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Thyroid UK
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Reverse T3 Results

Hi, I've just had these results back from medichecks.

TSH 0.681 (0.27-4.2)

Free thyroxine 23.2 (12.00-22.00)

Total thyroxine 128 (59.00-154.00)

Free T3 4.23 (3.10-6.80)

Reverse T3 25 (10.00-24.00)

Reverse T3 ratio 11.02 (15.01-75.00)

Thyroglobulin antibody 336.000 (0.00-115.00)

Thyroid peroxidase antibody 381 (0.00-34.00)

Active b12 256.00 (25.10-165.00)

Folate (serum) 4.84 (2.91-50.00)

25 OH Vitamin D 133 (50.00-200.00)

CRP 6.3 (0.00-5.00)

Ferritin 28 (13.00-150.00)

I have bought some T3 in anticipation of these results and have lowered my T4 dose ready to start, but since then I've been in bed with flu and not been able to pick up my repeat prescription. I've not taken any T4 for about 4 days. My question is would you start T4 again given the high reverse t3 levels and just start with a low T3 dose and see how that goes? Thanks x

12 Replies
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So long as you can get your FT3 to a good level, say about 5.5 the rT3 doesn't really matter. All that is showing is that you have slightly too much T4 which excess is being got rid of by the rT3 route instead of converting to T3. Your FT4/FT3 ratio on T4 only is nearly 5.5/1. T his indicates inadequate conversion of T4 to T3, so some T3 supplementation might help, with a small reduction in T4 dose. Your reasonable TSH shows that you have room to try this.

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Thank goodness! A simple easy to understand explanation of rT3 with added benefit of learning what is a good conversion ratio for T4 to T3.

Too much panic about rT3 blocking the receptor cells and how that can blocks T3.

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Thank you for your reply. My T4 dose was 150mcg per day when these bloods were taken. How much do you suggest is a small reduction if I start with a dose of 6.25mcg of T3 (I have 25mcg of Tiromel) please?

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I'm no expert but try 100 T4 as a start an∂ see how you get on.

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Thank you

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Kazmacd1,

I think you can make a smaller reduction. 6.25mcg T3 is equivalent to 18.75mcg T4. If you reduce T4 to 125mcg and add 6.25mcg T3 that is a overall reduction plus the addition of T3 will encourage better conversion of T4.

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Thank you Clutter. How does the addition of T3 encourage better conversion of T4?

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Kazmacd1,

I can't explain the process but if you didn't alter T4 dose you would see T4 level drop after adding T3 which indicates better conversion.

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Your ferritin is too low, it needs to be at least 70 or half way in range

See SeasideSusie advice on how to improve

Are you supplementing B12 and vitamin D

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kazmacd1 Yes indeed, your ferritin is far too low, it needs to be at least 70 for thyroid hormone to work and conversion to take place, best is half way through range.

You can help raise ferritin by eating liver, maximum 200g weekly, and include lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

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Thank you I'll have a read of that

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Yes, supplementing with b12 injections every other day, folate and vitamin d3

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