Hi ... Medichecks blood tests showed this, with a comment from the doc analysing the results that not to expect any help from the NHS re medication, as they don't use this for diagnosis.
Considering so many GPs use only TSH for diagnosis, his comment was of no surprise at all..!
I'd very much appreciate advice from anyone who has experience of this Reverse T3 Ratio being under 'range' ~ and how it can be dealt with please?
Does it have a 'name' (the Medichecks doc didn't say if it indicated Hypo or Hashi's).
I am not receiving any treatment for a thyroid problem, as my GP says 'all results are within range' ~ she couldn't analyse Blood Test Results to save her life ... never mind saving my life ... Grrrrr.
Thanks in advance for any information provided. B xx ❤️️
PS: 3 sets of Blood Test results are on my Bio now. (NHS, Medichecks and Blue Horizon) ranging from March through to September of this year. I'm addressing all of the Vitamin Deficiencies she's totally ignored with thanks to help received here!
Written by
LadyBarb
To view profiles and participate in discussions please or .
It would be worth asking Medichecks how they calculate the Reverse T3 Ratio.
It would also be helpful if you gave us your Reverse T3 result and your Free T3 result, plus their reference ranges, plus TSH and Free t4, assuming you have them.
Good morning humanbean! Thanks for getting back to me so quickly!
I edited my post (obviously after your reply ~ sorry, my brain is working slowly due to lack of sleep/ chronic insomnia) to show my past 3 blood tests this year, which are now on my Bio at the top.
They range from NHS, to Medichecks, to Blue Horizon ~ from March 2017 through to September 2017 .
I've tried to make them easy to read, by putting together each result under it's heading, from each source ~ where the same results have been give ~ but not all blood tests, especially from the NHS, were done.
I was very fortunate to get T3 done when the Doc didn't even request it! I think the Lab did it because of my high CRP! Not that that'd occur to the GP who has completely ignored the C Reactive Protein. I even wonder if she knows what it is...
(And no, due to where I stay (very long story), I'm not in a position to change GPs or go to another medical practice ~ however, I do want to get "well enough" to sell my home here and get back to civilisation and a choice of GPs and/or Medical Practices!) ❤️️)
I can try to get info re what the Doc uses for Reverse T3 Ratio Conversion ~ however Medichecks act as a 'middle-man' and they won't be able to tell me, but should be able to direct me to which Lab and 'who' did the calculations and how (I hope!). Medichecks were the only company to do the Reverse T3 Ratio Conversion, so no comparison available.
If I can get the info, I will let you know and publish it here. B xx
Your rT3 ratio is just about the least important thing on there! It certainly doesn't indicate anything taken out of context.
Far more important is to look at your FT4 and FT3 and compare them. And, what we see is a lowish FT4 and a very low FT3, indicating that your conversion isn't brilliant.
Then we look at your rT3 and see it's heading for the top of the range. However, your FT4 isn't high enough to account for that. Therefore, it must be 'something else' causing the highish rT3. Did you have some sort of a bug when you did this test? Have you had your cortisol tested?
So, your rT3 on that test was nearing the top of the range, and your FT3 at the bottom of its range, which is why the ration is low. It doesn't mean anything more than that.
Another thing you need to consider is that you have quite a low TSH considering your low FT3. Which could be the reason for your less than brilliant conversion. What you should be thinking when you see that is that you could have Central Hypo. However, your GP is unlikely to have ever even heard of that! Central Hypo is when the problem lies with the pituitary or the hypothalamus, rather than the thyroid itself. Doctors think it's very rare, so never test for it... You can draw your own conclusions from that!
Hi Greygoose ~ and thanks so much for your usual very informative reply.
Every time I've had a blood test done, the CRP has come back high, indicating, I am led to believe, that I have(had an 'infection' of some sort..? The blood tests have, strangely enough, all been taken on days when I was feeling slightly less ill..!
*C REACTIVE PROTEIN: CRP*
Blue Horizon Results: 22/9/2017 13.6mg/L (HIGH) <5.0
Medichecks 28/7/2017 9.9mg/L (HIGH) 0.00 - 5.00
N.H.S. 23/3/2017 44.mg/L (HIGH) 2.0 - 10.00
At the time of the Medichecks the CRP was nearly double the top of the range ~ which was an improvement on when the GP had done the initial tests, when it was 4.4 times the top of 'the range' (which she ignored). Would this explain the strange results?
The GP didn't want to know then, and doesn't want to know 'now', so I don't quite know where that leaves me ~ apart from feeling really ill.
I'd say your assessment that the GP wouldn't have a clue as to what Central Hypo is, is extremely accurate.
