Thyroid UK
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Advice please!?

I am reposting this in the hope for more responses. Does anyone think I may need T3 due to my high RT3?

Hi. I've just had the results from my private thyroid test and hoping to get some advice please. I had a total thyroidectomy a year ago and have been taking levothyroxine since. The gp keeps changing my dose up and down and my levels have been up and down. I am currently taking 100mg.

T4-111. (58-154)

Tsh-1.55 (0.4-4.1)

Ft4-16.3 (10-22)

Ft3-4.33 (2.8-6.5)

Ft4:ft3 ratio-3.8 (2-4.5)

Rt3- 0.55 (0.14-0.54)

Tg-<20 (0-40)

Tpo-20.2 (0-35)

Doing the ft3/rt3 myself- 4.33/0.55= 7.8 (is this correct?)

My gp is pretty clueless so would like to go armed!

Many thanks in advance!

12 Replies

Bagpuss, I would say you need more Levothyroxine to bring your TSH down to just above/below 1.0 which will boost your T4 which should then convert to more T3.


I've tried more t4 and I was even worse!! my rt3 is high therefore im not using the t3 I already have. The rt3 then builds up which comes from t4 and blocks the receptors making the situation worse. I think I need t3 and less t4 to help clear out my rt3. Have a look at my ft3/rt3 ratio, it's very low, needs to be above 20 ideally.


Bagpuss, I don't understand T3/rT3 ratios or how rT3 levels are interpreted.

Your TSH is higher than comfortable for most but if you don't tolerate more Levothyroxine then you may find the addition of a little T3 is beneficial. Thyroidless patients often need T4+T3 combination because they're unable to convert any T3 in the thyroid gland and they may not be able to convert sufficient T3 in the other organs.


I had high rT3 last year - 0.72 with the same ref range as you. I took T3-only for about 7 weeks or so, and a couple of months after stopping the T3 I re-tested. My rT3 was 0.35 - just above mid-range, so I would have preferred it to be lower, but I did feel a lot better. I wouldn't take T3-only again though. I didn't enjoy the experience, apart from briefly rediscovering dreams again, which I loved.


I was thinking of a t4/t3 combination. Do you still take t3? What was wrong with taking th t3 only? Did you get it from your doctor? did you look at your t3/rt3 ratio?


I don't take any thyroid hormones at all at the moment. Last year I tried levo under the guidance of Dr Skinner just before he died. I didn't do well on it, I felt like I was being poisoned, and it probably contributed to my high rT3. Unfortunately I never got the chance to have a second appointment with Dr S, so I ended up doing my own thing. That was what made me try the T3 on its own. I bought the T3 online. My T3/rT3 ratio was about 8 before I started. When it comes to thyroid and nutrition I do my own thing, do my own research and take my own risks. It is less daunting than having to see a doctor.

On T3 alone I did reasonably well. But I already had chest pain before I started taking any thyroid hormones of any kind. I found the T3 helped, but only if I got the dose absolutely correct. Too little, and I was in pain, too much and I was in pain. The problem was, finding the sweet spot was very, very difficult. In the end I went hyper. Ever since then I've mostly stayed off T3, and I've just concentrated on trying to eat the best diet I can, improve the health of my gut, and I've been waiting for my iron levels and my vit D levels to rise before trying NDT. But it has taken nearly 18 months to get my iron and other iron-related levels up to 30% of the way through the reference range. My gut is still dodgy. My TFTs have improved, but overall my TSH is still over the range, and my FT4 and FT3 are still too low in range. The one thing I am pleased about is that with the increase in my iron levels my chest pain has massively reduced.


Hi Once settled after surgery, thyroid should be treated the same way as pre surgery. I suspect you need a little T3 with the levo if you feel unwell. I need my FT3 near the top of range, it must never go over.



Here is a link explaining more about reverse t3..

If your t4is converting to rt3 taking more t4 will only exacerbate the problem.

Xx. G


Hi I to have had a total thyroid removal. its not nice the after effect. The bottom line is and I keep banging on about this, all your GP will do is look at your TSH, if you still have problems he will treat you for depression thats a fact.

Now this does not help you. If you have a RT3 you need a dr who knows what they are doing. Also you need sustained release T3 for about 3- 6 months,any T4 you take will just add to the RT3.

I have been on SRT3 for about 6 months and I am in the process of moving to NDP but there again you need a dr to treat your adrenals and your other sex hormones.

If you want to get back to me please feel free.

John c


Thanks for the reply. What's the name of the srt3 you take? Do you get it on the nhs? Will you be getting your ndt on nhs? I plan on suggesting there is a problem with my adrenals. What are the other sex hormones you refer to? Did your doctor help you with all of this or did you have to go it alone?!!


HI, I saw a dr in Hove and it comes from the USA but you need a prescription. There is a pharmacy in London called the specialist pharmacy but again you need a prescription. I have seen all the drs that can been seen. I am sort of going it alone now but I have an appointment in November with Dr moulton . He is good but expensive.The sex hormones are in Men Testorerone and DHEA and Prenenalone. In women I am not sure.

Good luck you are going to need it.



Thanks! Hope you get some help!!


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