Hypothetical situation:
Someone has high TSH and high reverse T3. Normal range T3, low-normal T4. This persons high rT3 is a result of high stress.
Synthetic T3 lowers both TSH and rT3…
If this person started using T3 until TSH lowered and rT3 lowered, then discontinued use, would rT3 stay low as long as there was no stress? Do thyroid hormones return to normal easy? Or do they shut down similar to testosterone production on TRT?
Reverse T3 would again become elevated if the underlying cause isn’t solved, like insulin resistance or something else that is causing your body to slam on the brakes metabolically.
Great question. I am in the same boat. I have high TSH due to elevated rT3 level as well. I did research on what can cause elevated rT3.
Clinically prevalent causes included
High Cortisol
Low Cortisol
Low Iron
I plan on having my cortisol tested (4X Salivary specimen) and full adrenal panel as well as testing iron pretty soon here as soon as I get in the door with an endo.
Low cortisol is the prime suspect for me given my symptoms but I also have low T.
Given that low T equals slower metabolism I would assume it to be a possible cause if you go through a period of trauma or toxic stress as I have in recent years.
Can also be caused by anemia low RBC and (low iron/ferritin)
There is also pernicious anemia which is caused by a B-12 deficiency
Elevated rT3 levels is a coping or survival mechanism to slow your body down after prolonged intense stress and I think it has to do with the concept of adrenal fatigue. Kinda like how bears hibernate in the winter as a survival mechanism
I’ve designed a little custom panel to try to diagnose or rule out hypoadrenia or anemia with these tests:
DHEA-S
ACTH
Pregnenolone
Progesterone
Androstenedione, LC/MS
Antiadrenal Antibodies, Quantitative
Adrenal 21-Hydroxylase Autoantibodies
Iron and Total Iron Binding Capacity (TIBC)
Salivary Cortisol 4X Specimen
B12
I have high rT3. 24 on a scale of 8-25. Everything I’ve read said people feel best if it’s at the very bottom of that scale. Defy put me on T3 and it didn’t come down much at all. So they bumped it up. We’ll see on my next labs. I have pretty Cush life so not sure stress is what made it high. But no way to really know I guess.