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If you have been recently diagnosed with Chronic Fatigue Syndrome (CFS) or suspect you have CFS, checking your Free T3, Total T3 and Reverse T3  levels should be something on your high priority list. I do this with all my CFS suffers, especially when they experience symptoms of weight gain, chronic pain and Brain fog. Increasing your T3 levels may be the difference between between a day disabling fatigue or a day filled with energy.

Chronic Fatigue Syndrome- New Test Markers That Shed light on CFS 

Lets face it, fatigue affects every aspect of ones life and when you have an undiagnosed Low T3 or Low Free T3 problem its double whammy. Heres the thing, Chronic Fatigue Syndrome and hypothyroidism often go hand in hand, but it’s important to realize that when it comes to chronic fatigue, it really exists as a spectrum and varies greatly from one person to the next.

On one end, you have people who have mild fatigue, they can still push through the day, they just feel run down but on the other spectrum you have people who describe themselves as being exhausted and wiped out.

This is the kind of fatigue that impacts you from doing things you love, going places, it’s the kind of fatigue where you schedule events around your energy, you don’t go out to see your friends anymore because you are exhausted, if you are a parent, you find yourself not wanting to spend that time doing things with your family because you are just so exhausted. You rather sleep than go for a bike ride with your kids, and in the most severe cases you are house bound and bed ridden

Video Transcription November 18-2020

Hi there, I’m Dr Hagmeyer and I’m the clinic director here at where we help patients from around the world find answers and solutions to their thyroid problems and chronic fatigue syndrome. We do this using the principles of Functional and lifestyle medicine.

Perhaps you went to your doctor complaining of Chronic fatigue and so your doctor was suspicious of your thyroid, but after testing your TSH levels and your free T4 levels, these tests came back being normal or close to normal. Do you have a Thyroid problem?, Does that mean we can rule out your thyroid as a culprit to this debilitating chronic fatigue and Brain fog?

And I would say NO! not by a long shot.

But……… My Thyroid Tests are Normal

What you might not know is that your chronic fatigue and your symptoms of brain fog, chronic pain, anxiety, depression) are related to your thyroid function but more specifically to unique pattern of thyroid markers that don’t normal show up on a routine thyroid test such as TSH and FT4.

If You have Chronic Fatigue Syndrome- You Need These Three Tests at a minimum.

  1. T3
  2. Free T3
  3. Reverse T3

Suspect a Thyroid Problem? Take My Thyroid Quiz

Why do I need T3, Free T3 and Reverse T3 Testing ?

You may need this test if you have symptoms of hyperthyroidism. Symptoms include:

You may also need T3, Free T3 and Reverse T3, If You Are At Risk for Hyperthyroidism and you:

You May Also Need T3, Free T3 and Reverse T3, If You Have These Symptoms

Unfortunately for many people suffering with thyroid disease, many physicians don’t test or wont test their patients T3 level, Free T3 levels or reverse T3 levels and when an if you ask them for these tests they will tell you that these tests are useless and they don’t mean anything. If this sounds familiar to you , I believe this is a huge mistake for this subgroup of patients who have Chronic Fatigue Syndrome.

Why is T3 Thyroid Hormone So Important When You Suffer From Chronic Fatigue ?

T3 thyroid hormone is one of the most important thyroid hormones because T3 is the active hormone produced by your thyroid as well as your liver, your gut and your brain

It’s your T3 thyroid levels that determine your body’s metabolism (how your burn or store calories), It’s your T3 levels that can speed up or slow down your heart rate, its your T3 levels that affect affect your bodies mitochondria, and its your mitochondria that are responsible for generating energy in the cells of your body.

If your cells don’t make energy or ATP you walk around feeling and thinking like a zombie. This is how low T3 and low Free T3 cause so many health problems and this is why I believe measuring both the total T3 and Free T3 are some of the most important thyroid markers that can be run for someone struggling with chronic fatigue syndrome.

Once we know a patient has low T3, or FT3 also called low T3 syndrome now what we need to do is find out what are some of the potential causes and I will talk about that in just a few minutes.

Now when we say total T3 thyroid levels- what we are saying the total amount of thyroid hormones in your blood which includes thyroid hormones that are bound to proteins and thyroid hormones that are not bound to proteins.

The free T3 represents the amount of T3 available to be used for the cells, So do you think it might be important to measure these levels? But that’s not what most doctor do. All they do is measure a T4 level which is the inactive thyroid hormone in the body. The body still needs to convert that T4 into T3.

