Hypothyroid Case Study 2 – by Sue Kira

Reverse T3 corrected naturally

by Sue Kira, Naturopath & Clinical Nutritionist

Client name and identifying information changed

It amazing how many times clients told me that they felt certain they had a thyroid issue because they had so many of the symptoms, but their doctor told them there was nothing wrong and that maybe they should go on antidepressants or see a psychologist.

It’s frustrating, yet so common, because normally I had a good idea of what was really going on. It’s usually one of two situations.

The first is Wilson’s Temperature syndrome (WTS) where all thyroid tests and antibody levels are perfect, but they still suffer from many of the symptoms of an underactive thyroid. But the key difference is that the body’s temperature is too low. (It’s not the same as Wilson’s disease, which is a genetic abnormality to do with copper build up in the body).

The second situation is they have reverse T3. Unfortunately, many doctors and even endocrinologists (specialists) either don’t believe reverse T3 is an issue or just don’t check for it when the other tests come back normal. Why? I just don’t know.

This was the case for Evelyn who came in to see me in tears. She was tired and angry that no doctor had found out why she felt this way. She had so many of the ‘classic’ symptoms of hypothyroidism such as cold hands and feet, weight gain, foggy head, female hormone imbalances, constipation, anxiety and of course relentless fatigue. Evelyn was so tired and unable to work that she needed to take long service leave for three months to try and get well.

Because Evelyn had already been to her doctor, we decided to do the thyroid testing via a private pathology centre. We tested her TSH, free T3, Free T4, reverse T3 and ratios and all thyroid antibodies. As previously, her TSH, T3 and T4 all came back normal but her T3 was outside the reference level – not by a high number, but when we looked at the ratios it showed to be more of an issue.

The ratio is done between the T3 and reverse T3. The ideal ratio of T3/rT3 multiplied by 100 should be between 1.06 and 1.13 and if below 1, reverse T3 dominance is present.

Any practitioner treating reverse T3 needs to look at adrenal exhaustion, hypoglycaemia, nutritional deficiencies and low sex hormones before using slow release T3. I also knew from testing Evelyn that she had nutritional deficiencies (Vit B6, B12, zinc, Vit D, Iron, Iodine and selenium) and adrenal fatigue. We needed to start here before T3 treatment, otherwise it would have only made things worse.

In other words, first get the nutrients right that the body needs.

It was great to have this time to work with Evelyn to see what could be done. We discussed how reverse T3 is often triggered by stress and normally, after that stress has left, then reverse T3 will self-correct, which is possibly why many doctors won’t treat it.

In Evelyn’s situation, she had a marriage breakdown, and there were several years of considerable stress prior to the break up. But by the time I saw her, the mental stress was over, but the effects on her hormones had left a devastating wake behind her which she still carried i.e. her body was still carrying the stress which wasn’t self-correcting.

The fact that her nutrients were so low didn’t help, as this created a vicious circle where the body’s stress sucked out the nutrients and created the hormonal and adrenal fatigue, which in turn sucked out more nutrients from her system. She was like a sinking ship going down fast. To make matters worse, because Evelyn was so tired most of the time, she wasn’t eating well. This was where we had to start.

Initially I asked Evelyn to go onto a healthy diet that omitted gluten, dairy, sugar, alcohol and caffeine to give her adrenal glands a rest and to support better nutrition. Also, to specifically focused on eating foods rich in the nutrients she was low in.

We used supplements for the first month to build her levels up quickly but after that she continued with this great diet which was a combination of anti-inflammatory, stress reduction, adrenal boosting and nutritive support for her thyroid.

After two months on the diet Evelyn felt much better, although still had most of her symptoms, but at a lesser degree. We then took the diet one step further and removed all grains, nuts and seeds along with the nightshade foods from her diet. This was more like an auto-immune and digestive support diet even though she didn’t have any antibodies to her thyroid.

My feeling was that she may have been manifesting an auto-immune disease but because the thyroid and other tests cost a fair amount of money, we couldn’t test other areas such as her digestive system or other immune markers, so I had to use my experience and intuition to know what to do next.

More time may have also helped, but Evelyn was under pressure to go back to work soon so we needed to move things along.

Three weeks of those further food restrictions made a great deal of difference. Evelyn was now feeling 80% better than when she first came in but was worried about going back to work, as I was, because I felt she really needed to support her adrenals with more rest.

I suggested to ask if she could work part-time for a while. Her boss was very open to the idea, provided she could job share if she didn’t mind doing so for 12 months so that he could employ someone else. This was perfect for Evelyn as it took the pressure off her which helped her to recover faster.

The effects of no stress during recovery can be huge.

At this stage I felt that it was a good time for Evelyn to start some gentle exercises to get her blood flowing and to stimulate her hormone pathways to work better. Provided you are not bedridden, exercise – even if a small amount at the start and gradually building as health and fitness improves – can really speed up recovery with thyroid conditions as it boosts metabolism and gets everything working better.

This was just what Evelyn’s body needed to fully recover. After three months of gentle exercise and slowly reintroducing many of the restricted foods back into her diet (except gluten, grains, dairy and sugar) she felt marvellous. I suggested getting her reverse T3 tested again and this time all was good and she didn’t even need T3 therapy as some do.

Just a note that in some situations T3 therapy may still be needed but supporting the adrenals, hormones, nutrients and thyroid are very important steps that need to be taken for the therapy to work effectively.

As we see from these and many other case studies, the body will often fix itself solely with support from the right diet and lifestyle.

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