My request for a referral to an Endocrinologist (which I made clear would mean me paying privately for any Consultations) was denied, leaving me nowhere to go. She seemed to be insulted that I even appeared to be questioning her unquestionable (!) 'talents' in deciphering what the blood test results were indicating.
I haven't had my Cortisol tested. I am, of course, willing to have that done. Privately. if there's anything else I should also have done at the same time, please advise me? I can't continue feeling like this, if there's an 'answer' out there which would improve my health. I'm feeling absolutely deathly.
The only doc who had seemed to pick up anything in the blood test results was the Medichecks doc, hence me asking about the Reverse T3 ratio.
I've had a diagnosis of M.E./Fibro since 1988, and my then Consultant believed M.E. was a problem related to the Pituitary/Hypothalamus ~ proving it? Quite something else at that time.
Do I take it from what you've said, even taking a very minimal dose of T3 would not be beneficial? (Sorry, more than a bit brain dead at the moment).
More like your strange results are causing the high CRP - although I don't think they're strange, at all. But, it's important to know the CRP in conjunction with your ferritin, because high CRP can cause high ferritin. But, I wouldn't expect a GP to know that - mine didn't!
I can never understand why GPs refuse referrals to private endos. Surely it's no skin off their nose! But, maybe if you explain to her about Central hypo, she will feel so out of her depth that she will be willing to pass you on. lol Actually, I wouldn't suggest seeing an endo if it weren't for that. They're a pretty useless bunch.
A 24 hour saliva cortisol test could be your next step. Although don't expect your GP to know anything about that, either! She won't. But the rT3 ratio is really a red herring, it's nothing much to do with anything.
I don't know if ME is anything to do with the pituitary. I don't know if ME even exists! Or is it like the naught stair, where they put recalcitrant patients? However, it could very well be your low T3 causing your symptoms, which lead them to diagnose ME/CFS. And the low T3 could be caused by a pituitary problem. I suppose it could be considered to come to the same thing...
No, I didn't say that taking T3 wouldn't help. It would be the only treatment - apart from levo/NDT. But, if there is a pituitary problem, you need to know, because the TSH will not be the only hormone that is low. It could be causing low cortisol as well, and more, which is why a good cortisol test should be your next step, before you try any form of thyroid hormone replacement.
Hi again Greygoose ~ Thank you for my first smiles of the day!
❤️️
it seemed to me ~ and I admittedly know so little! ~ that the Ferritin was sort of in the middle of "the ranges" (I can't believe I'm still believing 'ranges'!), until the Blue Horizon Doctor's Analysis said that the "Optimum Ferritin level for females is : below 27 ug/L", which if so, makes all of the Ferritin results more than a tad 'high'..?
*FERRITIN:*
Blue Horizon Results: 22/9/2017 105ug/L (13 - 150)
Medichecks 28/7/2017 88.5ug/L (13 - 150)
N.H.S. 2/5/2017 117ug/L (12 - 300)
*C REACTIVE PROTEIN: CRP*
Blue Horizon Results: 22/9/2017 13.6mg/L (HIGH) <5.0
Medichecks 28/7/2017 9.9mg/L (HIGH) 0.00 - 5.00
N.H.S. 23/3/2017 44.mg/L (HIGH) 2.0 - 10.00
Sadly, I believe it's clear that the GP believes only in her own 'god-like' powers to divine what's wrong with me ~ and I need have no other input, just blindly trust her. (As if I've EVER been that 'blind' or trusting..! I've had several Referrals before, the most notable being for M.S. (which one of my M.E. friends was finally diagnosed as having and she thought I had M.S. too. Talk about frying pan to fire?!?).
I got the top Consultant in Scotland and a brain scan as a generous Birthday present to myself about 10 years ago, and couldn't have been happier to be told I didn't have M.S..!
I doubt the god-doc would even listen to an explanation of "Central Hypo" because if she hasn't heard of it, then it can't exist ... or if she has (???) heard of it, it's "too rare". .
(Just a quick aside, what sort of Consultant, other than an Endo, would have more of an open mind / knowledge about Thyroidism / Central Hypo / whatever, once I've collated all of my test results together? I'm now willing to 'blag' an Appointment with a Consultant, even if I have to lie about having a Referral letter. Was there mention on this Forum somewhere of a trusted Consultant who did Consult in Glasgow occasionally? I've a friend who would take me up there (my home City!). I now don't care if I break the back of my Credit Card ~ they'll probably just raise the 'limit' on it anyway! )
Any recommendations for Private '24 hour saliva cortisol test? And no, the GP would have no understanding about that either. That's a given.
