Elevated Reverse T3

[Blondiejayjay]

At the moment I have low TSH with normal levels of T4 and T3,

However the recent private blood test shows

Reverse T3 28 ng/dl (10 - 24)

Reverse T3 ratio 11.6 (15.01 - 75)

Thyroglobin antibody 478 iu/ml (0.00 - 115)

Thyroid peroxidase antibody 198 iu/ml (0.00 - 34)

comments; Your rT3 is elevated and Ft£/rT3 ratio is low which would suggest that you are not getting sufficient free triiodothyronine (Ft3) into your cells. There is currently little scientific research into the FT3/rT3 ratio, but some experts believe that this could lead to symptoms of hypothyroidism (slow metabolism) even though your thyroid levels are at normal levels. you may wish to discuss these results with your GP although you should note that it may be difficult to get advice and treatment for elevated rT3 or abnormal ratio through conventional channels.

i also have low levels of B12 and Vitamin D

Does anyone know of an endocrinologist in the UK who would look at this aspect of Thyroid health?

[SlowDragon Administrator]

What about levels of ferritin and folate

Are you supplementing to improve low Vitamin D and low B12

Low vitamins will stop you using your thyroid hormones, so TSH goes low suggesting over replacement but actually you are hypo

High antibodies is Hashimoto's this causes low stomach acid and leaky gut

Very common to have gluten intolerance and changing to strictly gluten free diet may help improve symptoms, and may reduce antibodies slowly

thyroidpharmacist.com/artic...

Endocrinologists ignore Hashimoto's. But to feel better we need to get antibodies lower

[diogenes Remembering]

However, another explanation for elevated rT3 is that you have or have had a mildish nonthyroidal illness. rT3 is elevated by illnesses of this kind - fever, infection etc.I wouldn't be certain from these figures that they show problems with your thyroid.

[Blondiejayjay in reply to diogenes]

I was diagnosed with Hashimoto's in 1984 and have been on low doses of thyroxine since. In the last 4 years I have been experiencing low levels of TSH t4 & T3.

My ferritin & folate are normal, I have no signs of inflammation or illness showing in the blood test results.

I have seen GP this afternoon & he has prescribed vitamin D and will be checking my intrinsic factor for the B12 before deciding on how to treat.

We are hoping that this will improve my thyroid health.

[Clutter]

Blondiejayjay,

What are your FT3 and FT4, B12 and vitD results and ranges?

Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

[Blondiejayjay in reply to Clutter]

Thank you for your response. It does seem that gluten free may be the way to go from the advice from all you lovely people on the forum.

I shall ask GP about this when I go back about the B12 results. Results 9 July was 125 Pom/l (140-724). I have been taking a ferrous & B12 supplement since June in attempts to improve my health

[Clutter in reply to Blondiejayjay]

Blondiejayjay,

I doubt your GP has much, if any, understanding about thyroiditis (Hashimoto's) so don't expect support from your GP about gluten-free. You are likely to be told that you don't need g-f unless you have coeliac disease. You really don't need your GP's approval to try g-f and see whether it improves your symptoms.

B12 125 is deficient. Go to healthunlocked.com/pasoc for advice about B12 deficiency before you see your GP.

[greygoose]

So, what are your FT4 and FT3 levels? You can't just take an rT3 reading out of context.

[Blondiejayjay in reply to greygoose]

They are within normal limits FT4 21 (12 - 22) FT3 4.99 (3.10 - 6.8)

[greygoose in reply to Blondiejayjay]

Within normal limits doesn't mean much. Your FT4 is right up the top of the range, the FT3 is just about mid-range, therefore you have a conversion problem, and all that unconverted T4 is converting into rT3, which is why you have high rT3.

Do you have labs from when your FT4 was about 17/18?

[Blondiejayjay in reply to greygoose]

Yes I have a lab result but without the rt3 tested -

TSH 0.34 mU/L (0.4-5.5)

FT4 16.3 pmol/L (11.5-22.7)

FT3 3.3 pmol/L 3.5-6.5

Tpoabs 198 ku/l (0-60)

[greygoose in reply to Blondiejayjay]

OK, so you are a pretty bad converter. And the answer to that is not to keep increasing the T4, because after a certain point, it just converts to rT3. How much are you taking, by the way? I can't find that info.

The answer is to add in some T3 and lower the T4.

[Blondiejayjay in reply to greygoose]

My dose of thyroxine is 100mcg now. The test results refer to 125mcg and now have been reduced due to the TSH being suppressed.

[greygoose in reply to Blondiejayjay]

Oh, ok, sorry. It's a bit confusing.

So, you're a bad converter and you have an ignorant doctor - a lethal combination!

S/he should not be dosing by the TSH. As you have Hashi's, you need your TSH suppressed.

And, you need T3 added to your levo, because you are never going to get your dose of levo high enough to give you enough T3 to be well. It's getting harder and harder to get T3 prescribed, so would you consider buying your own, and self-treating with it?

[Blondiejayjay]

It is confusing isn't it. I gone through titration of T4 from 50mcg to 75mcg to 100mcg, 125mcg & back and forth, which prompted me to get a blood test done via medichecks thanks to advice on this forum.

From this one group of tests I have discovered a low B12 which GP couldn't see any reason for testing because I didn't show up as anaemia on the Full blood count.

Now that I know I am a bad converter & I know that NHS will not prescribe T3 yes I would be prepared to buy & self treat if I knew how much to take of each