Hi
I have just received the test from private blood results about my RT3.
RT3 32 [10-24]
Please do you have any suggestions and opinions about this.
I am not entirely sure what should I do to get this result in range.
I am on 150 of Levo and 12.50 of Tiromel.
My energy levels increased since I had added Tiromel. I am still tired but I think this is now more related to my little busy boys and life itself.
Any comment appreciated.
Many thanks
u need to reduce your levo to 0 for quite some time so the tiromel can push the rt3 away. after that u can take some levo again, but i suggest u take a lot less so your thyroid can't make rt3 out of it again.
This is an excerpt from a doctor who was an Adviser to Thyroiduk.org.uk
Old studies show that on average, most people convert more than 50% of their T4 to reverse T3; correspondingly, they convert less than 50% of T4 to the metabolically active hormone T3. And the levels of reverse T3 fluctuate up and down through the day. Because of this, I’m never confident of coming to a conclusion that someone has a problem with high reverse T3, not unless the person has had multiple measures of the reverse T3 over a 24-hour period. Like the TSH, free T4, free T3, reverse T3 levels vary dramatically every 30 minutes or so. Depending on when a person’s blood is drawn or saliva taken. Sometimes the levels will vary enough so that a clinician will give the patient a different diagnosis from the one that he or she would have given 30-minutes before or after the blood or saliva sample was taken.
So blood levels vary rapidly. Because of this, I don’t believe the reverse T3 or the other lab tests in general are very useful. However, I do believe the reverse T3 is useful under one circumstance: when we have enough measures to get averages over time, and when the levels are regularly way out of range. So, in my view, the reverse T3 can be useful, but I think its usefulness is limited, which is true of the TSH and other thyroid hormone levels. >>>
This is more info on RT3.
Under normal conditions, cells continually convert about 40% of T4 to T3. They convert about 60% of T4 to reverse-T3. Hour-by-hour, conversion of T4 continues with slight shifts in the percentage of T4 converted to T3 and reverse-T3. Under normal conditions, the body eliminates reverse-T3 rapidly. Other enzymes quickly convert reverse-T3 to T2 and T2 to T1, and the body eliminates these molecules within roughly 24-hours. (The process of deiodination in the body is a bit more complicated than I can explain in this short summary.) The point is that the process of deiodination is dynamic and constantly changing, depending on the body's needs.
Under certain conditions, the conversion of T4 to T3 decreases, and more reverse T3 is produced from T4. Three of these conditions are food deprivation (as during fasting or starvation), illness (such as liver disease), and stresses that increase the blood level of the stress hormone called cortisol. We assume that reduced conversion of T4 to T3 under such conditions slows metabolism and aids survival.
The most important other result in relation to rT3, is your FT4. Do you have a result for that?
Hi - a reverse t3 measure means very little in isolation. To interpret it properly we would really need tsh, ft4 and ft3 taken at the same time. Also, do you have any other health issues at the minute as rt3 is the body's braking mechanism, used to slow you down to allow for recovery from any viruses, infections, etc. It will also be produced if you are on a calorie restricted diet to preserve energy supplies, for instance.
It could also be that you need to reduce your levo a bit to allow for the t3 you are now taking. 12.5 mcg t3 is roughly equivalent to 50 mcg t4, so as your ft4 was previously at the top of range, the fact that you are taking t3 could have pushed that higher as it doesn't need to be converted. To get rid of this, the body can convert it to rt3 instead.
But without more details and test results, this is all non-specific and your particular issue can't be defined.
BTW - did you start supplementing your vit b12? Low levels of that will impact on the effectiveness of t3.
Gillian
My two cents worth: A high rT3 can mean that you are exceeding your necessary T3 production. My (sensible) GP once told me that you are not only tired because your thy medication is too low (and therefore hypothyridic) but if your T3 is too high then it's like running a car engine with it's idle turned up and it's pistons are screaming away - you get exhausted from running "too hot". The trick is to achieve and maintain that critical level. IMHO dial back on your T3 a bit and see how you feel (get your blood test results first though so that you know what you are doing - i.e. after you change your dose did anything change in your subsequent blood levels or the way you feel).
Elevated Reverse T3 
Confused by Medichecks reverse T3 ratio calculation
Reverse T3
Could this be reverse T3 clearance?
High reverse t3 on T4 only
