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Thyroid results - elevated Rt3 but low FT3/rT3 ratio

Hi everyone,

I have been struggling with fatigue, weight gain, hair loss, and tingling toes etc for the last year or so (and to be honest have been struggling on and off with energy levels for many years) and so had a full thyroid screen done by medichecks. These are the results:


FREE THYROXINE 16.5 pmol/L 12.00 -22.00

TOTAL THYROXINE(T4) 94.1 nmol/L 59.00 -154.00

FREE T3 5.11 pmol/L 3.10 -6.8

REVERSE T3 *30 ng/dL 10.00 -24.00

REVERSE T3 RATIO *11.09 15.01 -75.00

THYROGLOBULIN ANTIBODY 11.600 IU/mL 0.00 -115.00


VITAMIN B12 280 pmol/L 140.00 -724.00

FOLATE (SERUM) 3.17 ug/L 2.91 -50.00

25 OH VITAMIN D 57.1 nmol/L 50.00 -200.00

CRP -HIGH SENSITIVITY 3.8 mg/l 0.00 -5.00

FERRITIN 126 ug/L 13.00 -150.00

They have recommended supplementing with 400 - 800 iu of vitamin D per day for twelve weeks - I have already been taking 3000iu daily for about 2 months. Any help interpreting the results and suggestions for next steps would be gratefully received as the fatigue is getting quite debilitating now and am desperate to get back to health again!

Thank you.

2 Replies


TSH 1.57, FT4 16.5 and FT3 5.11 are euthyroid (normal) and don't indicate thyroid dysfunction. Thyroid peroxidase and thyroglobulin antibodies are negative for autoimmune thyroiditis (Hashimoto's).

rT3 is elevated which may be due to non-thyroidal illness such as a virus or infection.

B12 280 is low in range. If you have symptoms of deficiency in go to for advice.

Folate is low in range. You can raise folate by eating fresh leafy greens or supplementing folic acid or methylfolate.

Vit D 57.1 is inadequate. Most people are comfortable around 100. I would supplement 5,000iu D3 for 6 weeks then reduce to 5,000iu alternate days and retest in April.

CRP is an inflammation marker and 3.8 is high in range and indicates you may have had some inflammation or infection.

Ferritin is optimal halfway through range but it can be raised due to inflammation so it is possible that yours is slightly elevated for that reason.


Thank you for replying! I showed the results to my sister who is a GP and she also said my b12, vit D and folate were too low considering the supplementation I had been taking since January (450% B12, 6000iu vitamin D and I can't remember the folate amount in the supplement - have been taking these sublingually daily. She has recommended that I am screened for coeliac (I have a number of those symptoms) to see whether that is leading to me not absorbing vitamins and minerals properly and could account for the inflammation marker and the low vitamin ranges, and also have a cortisol test to check for adrenal fatigue. Fingers crossed I can finally get to the bottom of it all as have had to give up work as was struggling to get through a full work day. Thanks again! Xx

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