You won't find me disagreeing with you about the 'proven' existence of M.E.. It is, after all, basically a "collection of symptoms" which so many very many people now have in common ~ and I do believe it consists of a combination of illnesses and isn't just 'one illness'. So many of the symptoms are uncannily similar to having "a" Thyroid problem that it took me by surprise to even read them.
M.E. "Naughty Stair" ? ~ Yes, a good analogy for people who are not complacent and obliging enough to neatly fit into the accepted parameters of any one debilitating illness at a time. I know I was tested for Thyroid in 1988, but only one element ~ but even before the bloods were drawn and sent off, I was offered a 'trial' of Thyroxine which spaced me out badly, but which I was told had helped some of my Consultant's "M.E" patients (!) ~ but what I was given was the same dosage as my mother was on, which wasn't low (!). So, no, the T3 wasn't a factor in the "M.E." diagnosis. I'd guess, the same as now, any result I had would have been 'within range' as my Consultant didn't suggest trying anything further re a Thyroid problem.
I'd been highly active and was very successfully ambitious, until I suddenly and inexplicably ground to a halt in 1988 at age 38, with what seemed to be a case of being 'burnt out'. Everything piled in all at once: 'tired all the time' syndrome. 'Fugue states' ~ I was on no medications / antidepressants ~ so nothing to cause cognition problems, and I'd even stopped drinking 2 years before, as it just made me feel very ill indeed. Horrific gastric problems (which turned out to be a total intolerance of wheat, so stopped eating anything containing that). But still I continued to get more and more physically ill and badly in what felt like 'bone pain' ~ no Arthritis / Rheumatism, but my muscles were contracting / spasming around my bones; I had a very weird mix up of symptoms, and my Doc at that time was open minded enough to know he didn't know all the answers ~ but reckoned he knew who would know when I'd asked off-handedly, if there was anything to this "M.E. thing"? I didn't actually believe in it, but was told that if the Consultant said I had it, I'd to accept I had it! And the rest is more or less history. I could go on and on, but won't..!
I tried to put all my 'symtoms' etc into the Bio, but my account is 'glitchy' (as some apparently are), and when I put them into the Bio and saved them, yet again they disappeared. Laura's looking into it (again).
I have a source of T3, if/when it's required. But will, of course, follow your instructions first re the Cortisol Test.
With grateful thanls for your patience and guidance, with Love, Barbara xx
Given that you have two completely different ranges for ferritin, there. I would say that's rubbish. If that is so, why have ranges? Besides, he didn't say hypo females, did he. That changes everything.
'or if she has (???) heard of it, it's "too rare". . '
Just tell her that everything is rare, if you don't test for it.
I'm afraid I have no idea about consultants. A gynecologist, perhaps? My gyne seemed to know more about thyroid than my endo. Or a rheumatologist?
Have a look on the ThyroidUK main page for information on private testing. In the blue menu, down the left-hand side.
You're more than welcome to my patience and guidance. I just wish I could do more to actually help.
Oh! Just a thought about 'specialists'. How about what is stupidly called an 'Anti-Aging' doctor? Usually, they know about all hormones, not just TSH or insulin.
Well done eagle-eyes, you've done it again! 😊 I didn't even notice that it's two different ranges ug/L and mg/L ~ just double checked it, in case I'd done a typo ~ but no ... that's what's written. That's of no help whatsoever, is it?! And no, as previously mentioned, he didn't say anything about any form of Thyroid. Back to just getting the 'Blood Test Results' and ignoring any comments. Some things don't change.
There's no talking to the doc, she's well and truly P'd off that I've already challenged her, gone and got private blood tests done, etc., since she turned into a Bot, or god, as she'd apparently call herself.
She wouldn't know about Central Hypo and certainly wouldn't look it up / read up on it. She can't even read a Thyroid Test Result, or deficiencies in vitamins. So no help to be found with her. I'll just get medications from her Medical Practice and blunder along on what's left of my wits and see how far I can get.
Damn it ~ she was going to send me to a Gyn Consultant, for something as simple as a discharge, until I reminded her that I've nothing left for a Gyn Consultant to see, as even my cervix had been removed when I'd they Hysterectomy in 1988, and after nearly 3 decades, my vag was damaged with adhesions! Missed opportunity there! 😄
I found where to look up the Cortisol Test, but amn't doing any more on Friday the 13th. I've had a bad enough day already and it's not over yet, and I'm too sleep deprived to do anything else.
Loved the 'anti-ageing doctor' ~ I need one as I'm looking about 90 at the moment. And so, to sleep ❤️️ ... B xx
Just because you've had a hysterectomy, that's not reason to stop seeing your gyne. They can test for sex hormones, talk about the menopause, and various other things that distinguish the girls from the boys.
