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Thyroid UK
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Finally Reverse T3 labs

Hi, I finally got my own ReverseT3 results done on my own. I am seeing a new doctor and she did all the labs but I don't see her for another month to follow up.

I am on 1 grain of Thai thiroid for about 3 weeks, after years of Levo. Have lots of work to do with high cortisol, low vitamin D and iron. I went up to 1 1/2 yesterday after another admin had me go back up

In the meantime what should I be taking for NDT right now.

FreeT4. 0.6. Range 0.8 -1.8 ng/dL

FreeT3. 2.7. Range 2.3 -4.2 pg/dL

Reverse T3. 7. Range 8 - 25 ng/dL

Thank you.

16 Replies

All of your levels are very low. How do you feel? What was your TSH level?


My TSH is 0.5. And I feel awful. I'm not sleeping except for an hour or so at a time even with HB and vitamin D. Those I just added last week though.

Terrible headaches and sweats. And swelling in my hands and feet. Just all around like something the cat dragged in, as my mom would have said!!!


Well i am not an expert on dosages, hopefully one of the seasoned HU members will add their comments on that, but I can see that your levels are very low and causing your issues.

Good luck and hang in there.


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Thank you.




lol That doesn't work on here, I'm afraid. But there will probably be more people reading your post in the morning.

I don't understand your question. You say you've just gone up by half a grain. That was the right thing to do, but you can't increase again straight away. You need to wait a couple of weeks.

I'm not surprised you're feeling awful, your T3 is much too low. It has nothing to do with the TSH.

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Thank you. I don't know why I hit the bump. See brain fog.

I went back up yesterday before I got these results after realizing I hadn't kept raising for long enough. Someone had looked at my results from a couple of months ago and told me to come back to 1 grain my Free T4 was high combined with my high 3 cortisol.

Looking at these results today I didn't have a clue what they meant. I am just getting very confused because I really feel terrible.

So do I just keep

Increasing my NDT until I feel

Better. Or do I need to add T3.

Sorry for so many stupid ? I really am just confused.

Thank you. I always read your posts.


It doesn't matter too much about a raised T4 - although that would be very surprising on NDT. It's the FT3 that is important. At what time of the day was cortisol raised? Do you have the numbers?

As Jazz says, at the moment you're doing the right thing, just keep it slow and steady. But, it might be an idea to get the vit D, vit B12, folate and ferritin tested, if you haven't already. :)


These are my test results from the saliva test about 4 weeks ago.

Estradiol. 0.5 pg/ml. (1.3-1.7)

Progesterone. 11 pg/ml. (12-100)

Ratio pg/E2. 10 pg/ml. 100-500

Testosterone. 10. Pg/ml. (16-55)

DHEAS. 1.9 nh/ml. (16-55)

Cortisol am. 0.6 ng/ml. (3.7-9.5). Low

Cortisol noon. 6.0 ng/ml

(1.2-3.0). High

Cortisol evening 3.9 ng/ml

(0.6-1.9). High

Cortisol night. 2.8 ng/ml

(0.4-1.0) high

FreeT4. 0.9 ng/dl. (0.7-2.5)

FreeT3. 4.0 pg/ml. (2.5-6.5)

TSH. 0.5 iU/ml. (0.5-3.0)

TPOab. 332. IU/ml (0-150)

Vitamin D D2. <4 ng/ml

(<4 if not supplementing) NOT

Vitamin D. D3. 30ng/ml. (32-100ng/ml)

Vitamin D total. 30 ng/ml


Ferritin. 27 ng/ml. (15-150)

Iron. 78 ug/dl. (37-145)

Transference. 267 mg/dl


TIBC calc. 381 ug/dl.


Iron sat calc. 20. (15-50%)

Vitamin B12. 1024 pg/ml.


One more question. Right now my sleep is all over the place if I get any. Best is right after I take my NDT at 530 ish. At least I get about 2 hours of uninterrupted sleep. Take second dose about 2 pm

Is there a better time for me to be taking it or do I just have to wait out adrenal repaid and vitamin D for now.

I'm just fall down exhausted.

Thank you for all the help. 💙💙💙💙


Sorry, I don’t know much about Estradiol or progesterone, but they look really low. Is anything being done about that? Testosterone is very low, too.


