesday, October 27, 2009 12:57:09 PMSubject: Re: Re: Dr. Holtorf's Comments

I have low FT3 (2.26) and RT3 under 250 (194), ratio 11. I'm using an over-the-counter natural thyroid. I had to dose 1/4 tablet 4 times a day for my temp to be even because my liver processes meds quickly, so I would get a surge in T3 and drop.

My dr told me to take 2/3 of the dose in the morning and 1/3 around 2pm, and when I dosed like this it was BAD. I crashed after 3 hours even with enough HC (which I had just taken 1 hr prior to the crash). I'm suspecting that it's the T4 not converting to T3. So I'm switching to Cytomel.

It could very well be a cortisol thing though, so it's worth a check.So I tend to think it's the ratio that matters more than the actual RT3 level... I mean, if your T3 is low, then your body is not producing enough and/or T4 is not getting converted. So if you have T4 to T3 conversion problem (due to vitamin/mineral deficiency or RT3), then taking more T4 would result in more RT3. That's just my guess.

KateOn Tue, Oct 27, 2009 at 1:44 PM, dawn volz <dawnv5sbcglobal (DOT) net> wrote:

so help me here..if you have a low FT3 and a RT3 under 250 then RT3 is not your issue?? so maybe raising NT would help and addressing adrenal issues?? this scenario is one of my hashi daughters low FT3 and RT3 of 199 but cant raise NT cause seems to give no benefit...so could this imply cortisol issue

From: bwilson195 <bwilson195yahoo (DOT) com>To: RT3_T3yahoogroups (DOT) com

Sent: Tuesday, October 27, 2009 11:50:10 AMSubject: Re: Dr. Holtorf's Comments

I asked him about this- he said if your ratio is low, but it's low because of low FT3, not because you have low RT3 (that is, your RT3 is below 250) you can take Armour or something with T4 in it and do fine. The interesting thing to me is that he said it is the RT3 level that matters withhin the context of the FT3/RT3 ratio, and that a low FT3 with a low RT3 implies that RT3 is not your problem-

> >

> > Shomon: At what point do you consider reverse T3 too high and requiring treatment?

> >

> > Kent Holtorf, MD: Like everything else in medicine it is a continuum, but healthy individuals are usually below 250 pg/ml and should have a free T3/reverse T3 ratio greater than 1.8 if free T3 is in ng/dl or 0.018 if free T3 is in pg/ml.

> >

> > 1)- I wish Shomon would asked whether he thought someone can have a healthy RT3 level (mine is 20) and a ratio below 18 and still be hypo. It's interesting that tho he talks about the ratio- he doesn't neglect to speak specifically about the importance of the RT3 level alone.

> >

> > Shomon: How do you typically treat elevated reverse T3 levels?

> >

> > Kent Holtorf, MD: The higher the reverse T3, the more ineffective T4 only preparations will be. T4/T3 combinations are significantly better than T4-only preparations, such as Levoxyl and Synthroid, but for the higher levels straight timed released T3 is optimal.

> >

> > 2) - Again, here he doesn't say the lower the FT3/RT3 ratio, he says the higher the RT3 level-- This is a bit of a black hole for people for whom the numerator of this ratio is the factor. In fact, he says T3 only is optimal for "the higher" RT3 "levels." THIS MAKES IT SOUND LIKE THE RATIO IS NOT THE MOST IMPORTANT FACTOR - THE RT3 LEVEL IS

> >

>

October 27, 2009