Getting closer! - Issues with elevated Reverse T3

Getting closer! - Issues with elevated Reverse T3

Just received my full thyroid panel, and looking for some advice.

My RT3 is elevated at 28.0 (10 - 24 ng/dL), and both ferritin/folate are on the lowish side 54.9 (30 - 400), 14.33 (10.4 - 42.4).

I understand the elevated RT3 'clogs' up the receptors with this fairly useless hormone (so despite normal results, it's causing me to be hypo - fatique, etc).

According to STTM webside, low ferritin/folate can be present due to being hypo.

I've added a copy of my results.

Your thoughts?

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12 Replies

  • Am I right in thinking you're not on any thyroid meds? But guessing you do take B12...?

  • No thyroid meds. Been injecting B12 every few months, but my body isn't utilizing it properly (possible MTFR issue)

  • OK. Not my chosen specialised subject, but I think high RT3 in the absence of high or even over the range FT4 is usually the body trying to slow you down because something else is making it want to reserve energy.  The something elses can be: extreme dieting, poor adrenal function, high cortisol, low B12 (so if you're not utilising B12 that could be it) plus a few other things most likely.

    For someone injecting B12, your levels aren't as high as I'm used to seeing. Is every few months enough - have you tried injecting more often?

  • I'll try increasing the injections, but will focus on my iron right now (as mentioned earlier re lowing fer/fol), and then test the adrenals.

  • Try taking a tiny dose of lithium to help you absorb and use the B12.

  • I guess this is through private blood test, not NHS.

  • No NHS, I got it done via Blue Horizon Medicals.

  • If you think there's a methylation issue then are you taking the right b12? I was injecting b12 but taking oral b12 methylfolate had bigger impact on my health.

  • I tried hydroxy, but may try methyl instead. Did you try methyl for both inj/oral?

  • I couldn't get methyl to inject. Took liposomal b12 folate and ramped it up one drop at a time under dietician supervision ( private of course not the ignorant NHS ones) 

  • There are many reasons that rT3 can go up. If you don't have a genuine thyroid issue then I'd work on those things.

    I would definitely have cortisol tested - an adrenal saliva test is a good idea, plus an 8:00am morning cortisol.

    Iron has to be ideal too. So, serum iron, serum ferritin, TIBC and transferrin saturation % is needed. Your ferritin is already pretty low so I'd get the full set.

    If you have any gut issues with absorption then this will affect ALL nutrients so addressing the gut with a healthy diet is important.

    Use of alcohol, or anti-depressants can also be a factor - these may show up in the cortisol results. 

    I wouldn't rush to throw in thyroid hormones yet. I'd dig deeper.

    Best wishes,


  • Thanks Paul for the reply. I'm already running some bloods for serum iron, serum ferritin, TIBC and transferrin saturation. Will do the 24 hr adrenal saliva test, and see if that shows anything.

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