Wilson's Temperature Syndrome: Thyroid resistance

Updated: Apr 4


Wilson’s Temperature Syndrome (WTS) is a functional endocrine disorder defined by low body temperature (average oral temperature below 98.6F) and symptoms of hypothyroidism although lab values may indicate normal thyroid gland function. (It is not related to Wilson’s disease which has to do with copper metabolism. )

Many people (more commonly women) suffer with unexplained symptoms that resemble hypothyroid disorder. In Wilson’s Temperature Syndrome (WTS) these symptoms often began after a period of stress (fasting, prolonged illness, pregnancy, loss of a loved one, divorce, etc).

Symptoms of hypothyroidism may include:

  • Intractable fatigue

  • Insomnia and / or waking up tired in spite of getting “enough” sleep

  • Feeling chilly all the time

  • Cold hands and feet

  • Dry brittle hair and nails

  • Hair falling out

  • Dry or rough skin

  • Depression

  • Mental fog

  • Constipation

  • Weight gain or inability to lose weight with exercise and healthy diet changes

  • Puffiness in face, especially around the eyes

  • Menstrual problems, particularly heavy periods, severe PMS, or irregular periods

  • Unexplained chronic body pain, aches, or muscle pain

  • Headaches and Migraine Headaches

This combination of symptoms is caused by inadequate stimulation of the tissues of the body by thyroid hormone. If the tissues are not being stimulated by thyroid hormone their metabolic rate drops, lowering the body temperature, and causing many other problems.


There are many things that can go wrong with the thyroid gland, and all of those possibilities should be ruled out by your doctor before an assessment of Wilson’s Temperature Syndrome can be considered. If the thyroid gland itself is sick it may need different treatment than the treatment given for Wilson’s Temperature Syndrome (WTS).


In WTS the thyroid gland is healthy and functioning normally . The thyroid is secreting a normal amount of thyroid hormone, but the thyroid hormone is not able to stimulate the target tissues properly. This said, patients that are hypothyroid, or have other problems with the thyroid gland may also have Wilson’s if their body temperature is chronically low in spite of thyroid treatments. If the body temperature is not low, it is not WTS. The lower the body temperature, usually the worse people feel.

The good news is that in most cases, Wilson’s Temperature syndrome is completely reversible with a 1-9 month course of treatment using special preparations of prescription thyroid hormone. Once the body temperature is back to normal, there is usually no need for continuing medication and most people experience significant improvements in their symptoms and over-all health.



Here’s the theory of what has gone wrong Background Physiology review:

  • There are several forms of Thyroid Hormone

  • T4: is the majority of what is excreted by the thyroid gland. It is an active form of thyroid hormone, but 4x less potent at the cellular level than T3

  • T3: is the active form of thyroid hormone, small amounts are secreted by thyroid gland. Most of it is made by enzymes converting T4 at the cellular level. T4 is converted to T3 on an as-needed basis. When functioning properly the body keeps T3 levels precisely level 24 hours a day.

  • RT3: “Reverse T3” is an inactive form of thyroid hormone, excreted in tiny amounts by the thyroid gland, most of it is converted from T4 by enzymes. (see below)

  • T2: is also an inactive form of thyroid hormone. It is excreted in tiny amounts by the thyroid gland, but most of it is made by conversion of T3 and RT3 by enzymes.

  • There are 2 relevant enzymes to know about:

  • 5’(prime) deiodinase: converts T4 into T3, AND converts RT3 into T2

  • 5 (non prime) deiodinase: converts T4 into RT3

  • Enzymes are chains of proteins / amino acids that are shaped into very complex twisted blobs. Their exact shape is very important in their proper, efficient functioning.

  • Temperature is a big player in how tightly or loosely an enzyme is folded and therefore how well it works.

Here’s the theoretical mechanism of WTS:

  • Background:

  • Normally the thyroid gland secretes T4 which is converted by both of the above enzymes into T3 and RT3.

  • 80% of the body’s T3 is produced by conversion of T4 at the tissues by 5’deiodinase.

  • Over 95% of RT3 is produced peripherally by 5(non prime) deiodinase.

  • The body normally produces more RT3 than T3, but also usually clears RT3 faster than converting T3. This makes it seem likely that the 5’deiodinase enzyme converts RT3 to T2 preferentially to converting T4 to T3.

  • T3 tells all the cells in the body how fast to operate (rate of metabolism), and is the main molecule that determines body temperature.

  • During times of stress (famine / fasting, childbirth, loss of a loved one, etc) the body naturally shunts T4 conversion to RT3, reducing the amount of T3 stimulating the cells and leading to a much larger than normal amount of RT3 in the body. This turns down the cells metabolic rate thus conserving energy. This is an elegant way to adapt to the potential loss of food supply or other stress.

  • Ideally this conversion is short term, but sometimes the backlog of RT3 is too much for the body to clear out.

  • When there is an overabundance of RT3, the 5’deiodinase molecule gets pre-occupied with clearing out the RT3, and doesn’t have a chance to convert T4 to T3 as much as is needed to keep the metabolic rate (and temperature) normal, so the body temperature drops below 98.6.

  • If the body is too cold, the enzymes are too tight and then they work less efficiently which leads to many of the problems associated with hypothyroidism and the general feeling of “heaviness” and “sluggishness”.

  • Enzymes not functioning at their normal rate means a decrease in all body functions (for instance the normal elimination of metabolic waste) which leads to many of the primary and secondary symptoms of hypothyroidism, chronic fatigue, fibromyalgia, high total load of toxins, etc.

So the end of the story is that you end up with all the symptoms of hypothyroidism in the context of a healthy thyroid gland and normal thyroid lab tests.



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