How is it treated
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The treatment for too much RT3 involves stopping more being made and waiting for what's in the body to decay or be excreted.

This is relatively easy but there are pitfalls along the way. A lot of Drs are worried by people doing this as things happen too quickly to be done by lab tests, patients need to adjust dose by symptoms and vital signs.

RT3 is only made from T4. If you get rid of T4, both from your own thyroid and from supplements, then no more RT3 gets made. In order to do this and stay alive an alternative source of the bio-active T3 is needed and this is readily available in the form of synthetic T3 hormone.

The basic treatment is to stop all meds containing T4 and start T3 instead, The dose of this is slowly increased week by week as the T4 levels in your body diminish. After 6 weeks or so the T4 and RT3 levels in your blood will be very low. You need to keep going longer than this though as it takes around 12 weeks for the RT3 to clear the receptors as well.

During this time you may not be able to take enough T3 to fully clear hypo symptoms though some people may feel pretty well at this stage. It all depends on hy hypo you were, how high the T3 and RT3 levels were, and your iron and adrenal status. We do not recommend going above 125 of T3 during this clearing process, there is no improvement in clearance achieved with a larger dose, provided there is enough to suppress TSH and stop T4 production then clearance will occur. 

If the  T3  you are taking does clear most hypo symptoms and you had high in range or over range RT3 levels then be prepared to drop the amount of T3 you are taking when resistance clears. This can be dramatic and you can end up needing half what you needed the day before when the resistance clears. This is one of the reasons that you need to go by symptoms and pulse/temperature, things happen too fast to base it all on lab numbers. 

You can of course keep the dose lower and put up with feeling hypo for longer, when it clears you simply end up feeling less hypo. Dosing at this time is a compromise between symmptoms and the effect when clearing and we do not recommend going above 125mcg of T3mcg.   Many people find that staying at 75 douring this clearance period works for them. It all depends how bad their resistance is and how sensitive they are to T3. (updated 12/12).