Like I mentioned a moment ago, identifying the Low T3 or Low Free T3 is only half of the equation and this is where most doctors mess everything up. If they are even smart enough to measure T3 or Free T3, they make the big mistake of prescribing T3 replacement.

And the reason I say this is a mistake is because prescribing T3 to a person with Low T3 does not address the reason or the root cause of the Low T3. Prescribing Armour or Cytomel (which are T3 repacement medications) does not fix the reason behind the low T3 levels.

This is why its important to understand thyroid physiology and how the thyroid works.

Take The T3 Thyroid Quiz

Think you Might have Low T3 or Low Free T3? Take the Thyroid quiz 

Chronic Fatigue Syndrome and Low T3- Why You Are Always So Tired 3

So Here’s a Few Things Worth Looking Into If you have CFS and Low T3 or low Free T3 levels

  1. Inflammation- high levels of HsCRP, TNF alfa, IL-6
  2. Autoantibodies reactions against neurotransmitters and neurotransmitter receptors in the nerve system
  3. Infections and vaccinations there has been a 2 fold increase in CFS after H1N1 vaccination
  4. Leaky gut- lipopolysaccharides (LPS) from Gram-negative enterobacteria with subsequent gut-derived inflammation was also found
  5. Gut dysbiosis and proinflammatory microbiome
  6. SIBO or bacterial overgrowth
  7. High levels of Cortisol
  8. Mold exposure
  9. Nutritional deficiencies.
  10. Liver problems- this might be a liver toxicity issue

Check out this article on Low T3 and Thyroid under conversion

Closing thoughts

  1. If you are experiencing chronic fatigue, brain fog, chronic pain its worth finding out if you have this pattern or subtype of hypothyroidism.
  2. This subtype or pattern of thyroid disease associated with CFS is characterized by Low T3, low free T3 and often high levels of rT3.
  3. These markers does not show up on routine thyroid screening and many doctors refuse to run these tests when patients ask for them. If your doctor won’t run these tests for you, I will leave a link in the description of this video and you can order these tests directly from our clinic. Once you order them, we will send you our a requistion, you can then take this directly to the lab and have your blood drawn.
  4. If you do have low T3 its not enough to take (Armour and Cytomel) while these hormone preparations contain T3 thyroid hormones, taking these still won’t address the cause of the Low T3, you need to find out why you have the Low T3 or low Free T3.
  5. Work with a doctor who is certified and trained in Functional Medicine– you want a doctor who is going to looks at the BIG picture not just prescribe replacement. Hopefully, you know understand why taking hormone replacement is not enough and why it doesn’t address the root cause.
  6. If you feel that the doctors you are working with don’t understand these things we have talked about today and you are searching for a comprehensive approach, I encourage you to visit my website and learn more about how we work with patients and partner with them in their health journey.

People Who Read This Article, Also Recommend The Following Articles

  1. Why Your Thyroid Medication Stopped working 
  2. Why Most Treatment approaches for Fatigue Fail 
  3. DHEA, Chronic Fatigue Syndrome and Adrenal Imbalance
  4. How Chronic Infections Cause Toxic Overload and Adrenal Fatigue
  5. Assess Your Thyroid Function Today and Find out Your Risk for Thyroid Disease
  6. Chronic Fatigue Syndrome Insomnia and Adrenal Stress: What’s Really Keeping You Up At Night?

Additional Studies

Dysregulation of the immune system in CFS may include autoimmune reactions and low-grade inflammation. Some studies demonstrated autoantibodies directed at diverse nuclear and neuronal components (1516) and against some neurotransmitters and neurotransmitter receptors in the CNS (1718). Others associated infection and vaccination with later CFS onset (1920). Recently, pandemic influenza A (H1N1) infection was related with a more than two-fold increased CFS risk (21).

A state of low-grade inflammation (22), as derived from elevated (hs)CRP (23), interleukin (IL)-6 (24), IL-1 and tumor necrosis factor (TNF)-α (22), and/or nuclear factor kappa B (NFκB) (25) has, however, not consistently been found (2628), possibly because of differences in experimental approaches and patient conditions (28).

Increased translocation of lipopolysaccharides (LPS) from Gram-negative enterobacteria with subsequent gut-derived inflammation was also found (29). Giloteaux et al. demonstrated intestinal dysbiosis resulting from a more proinflammatory gut microbiome that may trigger the immune system (30). Recently, the relationship between the thyroid with gut microbiome and inflammation became apparent from the associations of both hypothyroidism and levothyroxine use with small intestinal bacterial overgrowth (31).