Reverse-T3 Syndrome – Is It Real?

Doctors Doubt the Existence of Reverse-T3 Dominance

Jun 1, 2009 Sarah Tomley

Dr Denis Wilson has suggested that a form of hypothyroidism is due to a misconversion of thyroid hormones, but most of the medical establishment denies this possibility.

The thyroid gland produces four hormones in order to fuel the metabolic process and provide all the body’s cells with energy: T4, T4, T2 and T1. Of these, T4 – the inactive thryoxine – is produced most extensively; it outstrips T3 (the active hormone) by 15:1.

However, T4 must be converted to T3 in order to release its energy. The conversion is achieved through an enzyme, which strips the thyroxine compound of one of its four iodine molecules – taking the iodine molecules of the compound down from 4 to 3 (and from T4 to T3).

The enzyme normally strips away a particular iodine atom, converting the compound to T3, but in some instances the enzyme strips away a different iodine atom – still reducing the compound to 3 iodine atoms, but a different three. This compound is still a form of T3, known as “reverse T3” or rT3; it is an inactive form of the energy-giving T3 hormone.

Does the body normally make rT3 hormone?

The body always generates a small percentage of rT3 when converting its own thyroid hormones (about 5%), but Dr Wilson has suggested that after periods of extreme or prolonged stress, the body switches its balance, and converts most of the T4 hormone to the inactive rT3 hormone (i.e. around 75%).

This is because the body produces huge amounts of cortisol to deal with prolonged stress, and this acts to prevent normal thyroid hormone conversion. The cortisol blocks the T4–T3 process, resulting a low metabolic rate. Dr Wilson describes the process as “a survival mechanism that has gotten stuck”.

Although rT3 is not presumed to have a metabolic effect itself, it blocks the body’s receptor sites for T3 (it still fits, just like “normal” T3, because it too has three iodine atoms) but it does not produce the metabolic uplift of T3. In fact, by preventing T3 from being able to work its normal energy-giving effects on the body, it produces a form of hypothyroidism.

Can’t the Doctors Diagnose Wilson’s Syndrome?

The problem is two-fold: people with this syndrome would suffer from all the problems associated with hypothyroidism (low energy levels, brain “fog”, hair loss, headaches, etc), but any blood tests would show T3 levels as normal. This is because T3 and rT3 both register on standard blood tests as “T3” – and their combined total would appear to be an acceptable level. Standard blood tests do not differentiate between T3 and rT3.

The other problem is that most doctors, including endocrinologists, do not accept the existence of this syndrome, and in most countries do not test rT3 levels.

However, where people have insisted upon an rT3 test, in some cases they have found to be producing more reverse-T3 than "standard" T3, and responded to treatment. This may be due to the scenario proposed by Dr Wilson, or to some other form of problem with the T4-T3 conversion.

How Would I Know if I have Wilson’s Syndrome?

If this syndrome does exist, people suffering from it would have difficulty in proving this to their doctor. One way to test yourself is to take your oral temperature at 10 random times throughout the day: if the average is less than 98.0F, you are hypometabolic (this means your metabolic rate has dropped below normal, though thyroid blood tests do not reveal a problem). However, there are many possible causes of hypometabolism, including Wilson’s Syndrome; others include fasting, Alheimer’s Disease and even meditation.

Is There a Cure for Wilson’s Syndrome?

If you have this syndrome, Dr Wilson recommends treatment through a programme of time-release T3 tablets (7.5–15mcg), which are taken every 12 hours until the body temperature reaches an average of 98.2 or until you develop symptoms of hyperthyroidism (such as rapid heart beat). Once you reach a normal temperature, you maintain the dose for 30 days, then taper the dose down slowly before tailing it off completely.

With little or no T4 left in the system, rT3 production eventually decreases, and the conversion of T4 can occur normally. The body is said to have been shaken from its "stuck" state, and can once again function normally.

Read More:

Why Isn't My Thyroxine Working?

Adrenal Insufficiency

The copyright of the article Reverse-T3 Syndrome – Is It Real? in General Medicine is owned by Sarah Tomley. Permission to republish Reverse-T3 Syndrome – Is It Real? in print or online must be granted by the author in writing.

Reverse T3