Folate low, b12 ok, reverse t3 and t3 ratio problem

Folate low, b12 ok, reverse t3 and t3 ratio problem

Hi, I have my latest blood results, tsh, t4 and t3 all good but still a prolonged problem with reverse t3 and the t3 ratio. Does anyone agree with the theory that you can still feel hypo symptoms if t3 ratio is wrong? Also, my vitamin d has improved (was previously deficient) and b12 has improved (again previously deficient) so supplements for both have worked but my folate has fallen and is now deficient, what supplement would you recommend?thanks

3 Replies

  • Kdiver25 What thyroid meds are you on?

    Your rT3 has increased and your ratio decreased since your last test. The ratio should be greater than 20. The usual way to deal with high rT3 is to use T3 only until it's back in range, I've read that it can take up to 3 months. You then reintroduce Levo and reduce the T3. I am not an expert, it was something I was looking into, and I'm not sure you will find an endo in the UK who knows anything about it.

    If you do some research on reverse T3 I think you will find that you can get hypo symptoms. Here's one link to get you started


    B12 - what are you taking? Did you show your GP your original results 3 months ago? Your B12 was under range, you should have been tested for Pernicious Anaemia.

    Folate has lowered, did you start taking a B Complex after starting B12 supplements? That would balance all the B vits and the methylfolate it contains would raise your folate level.

    If I were you, I would take both sets of B12/Folate results over to the Pernicious Anaemia Society forum here on Health Unlocked for their advice. Explain what you have been supplementing and see what they say.


    Vit D - Recommended level is 100-130nmol/L so carry on with supplementing. Are you also taking D3's important co-factors K2-MK7 and magnesium?


    Ferritin could do with a bit of a nudge up. It needs to be a minimum of 70 for thyroid hormone to work properly, better is half way through range and for females 100-130 is best. Easiest way to raise this is to eat liver regularly. With your level once every 7-10 days will do it. You can have it as one meal or hide it in casseroles, cottage pie, curries, bolognese sauce, etc.


    As you have high antibodies, which mean that you are positive for autoimmune thyroid disease aka Hashimoto's, have you adopted a gluten free diet and started supplementing with selenium to help reduce the antibodies?

  • Wow, thankyou so much for your reply and detailed information. I am taking 100mg of levothyroxine and have done for the past 6 years or so. I was fed up of feeling ill so decided to get my bloods done privately. My gp was given the results and said they couldn't use them and would have to do their own, which they did and apparently they had 'no concerns' I asked for more detailed information and they said they were normal, I said even the vitamin d and thy said no but pretty much everyone is low on this so it's not really a concern but I pushed for supplements. I think I'm going to try and get a print of the results they 'verified' back in November, I am taking jarrow b12 1000mcg every 3-4 days but no other b vitamins or folate.

    I have read a little about rt3 and pooling and the suggestion of t3 only but just don't know what to do, can't believe no medical professional in the uk is willing to consider the theory that rt3 can inhibit the free t3. Not sure how comfortable I am in buying the medication online as you just don't know what your getting 😕.

    I also haven't considered any other vitamins, should they be specific or will a multivitamin do? I am always sceptical as whenever vitamins are mentioned on health shows they seem to play them down and say very little gets absorbed and that a balanced diet is enough (which I have) although it's definantly not ggluten free, again probably largely as I have read if your not celiac it can be harmful, have you gone gluten free, do you feel any benefit?

    Again thanks for your reply, I will be re reading and addressing the vitamins 😊

  • Kdiver25 I suppose I can see why your GP said they had no concerns if their results reflected most of what your Medichecks results say. Your TSH, FT4 and FT3 were in range, he wouldn't take any notice of rT3, probably wouldn't take any notice of your high antibodies either but should have addressed your B12, folate and Vit D if they were anything like your original Medichecks test.


    Your dose of methylcobalamin is too low to raise your B12 in a reasonable amount of time. 5000mcg daily is the norm for your current level, but please do seek advice from the Pernicious Anaemia forum. Your original results are worrying as both B12 and Folate were under range and you probably shouldn't be addressing B12 until the folate has been addressed. They know their stuff so please take their advice, give them all results and information. On your original results you probably would have been advised to get tested for Pernicious Anaemia and maybe need B12 injections as well as prescribed folic acid.


    I hope your Vit D supplement is D3 only and not one that contains calcium. Here is a link to read about D3's co-factors:

    D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

    And a link to the different forms of magnesium, see which would suit you best and as it's calming it's best taken in the evening before bed:


    Multivitamins are a waste of money. They generally contain too little of the ingredients to do any good and usually the cheapest and wrong form of them. Far better to test and supplement what we are deficient in. Vit C being the exception as it supports the adrenals and immune system.


    Being gluten free if you're not coeliac isn't harmful. Adopting a gluten free diet when you have Hashimoto's is nothing to do with being coeliac. Gluten contains gliadin which is a protein thought to trigger antibody attacks, so if you remove gluten you are removing the trigger. It will help reduce antibodies, as will selenium L-selenomethionine 200mcg daily. Also, keeping TSH suppressed reduces antibodies. Such a shame that most doctors don't know anything about this. Many members have found that being gluten free helps enormously. I'm not gluten free as my Hypothyroidism is non-hashi's.

    Gluten/Thyroid connection -

    Hashi's Information:


    You don't have to worry about sourcing T3 as long as you get details of recommended, reliable suppliers from members of the forum. You'd have to put up a post asking and replies would have to be by private message.

    I don't know if any members can actually guide you regarding your high rT3 - we are not medically trained but there may be a member who has done this and can share their experience.

    It might be worth looking through this website about rT3

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