A Must Read: T4, T3, Reverse T3, and Thyroid Disease

A Must Read: T4, T3, Reverse T3, and Thyroid Diseasefeatured

Wedding day photo

Our Wedding day: 2 years before I’d get correct treatment!

This September marks 4 years of marriage!

To quote Charles Dickens: “It was the best of times, it was the worst of times.”

The fact that my husband stood by and supported me through such a dark time in our lives is a true testament to his love. It’s made us much stronger.

But, my friends, it was tough!

You see, for years I knew something was wrong. I had irregular, long menstrual cycles. But more importantly, I had horrible PMS symptoms.

I started to get heart palpitations, anxiety and, at times, depression. And I should mention… all of these symptoms developed roughly around the same time.

But the worst symptom was the unquenchable, all-encompassing exhaustion…

It became such a part of my life that I viewed it as “normal.”

I’d sleep in until 10 am and then take a nap in the afternoon. Only for a few hours in the evening did I feel a sense of relief… but even that was short-lived.

When I got my first nursing job I begged my employer to allow a 4 day work week. I knew I couldn’t manage a 5 day work week. I was too unwell.

And the worst part? I had no clue why I was utterly drained… all the time.

Thankfully, I have an amazing and supportive family doctor. She stood by me, she trusted my symptoms. She listened and believed what I told her.

My doctor did not abandon me.

I cannot say the same for my other doctors. They would read my thyroid levels and – without asking me if I had any hypothyroid symptoms – they would say, “You’re fine… your levels look good.”

Photo of myself from when I felt well around 2006

A photo of myself from 2006 when I felt well… the next 6 years would be challenging.

I had been diagnosed with Hashimoto’s thyroiditis 10 years ago, and never once was I asked if I had hypothyroid symptoms.

When I’d mention my symptoms I was told, “everyone is tired.”

What a disgrace! I am not a number. I am a person. I have a name. I have a life. And my life is valuable.

And I strongly believe that people who live in their body day-in and day-out hold very important information as to how their body is doing!

I would say this is a critical piece of information that ought to be inquired into as a part of a physician’s or health care professionals assessment.

When I finally found a physician who listened to me, it was therapeutic and healing in itself. Recently, I told her:

“Thank you for listening to me, thank you for believing me!”

What I had, my dear friends, is a thyroid converting disorder.

A photo of myself from 2008, I'd been feeling tired for 1 year now.

A photo taken in 2008 of myself… over a year of feeling exhausted with no answers. I look like a different person.

Essentially my body was not converting T4 into T3.

So even though my TSH and T4 and even my T3 on paper looked fine and dandy, my body was not getting the active form of thyroid, T3, that I needed.

This was eventually diagnosed with a blood test (that I had to send from here in Canada to the US) to measure my ratio of Total T3 to Reverse T3 (RT3).

Reverse T3 is made by the body, specifically the liver. It’s your body’s way of getting rid of too much T4.

Your body, especially the liver, is constantly converting T4 to RT3 as a way to get rid of any unneeded T4.

According to Stop the Thyroid Madness (a patient advocacy group): 

In any given day, it’s stated that 40% of T4 goes to T3 and 20% of T4 goes to Reverse T3.

With conditions such as: diabetes, high stress levels leading to excess cortisol production, and other forms of bodily stress, the body starts to convert more T4 to Reverse T3. You can read more about this here.

Thyroid blood test - Total T3 to ReverseT3 Ratio

Here’s the copy of my Total T3 to Reverse T3 ratio.

My Total T3 to Reverse T3 ratio was 2.7 when it was tested back in 2012. A healthy person should have a Total T3 to Reverse T3 ratio above 10.

Essentially, when there are very high levels of Reverse T3, your receptor sites become blocked with Reverse T3 and do not allow the active form of thyroid, T3, to be used.

And this is why even though I had normal looking thyroid labs, I was very hypothyroid at the cellular level.

Unfortunately, this test of Total T3 to Reverse T3 ratio is no longer tested in Ontario, Canada. I’m guessing it’s because many medical professionals do not believe this condition exists.

You can read here how the Thyroid Foundation of Canada feels about T3 treatment.

I’ve learned that doctors believe that T4 is converted as it should be in the body. Sadly, I worry that many people… many PWDs, specifically may be walking around with this condition.

The treatment for me was sustained release T3. By taking sustained release T3 my cells were cleared of the Reverse T3 and my body was then able to use T3 again.

The levothyroxine (a T4 only medication) was just not working for me. It was the reason my husband and I could not even entertain the thought of having children.

I’d say to my hubby, “How can I have kids if I can’t even get myself out of bed before 10 am.”

Within a few months of starting T3 treatment my symptoms were resolved completely.

Anxiety almost gone, depression gone, heart palpitations gone (I haven’t had one in over a year), PMS gone (ask my husband… I’m a different woman!), exhaustion almost gone (It was night and day).

My energy was so much better that, two months after getting treatment, Golden Top was conceived :)

I realize this condition, sometimes called Wilson’s Syndrome is controversial. But I don’t want people who could benefit to be denied access to getting their life back. And that’s why I’ve done this post!

Stay tuned for my next post on how I went back on T4 and learn what happened after that!

To read more about thyroid converting disorders click here.

Do you think you could be suffering from a thyroid concerting disorder? Please share in the comments below!

About the author

Melissa Shannon

Melissa Shannon is diabetes obsessed! She's a diabetes nurse, diabetes advocate, and person with type one diabetes. Melissa loves sharing stories about life with diabetes and is a passionate speaker and diabetes evangelist. Melissa's motto is: "Let's not let diabetes rule our lives, let's have diabetes to go!"

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