So, your am cortisol is very low – I wonder you manage to get out of bed in the morning! And at noon it is high, which is typical of adrenal fatigue. The adrenals struggle all morning to make cortisol, to get you going, but don’t manage a decent amount until lunchtime. It then continues high through to bedtime. And it’s that high cortisol that is stopping you sleep.

So, all in all, your adrenals are pretty wacked out! What has your doctor said about that? At the very least, you need something to support your adrenals. Do you get plenty of salt and vit C? And B vits? Have you tried Holy Basil at night to lower the cortisol and let you get some sleep? Your doctor could prescribe you a small dose of HC, but I doubt he knows how to dose it. Have you seen an endo with these results?

Your vit D3 is too low, needs supplementing, but that’s not my subject. Your ferritin is even worse! That needs supplementing urgently. But, on the bright side, you vit B12 is really good, there!

When taking NDT, or any form of T3, you would expect your FT4 and TSH to be low. That’s not a problem. The problem is that your FT3 has gone down, rather than up.

So, for the time being, your priority should be to sort out your adrenals, and supplement the nutrients that are low, and then you might absorb better and be able to use the hormone you’re taking better.

‘Is there a better time for me to be taking it or do I just have to wait out adrenal repaid and vitamin D for now.’ I don’t understand that question. But, I don’t think your lack of sleep has anything to do with the NDT, it’s the high cortisol the problem.


Greygoose, thank you for laying all that out so not only can I understand it, it has made me feel less like there will never be an end in sight. I hate the word validate but that did. I want to cry!!! I kept telling this to my doctor for years and she said it wasn't thyroid related. I had brain scans, on anti depressants, neurologists, etc

I kept going back and got the same response.

I started self medicating with NDT about 6 weeks ago or so. I didn't want to wait until I saw a new doctor that someone recommended to me here. I have been to every endo in the Boston region. I was fine My TSH said so.

So 2 weeks ago I did finally find a good doctor but she is waiting for all new test results. She did leave me on the NDT Thiroid of 60 but I raised it myself Monday after getting those latest results.

She also gave me a stress reducing with HB, etc but after reading here I went and got straight HB which I have been taking one before each high and 2 before bedtime one. No improvement yet.

And she gave me liquid vitamin D3 with K2 which I am trying to take with food.

I have no appetite.

So that's where I am at right now.

Why would my FT3 be going down. I'm going to look at history.

I have been very anemic in the past so is that related to ferritin?

Sorry for all the ? I used to be smart now I can't understand anything complicated.

Thank you. I am going to copy your post and show it to my husband. Sometimes he gets it and sometimes not. But maybe if he can read me having a reason I can't get up in the am, he will at least give me a break.

I know it's an over used word but I just feel like you validated my current situation.

I wish I could send you an overseas hug. Thank you!!!!



You have to remember that doctors know nothing about thyroid – not even the so-called ‘specialists’, the endos. They would much, much rather put you on a collection of drugs for your symptoms – like anti-depressants – than give you a simple hormone treatment, like levo. That is why we have to learn as much as we can ourselves, so that they don’t get away with it! We have to stand up for ourselves and not be bullied into conforming to their mistaken ideas.

Your doctor couldn’t have given you a different response because she had no idea what was going on. She, like all the others, has been brainwashed by Big Pharma reps. Quite why supposedly intelligent people, like doctors, cannot see that these reps have their own agenda, I will never understand.

I hope your new doctor is more intelligent and able to think out of the box. Sorry, but bit tired tonight, what is HB?

It’s very good she’s given you liquid D3 with K2, but how much has she given you? They do tend to under-dose.

D3 is fat soluble, so you need to take that with a slice of bread and butter, or something like that. Doesn’t have to be a big meal, just some fat to dissolve the D3. Or even just a glass of full fat milk, perhaps?

Why your FT3 is going down is anybody’s guess. Have you had your antibodies tested? If you have Hashi’s, it could be because you have less and less gland activity.

Anemia is indeed related to ferritin. Ferritin is the protein in which the iron is stored. You need to have good stores of iron for the body to dip into. It needs it for so many things.