So, you're French - congratulations on your brilliant English! - but where do you live? In the UK? Fancy a trip to Paris? There resides one of the top hormone docs - Dr Claude Dalle. He is an Anti-Aging doctor, but also has Hashi's himself. He's expensive, but you said you didn't care! Google him.
Yes, gg is correct, you need your Free T3 (FT3) results. The reverse T3 (rT3) ratio is simply your FT3 result divided by your rT3 result - so long as they are measured in the same units (that has to be for any true RATIO). In the US they are both usually measured in ng/dL. So in order for your ratio to be low, either your rT3 was high or pushing the top of the range or your FT3 was low or approaching the bottom of it's range - or both. Probably your FT3 is low, that is usually the cause of many problems we report here since converting T4 to T3 is a common problem.
Read your post posted just as I was writing my last one. So I should add, following on from gg's post, that any physical problems affecting the pituitary or hypothalamus which may be causing "downstream" problems at the thyroid level is diagnosed via an MRI -- you must get that done through insurance, mine cost $9000 but fortunately my insurance paid for it.
I'm in the UK and couldn't afford the Insurance premiums some 29 years ago, because of crippling prices and the exclusion of 'pre-existing conditions' ~ which would have made it rather pointless.
I've paid for a brain scan previously (re a query over M.S. which a friend in the States, who had had her diagnosis of M.E./Fibro changed over to M.S. (!) and she thought I had it because of the similarities in our symptoms ~ which were basically all M.E. 'symptoms'..!).
It cost approx 400GBP for an MRI Brain Scan and analysis around 10'ish years ago. Of course, the Consultations with the Specialist cost considerably more...
No doubt they'll both have gone up considerably, but hopefully not to the price it is in the States! I'm sure I've still got the copy DVD of the former scan, which the Private Hospital were only too happy to provide when asked.
The MS Consultant went over the scan analysis in detail with me ~ whether whoever had analysed the scan would have noticed a problem with the pituitary and/or hypothalamus, I don't know? I would have hoped so ... or that the MS Consultant, knowing I'd a diagnosis of ME/Fibro would have had a look?
Of course, things change over time, so another scan would be wise anyway ~ do I gather that the scan has to take in the thyroid gland too? Is there any use of dyes?
Sorry, it's taking ages for me to write tonight, and I've a UTI which is driving me mad, going as fast as I can, to and from the bathroom. I'm getting a blinding headache too.
I apologise, I'm going to have to close down for tonight, but I thank you so much for the information provided and would welcome your answer to the scan queries please? Everything's helpful at this point! ❤️️
Hi LadyBarb, I did not have any dye injected for mine, they were looking for physical abnormalities, not a trace of my arteries/veins in my brain. An MRI looking at the pituitary / hypothalamus region would not go down as far as the thyroid. The thyroid can be examined via less expensive means e.g. ultra sound. I am also not sure of the wisdom of bombarding the thyroid with a strong magnetic field - but then the same can be said of the brain... hmm.
Have taken my final meds and some Imigran for what was a pending migraine, and am starting to feel better than I have all day! I shouldn't need to be medicated to a high degree, to feel slightly better. I 'should' be being 'treated' appropriately and could probably come off of at least half of a box-full of meds! Arrggghhh..!
Thanks for the further info LAHS ❤️️ ~ and glad that there were no dyes involved in your treatment. I've so many allergies, I'd probably be on bad ground if dyes were used!
An MRI needn't be a full brain scan then? From memory, the pituitary / hypothalamus are low down at the back of the head? Below eye level? Yes, I'd totally agree with you that the poor old thyroid could do without being bombarded with a strong magnetic field. I don't mind the MRI for the brain, as I've only had one in my life, and it was a long time ago ~ and 'needs must', if I'm going to get to a point where I'm treated properly, and /or know how to self-medicate to get my thyroid health back into balance.
I requested a simple ultra-sound of my thyroid in March 2017. Reply? A blunt "No". No further discussion ~ it just wasn't going to happen, even although the Medical Practice is in the 'local' Community Hospital (and I'd an appointment on one of the two days that the Ultra-sounds are done!). The "Community Hospital" is a total farce ~ brand new building, used on only a partial basis most days ~ and offer no service after 6pm! They've all the fancy new equipment and won't pay for the staff to use them full time ~ again, unreal!) 😟
Hope all's well in your world re your thyroid health? ❤️️
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
~ I need one as I'm looking about 90 at the moment. And so, to sleep ❤️️ ... B xx
Confused by Medichecks reverse T3 ratio calculation
NDT T3 over range
Advice please
Above range T3. 
Medichecks results.
