low Rt3 ratio

Just got my lab back: 

6. april,4 days after increase to 135 mg NDT . It was necesarry to use anorther lab which had the Rt3 test avaiable:

TSH 2,26 (range 0,5-3,6)

Free T4 13,4 (range 8-13,0)

Free T3 5,8 (range 2,7-6,3)

Rt3 0,34(0.14-0.54

This gives ratio of 17,1

I then took a scheduled test on the 18 of april:

TSH 2,1(range 0,2-4,0)

Free T4 15,7 (range 11-23,0)

Free T3 5,8 (range 3,5-6,5)

This is the best results during this winter. On all the other tests I had a TSH around 3,5 so I had been clearly undermedicated.

Now,question is. Im still feeling crap but maybe a bit better than in march. Mid march I did a hard exercise training camp with 3 days(during 4 days,1 day rest) 

Could this be causing the bad rT3 ratio? I starting to worry if I am doing something wrong. I also understood that excess Ft3 could cause this but since my TSH had been elevated I cannot understand this. Nowadays Im to exhausted to do bike training. I just go for 30 mins walk

7 Replies

  • Jeschiotz,

    It's high rT3 which can be problematic, low rT3 isn't seen as an issue.

    You can increase dose at 2 week intervals until TSH is <1.0 as long as FT3 remains within range.  Until you are optimally medicated it would be best to avoid strenuous exercise which depletes T3.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • I think you missunderstood. Ratio Rt3/ft3 is low. Meaning that Rt3 is high

  • Jeschiotz,

    rT3 0.34 is mid range, it isn't high.

  • Clutter, so even if ratio is below 20 I should not worry?😊

  • Jeschiotz,

    No need to worry.

  • THx, Clutter! Final question. I worry mostly of my higher pulsrate. With every increase there was a faster Pulse. I go back one year and see that now Im 20 beats higher in Resting state than last year on the same dose(from 55 to now 75) . I dont know what to think. Sit it out and hope it settles lower?  

  • Unless you are an Olympic athlete a pulse rate of 55 is not good, but shows that your metabolism is running much too slow.  75 is closer to normal.

    T3 is the active thyroid hormone which controls the metabolism and the symptoms. T4 is the storage form and is not active.

    Your free T3 is high in the normal range and most people would feel well at this level.  This level with continuing hypothyroid symptoms could however indicate thyroid hormone resistance, also known as impaired sensitivity to thyroid hormone. This is a genetic condition which requires very high levels of T3 in the body to compensate. 

    If there are other family members with ME, CFS, fibromyalgia, depression or thyroid issues this would further support this idea. 

    I will send you a personal message about a book on this.

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