Do I pay attention to rT3 ratio being significant?

[nighteowl]

First can I say to forgive me if my question seems not wholly relevant to this community, but I would be very grateful to hear people's views...

I am new to this forum and discovered it because I had a 'eureka' moment when, trying to understand what's been going on for my elderly mother (on levothyroxine for years but I never knew, with dementia/deteriorating health & in a care home now), realised I too have had hypothyroid type symptoms for a long time. Without appreciating its value for hypothyroidism, I went GF nearly 30 yrs ago... I’ve long had what I can only describe as a sluggish gut! (At a recent sigmoidoscopy screen I was told I have diverticula).

In the last 6 months however, I have been feeling particularly yuk: low mood, itchy scalp, thinning/loosing hair, dry, flaky skin, hot night sweats but cold feet, poor sleep, joint pains, bloodshot (left) eye, jumpy heart beats etc. Most worryingly I have persistent high diastolic BP and fluctuating high systolic BP, according to bowel action. I had what I perceived to be a bit of a goitre, which does seem now resolved (after reading up lots on this forum/following links etc I have reined back in dietary bad habits!).

From a visit to my GP this January my blood results were all classed as 'normal' (except cholesterol (6.0mmol (<5.0)) & platelet distribution width (21.5% (9.0-14)). This test at 4pm showed (amongst other things):

Serum TSH level1.6 mu/L[0.4 - 4.9]

Serum Ferritin94 night/mL[15.0 - 204]

Total Vit D96.2 mmol/L[ > 49.9]

Serum B12 858 night/L[187.0 - 883]

Serum folate14.4 ug/L[3.1 - 20.5]

Iron/Iron Binding:

Serum iron16.1 mmol/L[9.0 - 30.4]

Serum unsaturated iron binding capacity31 mol/L[13.0 - 56.0]

TIBC47.1 mull/L[45.0 - 72.0]

Iron saturation (%)34.2%

A private blood test I had done subsequently, in March at 9am, showed the following:

THYROID STIMULATING HORMONE 2.89 mIU/L (0.27 -4.20)

FREE THYROXINE 15 pmol/L (12.00 -22.00)

TOTAL THYROXINE(T4) 72.7 nmol/L (59.00 -154.00)

FREE T3 3.39 pmol/L (3.10 -6.80)

REVERSE T3 21 ng/dL 10.00 -24.00

REVERSE T3 RATIO *10.51 (15.01 -75.00)

THYROGLOBULIN ANTIBODY <10 IU/mL (0.00 -115.00)

THYROID PEROXIDASE ANTIBODIES 9.3 IU/mL (0.00 -34.00)

I am advised following this, that my thyroid function is normal, although the rT3 ratio is not. I think I’ve discerned that interpreting rT3 ratio is controversial?

However it may explain my ‘symptoms’??

Sorry for the length of this post - but if you have any thoughts having read this far I’d be very grateful to hear what you think.

Thanking you for any time you are able to give.

[greygoose]

No, it doesn't explain anything. It's pseudo-scientific goobledegook. It's not even a true ratio because you're not comparing like with like. I'd forget it, if I were you. And, for future tests, there's no point in going to the expense of an rT3, rT3 ration test. Doesn't give you any extra information.

What you should be looking at in those results is the FT3, and that's much too low. And doesn't really correspond to your TSH. The FT4 isn't very high, either. You could show this to your doctor, but he's only likely to look at the TSH and say it's 'normal'.

Your antibodies are so low, that there's little likelihood of Hashi's - although you can never completely rule it out.

And your nutrients are all good.

However, if your cholesterol is high, that will be due to your low T3. Do not be brow-beaten into taking statins!

I think you ought to keep an eye on your thyroid results, testing from time to time. Because there's a possibility that you have Central hypo, where the problem lies not with the thyroid, but with the pituitary or the hypothalamus. If your FT4 and FT3 get any lower, without your TSH rising, then it's almost certain that that's what it is.

[nighteowl]

That’s really helpful - thank you! I will keep an eye then over more time of what’s happening. Thank you again...

[greygoose in reply to nighteowl]

You're welcome.