Blood Test Results Showing High Reverse T3

Hi Starahelm and welcome

I can't help with reverse T3 I'm afraid but I'm sure someone else will come along with some advice.

As for the rest:

Good news - your antibodies are low so do not indicate autoimmune thyroiditis (Hashimoto's disease). One less thing to worry about

B12 is too low. The Pernicious Anaemia Society recommend 1000. You can supplement with Jarrows or Solgar sublingual methylcobalamin lozenges 5000mcg daily, and in a couple of months, when level is nearer optimal, reduce to 1000mcg as a maintenance dose.

When taking B12 you need to take a B Complex to balance the B Vits. Thorne Basic B is a good one and contains 400mcg folate which will help yours which is a bit low, it needs to be at least half way through range, ie 26+.

Vit D is low, needs to be 100+. Supplement with D3 and also take K2 or a K Complex which includes K2. Vit D aids absorption of calcium and K2 directs calcium to bones and teeth rather than arteries and soft tissues.

If you get all your vitamins and minerals at optimal levels it will help thyroid hormone to do it's job properly, ie help convert the T4 to T3 which is the active hormone. Your conversion, at the moment, isn't too bad but could be better. For normal converters the ratio should be FT4:FT3 - 4:1 or less. Yours is 4.6 so you might feel better if your ratio was less. It's possible optimal vits and mins will help there.

A treated hypo patient generally feels best with a TSH around 1 or below or wherever it needs to be for FT4 and FT3 in the upper part of their ranges. So your TSH is too high at 2.87. An increase in your Levo would bring that down and increase your FT4 and FT3 to higher in their ranges. I would try for a 25mcg rise, if GP is not willing then maybe compromise on 12.5mcg.

Here is some evidence that may persuade him, it is from a Pulse article written by Dr Toft who is past president of the British Thyroid Association and a leading endocrinologist so maybe that will hold some clout when discussing with your GP.

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

If you email louise.warvill@thyroiduk.org.uk she will let you have a copy of the article which you can print out and show your GP.

At the moment, whilst you are not optimally medicated, exercising to lose weight is pretty pointless. You have a better chance of achieving weight loss when on the correct dose of Levo. Also, exercise will deplete T3 (and you don't have too much of that at the moment) and make you feel worse so you might want to ease up on fast cycling at the moment.

Your rt3 is the way too high. In cellular level you are hypo as rt3 blocks t3.

Converting T4 to rt3 is very genius process from human body not only signaling that things are going wrong but forcing you to slow down in order to protect you.

Instead upping levo you would need t3. Plus you need to up your calories to prevent T4 converting to rt3. If you are starving yourself it turns on self protection mode slowing you down. You need good fats and good carbs.

It's your doctor that's the quack! He knows nothing about it. So, I really don't think there's any point in showing him these results - unless you want to be forced to change your practice! Everything is in range - albeit rather low in range - and that's all he cares about. He doesn't know any better. No point in saying to him that you're not converting and your B12 is low.

But, you're right, you aren't converting very well. And that is probably due to your low nutrients. They all need to be optimal for your body to be able to use the hormone you're giving it.

I wouldn't worry about the rT3, that's a bit of a red herring at the moment. But, you certainly don't want anymore levo! Unconverted levo floating around causes trouble! You either need to reduce it, and add some T3 - as Justina said - or go onto T3 only whilst you supplement your nutrients up to optimal. And I can't see your medieval doctor agreeing to either of those solutions! In fact, I think you'd have a job finding a doctor that would, these days. The other solution is to buy your own, and self-treat, like so many of us do.

With a vit D that low, I really don't think just going out into the sun is going to help. You really need to supplement - and also take some vit K2, magnesium and zinc. SeasideSusie explained about the B12 and folate. But where is the ferritin result??? If that's low, too, you're not going to improve, whatever you do.

Starahelm,

High rT3 is usually caused by a build up of unconverted thyroxine (T4). Increasing Levothyroxine dose is likely to make it worse. I would be very surprised if your GP knew anything about high rT3, it isn't something which is tested on NHS. Usual advice to reduce rT3 is to switch to Liothyronine (T3) only for 3-4 months.

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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.

You most likely do need the T3.

It's over the counter in Europe and not a dodgy drug that the NHS seem scared of. Not just the price, imo.

Tricky to take, though - as you need to watch daily rising am temps, BP and weight.

Slow start and roll off of using it is needed. [P Robinson stresses this starting with 5 or 10 and raising every 3 days, or so].

Best if you get a referral though as I'm not saying what will work or not work for you -and I waited till I got support in NHS.

That will vary for you, depending on condition a lot- and in where you live, too..