Latest blood test results-don’t understand RT3 - Thyroid UK

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Latest blood test results-don’t understand RT3


Would be very grateful for peoples views on my latest blood tests. I will also post my last results from January of this year in the comments

17 Replies

I don’t seem to be able to attach a photo to the comments

It's not possible to attach a photo to the comments. All we're allowed if one photo per post, in the main body of the question. :)

Ok. Thanks. There is just a massive drop in antibodies from January

Doesn't mean a thing. You still have Hashi's. Antibodies fluctuate all the time.

Ok. Thanks. Still not medicated so do I just treat myself?

Not if you want a diagnosis, no. But, at the moment, your thyroid results are euthyroid. Thyroid hormone replacement probably wouldn't help. And, as diogenes said, you need a doctor to sort that insulin out. Don't do anything about your thyroid until that has be seen to.

What you need to do is ask your doctor to test you for Pernicious Anemia. Your B12 is much too low. And, given that you have Hashi's, it's likely that you could also have PA - they are both autoimmune diseases.

And, you could try raising your vit D a little, with supplements. You doctor will think your vit D is good because it's in-range, but hypos need it up around 100.

Thank you. I shall get an appointment tomorrow x

You're welcome. :)

From these results you have insulin resistance syndrome, which causes elevated rT3. The primary problem is with the insulin and you need medical advice as to how to reduce it. Your rT3 should then resolve.

Hi, I had a look at your results and your CRP is too high, this points to an infection/inflammation as it is a marker of inflammation. Also, if the CRP is high, this means your serum ferritin levels may not be as good as they seem - like diogenes mentioned, I would make an appointment with your doctor to discuss these results.

Hope all gets sorted out soon - take care.

Hi I just saw your post and am concerned for your health. There seems to be a bit of confusion about hypothyroidism and its ability to drive insulin resistance. Your thyroid gland is responsible for steering the entire metabolic processes of your body, including glucose metabolism. Here's a clinical research article discussing this apparent paradox:

Your reverse T3 is high, as noted clearly in your report. High is not good. High suggests that you may have a genetic predisposition to poor conversion of T4 (also known as "resistance to thyroid hormone"). T4 is the hormone produced by your thyroid gland and it must be converted to T3, the hormone that powers your mitochondria and all of the metabolic functions at a cellular level throughout your body.

Reverse T3 has not been studied extensively, but in the late 1970s researchers found it to be 100 times more potent than PTU, a pharmaceutical used to throttle metabolism in cases of hyperthyroidism. Both PTU and rT3 lock to the beta-adrenergic receptors on the cells. These receptors are supposed to be able to latch onto T3 and produce energy from it from a complex biochemical process. The body is an amazing system. But if it produces rT3 in response to T4, then the wheels are going to fall of the train and you'll have a derailment of proper system functioning. This cascades into all sorts of aberrant test results and symptoms.

If you are producing high levels of rT3, as evidenced from your lab results, you would still be clinically hypothyroid despite the other normal-looking thyroid measures. The rT3 would produce a cascade of ill effects across your body, including difficulty absorbing important nutrients. A trained physician would theoretically be able to look at your physical symptoms are recognize clinical hypothyroidism despite the preponderance of normal lab numbers. Unfortunately many clinicians completely overlook rT3 because it is not discussed in any textbooks on endocrinology in general and thyroid textbooks specifically. I borrowed a current textbook devoted to the thyroid and it had absolutely nothing about rT3, which seems both irresponsible and unconscionable.

The way to test whether you are resistant to thyroid hormone is as follows: Try taking liothyronine (LT3) and see what happens to the rT3 and see how you feel. This is Dr. John C. Lowe's empirical method, described in detail in The Metabolic Treatment of Fibromyalgia.

The alternative method, which I had to employ, involves genetic testing via 23andMe, rummaging through your raw data and looking for genetic polymorphisms associated with poor T4 to T3 conversion. There are commercial genetic tests available, but the ones I've seen only look for a few common polymorphisms and there are more than a few that would degrade conversion and cause rT3 to rise.

Digging through the raw data is quite time consuming and cognitively demanding and I wouldn't recommend it if you have the option of simply trying a bit of LT3 for a few weeks; get your rT3 tested again and watch what your body is doing in response. I spent several months perusing mountains of research articles and several textbooks, while watching my rT3 rise in response to increased doses of levothyroxine prescribed by an endocrinologist who hadn't been taught about rT3. I finally realized I needed to abandon the LT4 and stick with LT3. The improvement in my health was dramatic and my endocrinologist has been fully supportive of my management of my condition. It was virgin territory for him and he is learning from my experience.

Thank you so much for your reply. Is there a way I can buy this? I know I can buy NDT.


I'm having trouble keeping track of what treatment you've had from your endocrinologist. I saw the thyroid-blocking drugs described a year ago. Are you taking anything now?

What did your endocrinologist say about the rT3? This person has been trying diligently to manage your condition for tome time, so you should bring this up with her/him and see it would make sense to have a trial.

I may have had hyperthyroidism at an earlier point in my life but my experience with treatment comes late and only involves LT4 therapy and its downfall.

I know it's difficult to obtain LT3 in the U.K. It is difficult here in the U.S. as well. I get mine through an order written by the endocrinologist. I've heard people on your side of the pond describe sources on the continent.

I am no longer under the care of an endocrinologist and my GP didn’t have a clue what rT3 meant. I take nothing other than gabapentin for fibromyalgia x

Thank you for explaining your unfortunate situation. I'm sorry you're having such a difficult time.

I'm familiar with gabapentin, and the metabolic aspects of fibromyalgia. Dr. John C Lowe treated fibromyalgia patients with thyroid hormone and they recovered. He also promoted exercise as much as possible, as it stimulates the thyroid. He wrote extensively about LT3-only therapy. This is where you can find his resources for self treatment.

(although it refers to the NDT product). His book, The Metabolic Treatment of Fibromyalgia, presents an incredible amount of detail to explain why hypothyroidism produces hypometabolism and how this is the (overlooked) cause of fibromyalgia. He also breaks down all of the typical arguments against using LT3 to treat patients.

I would suggest you present this information to your GP and see if you can get a prescription for liothyronine. I saw this morning that there are places you can buy it online once you have a prescription. If you search for Cytomel and Cynomel you will find vendors who sell the starting dose of 5 mcg and the 25 mcg tablets for after your body adapts to the new source of energy.

Thank you very much. I very much doubt I would get any help from my GP. Their hands are quite tied in the UK. The one thing I make sure I do is exercise. I go to a personal trainer and walk most days. I also have a one on one Pilates session each week. I will look to see what I can buy xx

Physicians here are concerned about taking responsibility for something going wrong, so it's rare to find one willing to give a try to something unfamiliar. Did you try an Internet search of Cynomel? Perhaps there's a source that would deal with you without a prescription.

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