Many people come to the Stengler Center for the treatment of hypothyroidism (low thyroid function). Many of the patients have either been diagnosed with hypothyroidism and do not feel well with their current treatment. I also see a lot of people that have been told their thyroid is normal, but they have several symptoms of hypothyroidism (fatigue, weight gain, poor memory, temperature intolerance, depression, hair loss, and several other possible symptoms).
In addition to listening to the patient and examining them for signs of hypothyroidism, I run an extensive thyroid panel. Many doctors run very basic thyroid tests and miss patients with suboptimal thyroid function. One of the tests in the panel of six markers is “reverse T3” (rT3).
The two primary thyroid hormones in the human body that play an essential role in energy production and metabolism are T4 and T3. There is more T4 produced in the body than T3; however, T3 is much more biologically active in the cells. There is also a metabolite of T4 known as rT3. rT3 has a similar structure to T3. rT3 is an inactive substance in that it does not affect cell metabolism. Yet rT3 blocks the metabolic effects of T3 by occupying T3 receptors on the cell membrane.
We find some patients have an elevated level of rT3, which has been proposed by some medical authorities to hinder the effect of T3 on cell metabolism. It can also be that an elevated rT3 is reflecting an imbalanced state in the body resulting in increased conversion of T4 to rT3. One of the more common causes of elevated rT3 is fasting or consuming a low-calorie diet and carbohydrate restriction. Another common reason for elevated RT3 is the effects of stress. There are many other causes, including:
When I see a patient’s thyroid results showing elevated rT3, I do some investigative work to figure out why this occurs. If a patient does not have an apparent cause, such as a low-calorie diet, high stress, specific disease state, I look at other reasons. This investigation often involves testing toxic metals such as mercury which can cause this rT3 increase. The goal is always to treat the root cause so that the thyroid balances out on its own.
If your thyroid treatment is not working well or has signs and symptoms of low thyroid, then work with an integrative doctor for a more comprehensive assessment and targeted therapy for better results.
Dr. Mark Stengler NMD, MS, is a bestselling author in private practice in Encinitas, California, at the Stengler Center for Integrative Medicine. His newsletter, Dr. Stengler’s Health Breakthroughs, is available at www.markstengler.com and his product line at www.drstengler.com
Rothenberg, R., Hart, K., Barrett, B., & Jurow, A. (2019). HORMONAL BIOIDENTITY (1st ed., p. 46). Encinitas: Barrowberg Press.