It’s perfectly normal for the brain to be affected by low T3. The brain uses the most T3 of the whole body. When you get your T3 levels up again, your brain will go back to being smart! 

I’ll take the hug as read, and send you one back! lol :)


Hi Greygoose, thanks again for the advice.

Yes, I do have hashi's I believe My doctor never told me

TPOab. 0-15O mind was 332.

HB is holy basil. I read to take it for highs. It helped a little but not great so I added PS last night and slept a little better. I cpuld actually feel my heart rate start to slow down.

So confused on the cortisol and how it works. Especially overnight.

I'm going to try my 1/2 grain of thiroid at night and see if that helps I used to take my Levo at night

I am on 10,000 of D3 is that enough Thanks for the tip on the bread I was trying to take it with a heavy meal that I don't really eat My sleeping schedule hurts my eating patterns

I will have to wait on my iron until I see her I'm afraid to add anything wo all new labs



Yes, if your antibodies are over-range, then you do have Hashi's. But doctors don't understand it, so rarely mention it. But knowing about it does change understanding of the disease's progression.

Are you gluten-free? Do you take selenium? Both of those things help lower the antibodies. But, you need to keep your TSH at zero, to stop provoking the attacks. Doctors have no idea about that!

Adrenals aren't confusing, they follow a logical pattern. You need to have your highest level of cortisol in the morning, to get you out of bed, washed, fed, dressed and on with your day. If they are fatigued, they have trouble producing enough cortisol in the morning to do that.

But, they keep on trying and trying and trying, and just manage to produce the morning's cortisol when it's time to go to bed! Then, production drops off, and they have trouble getting going again in the morning.

I don't know how good an idea Holy Basil is (it's awful seeing initials when you don't know what they stand for! What is SP?), and I don't know how well it works, but then again, I don't know what else you can do. A lot of people recommend adaptogens - like ashwagandha - but, in my experience, adaptogens are better at lowering cortisol than raising it. Although, they're supposed to do both. But, their means of raising cortisol - which is what you need in the morning - is to stimulate the adrenals. And, stimulating a sick gland is not a good way to go. Your adrenals need resting...

I think I mentioned above, that what you need is to give your adrenals a helping hand in the morning. Something like HydroCortisone. But, not many doctors know anything about dosing them. Try asking, anyway. It's all very well trying to stop production at night, with the Holy Basil, but you need your adrenals to be able to get going again in the morning. And at the moment they can't. And I do wonder if the Holy Basil doesn't make that worse.

Do you eat breakfast? That's the best thing you can do for your fatigued adrenals. They need protein as soon as possible after you rise. Not masses of it, necessarily, but something. Do you get enough salt? How much vit C do you take?

If i were you, I would take 50 000 iu vit d3 for a while, to get your level up. It really is very low, and must be making you feel bad.

And I would not wait for the iron! With ferritin that low, you need something now. Doctors are not doing you a favour by testing and prescribing, that is their job. Make them earn their money! lol


You probably didn't need to do a reverse T3 test. If you'd been on a highish dose of levo it might have given an indication of how well (or not) your body is able to convert levo to T3. But reverse T3 was unlikely to be an issue on a grain of NDT. Not enough levothyroxine in a grain to cause a problem - and your results bear that out.

There's not much more to do than you're already doing. You need to raise NDT slowly, so you need to give the half grain you've just added at least a fortnight to get into your system. After a fortnight you could then raise to 2 grains if you're still experiencing symptoms.

Standard advice is to stick at 2 grains for several weeks then, if you still have symptoms, to raise by another half a grain - and so on. Somewhere between 2-3 grains it would be worth having another blood test - but it's not essential. Before blood tests doctors worked on the basis of symptom resolution. You'll know if you take too much NDT as you'll experience overmedicated feelings (feeling wired, restless, heart rate too fast etc). If you do, back off from the dose you're on by half a grain a day. You can always experiment with quarter tablets if cutting back half a grain is too much.

Honestly, keep it steady and slow and you won't go too far wrong. Resist the urge to increase too quickly or slash your dosage drastically - little changes will work best and it's well worth the effort.

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Thank you. That's great advice and I understand exactly what your saying. I'll go slowly and work on my other stuff as well.


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