test results & what does high Reverse T3 mean

Hi All,

I've been following posts on here for some time and have been amazed at how helpful everyone is. Having now had a private blood test I would really appreciate some help with what to do next.

I've been on 100mcg of levothyroxine for 12 years and am based in Birmingham, UK.

I have never felt that great on the levo but recently have realised I've been feeling worse and very hypothyroid - I won't list all symptoms but can if it is useful.

I Basically have very low Ferritin, high Reverse T3 and high Thyroid Anti-bodies (T3 is at low end)

these are my results:


CRP 1.50 <5.0 mg/L

Ferritin LOW 7.7 20 - 150 ug/L

TSH 2.61 0.27 - 4.20 IU/L

T4 Total 101.0 64.5 - 142.0 nmol/L

Free T4 16.28 12 - 22 pmol/L

Free T3 3.78 3.1 - 6.8 pmol/L

Reverse T3* HIGH 32.0 10 - 24 ng/dL

Reverse T3 ratio LOW 7.69 >20 Ratio


Anti-Thyroidperoxidase abs 11.0 <34 kIU/L

Anti-Thyroglobulin Abs HIGH 192.2 <115 kU/L


Vitamin D (25 OH) 64 nmol/L

Vitamin B12 364 pmol/L

Folate 30.90 10.4 - 42.4 nmol/L

So now I plan to see my GP but don't know if she will do anything. I don't know how you solve a high RT3 problem.

I have read that increasing T4 can make the reverse T3 situation worse - (I'm guessing this is what is causing my hypo symptoms), but will a GP have any other options?

Will taking an iron supplement solve the problems or just part of it? Can NDT help with this or not?

(need to go and nap now!)

7 Replies

  • Hi Raucous, having high reverse T3 is usually in response to having excess T4 in your system. Having low iron means you may not be converting T4 to T3 very well, because iron, along with selenium and zinc are used for this conversion process. Therefore the low iron possibly giving you the excess build up of T4. You need to get your iron up. This will assist in your thyroid hormone conversion and with the energy cycle within the mitochondria. Your ferritin being below range means you will hopefully be offered iron tablets from your GP, if not, take your own. I'm on iron bisglycinate, I find that a non constipating and well absorbed type. Others here on the forum may have found other types work well for them too.

  • Thanks HEA72, yes I'm hoping GP will offer iron and I guess I'll have to see if that helps over time. I'm also worried about the Anti-Tg level but perhaps that too will be helped by the iron.

  • I don't know about the iron and anti-Tg, probably best to discuss this with your doctor. :-)

  • Raucous Your high Tg antibodies means you have autoimmune thyroiditis aka Hashimoto's disease. Many people find that going completely gluten free helps to reduce the antibody attacks, some people also need to be dairy free.

    Your ferritin needs to come up to at least 70, thyroid meds can't do their job properly otherwise. A level of 100-130 is even better. With yours being so low maybe your GP will offer iron injections.

    Your Vit D needs to come up to around 100+. Supplement with D3 and also take K2. Vit D aids absorption of calcium and K2 directs it to bones and teeth rather than soft tissues and arteries.

    Your B12 needs to be around 1000. You can supplement with Solgar or Jarrows methylcobalamin sublingual lozenges. Start with 5000 mcg daily, when you reach 900-1000 you could reduce to 1000mcg as a maintenance dose.

    Your thyroid results aren't in the best place. For a treated hypo patient the TSH should be 1 or below or wherever is needed to get your Free T4 and Free T3 in the upper part of their ranges.

    I'm not quite sure about rT3 so wont suggest anything, maybe someone else will come along.

    Be ready for your GP to poo-poo your private test results, some don't like it at all. However, if she doesn't accept them then you could suggest that she gets NHS tests done if that would satisfy her.

    If you can get all your vits and mins to their optimal levels your thyroid hormone may work better.

  • Thanks SeasideSusie, that's really useful I was wondering about the B12 & D because they are not actually in the 'insufficient' ranges. I was actually taking bit D & B12 for a while but had stopped about 1 week prior to the test as I wanted it to show the reality rather than after supplementation. Did';t know about the K2 though.

    Dairy free could be difficult for me as I am vegetarian but had been wondering about gluten as I'm really suffering with bloating after quite small meals. I have already cut down on it.

    I will post again after I've spoken to doctor!

  • Raucous I hope you get on OK with your doctor.

    In case you didn't know, when cutting out gluten to help reduce the antibody attacks, it must be completely. Even the slightest amount of gluten can cause problems so you'd need to check everything you buy. Don't expect your doctor to know about that. I never expect anything from my doctors any more, that way I'm never disappointed :)

  • So I gave my doctor my blood test results and she prescribed iron tabs (ferrous sulphate 400mcg p/day), she also ran the tests past the endocrinology dept but they have said no need to treat. I asked again to try a higher dose of Levothyroxine but she won't.

    She is giving a referral to rheumatology because I'm getting lots of pain in my finger joints but that is it.

    I've started taking B12, VitD & K2, and Selenium in addition to the iron - it is quite hard working when to take what though!

    I think they are helping a bit as I feel a little less tired but it would be nice not to feel bloated after a small meal and lose some of the weight, lose the joint pain and not have such ridiculously heavy periods so I wonder if I should see a private GP or perhaps a Functional medicine doctor......

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