It’s the first time I have tested revers T3 and I’m not sure how too interpret the results.Is it high , am I a good converter or not so good one?
Reverse T3 0.264 (range 0.17-0.44 so 38%)
TSH 1.4 (range 0.27-4.2)
FT4 1.32 (range 0.93-1.7 so 50%)
FT3 2.69 (range 2-4 so 28%)
TPO antibodies 45 (range says below 100 is normal)
Low ferritin 38 ( range 15-200)
B12 350 ( range 170-650)
I use 65mcg levo pr day. I have my thyroid but it’s sluggish , TSH was only 4.5 when I was placed on medication but had a lot of symptoms. Should I add T3 or increase levo?
Thank You🙏
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Nemi123
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I’m not sure how too interpret the results.Is it high
No, it's not high, as you've worked out it's 38% through range, high would be top of range or over range.
am I a good converter or not so good one?
You don't need a reverse T3 test to tell you that, you look at your FT4 and FT3 results and they will tell you.
FT4 1.32 (range 0.93-1.7 so 50%)
FT3 2.69 (range 2-4 so 28%)
With FT4 50% through range and FT3 only 28% through range then your conversion isn't particularly good.
However, forget the reverse T3 test, it's a red herring. Even if it was high the test can't tell you why. High rT3 can be caused by many things, only one of which has anything to do with the thyroid and that's when there is an excess of unconverted T4 and you will know this from the FT4 and FT3 results, you don't need a rT3 test to show this.
High rT3 could be caused by low ferritin, by an infection, by low-calorie diets, selenium or zinc deficiency, cortisol issues, stress, dieting, chronic illness, inadequate or low iron, chronic inflammation, high cortisol, or liver issues and any other chronic health issues, and probably several more things.
Other conditions that contribute to increased Reverse T3 levels include:
· Chronic fatigue
· Acute illness and injury
· Chronic disease
· Increased cortisol (stress)
· Low cortisol (adrenal fatigue)
· Low iron
· Lyme disease
· Chronic inflammation
Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.
So really there is no point in wasting time and money on the test.
Should I add T3 or increase levo?
The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.
Your TSH is too high at 1.4 (range 0.27-4.2) so the first thing you should do is increase your dose of Levo to get that TSH down and that will increase your FT4 and, hopefully, your FT3 as well.
We need optimal nutrient levels for thyroid hormone to work propery and good conversion to take place.
Low ferritin 38 ( range 15-200)
This is way too low. Ferritin should be half way through range so about 107 with that range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Don't consider taking an iron supplement unless you do an iron panel, this should include serum iron, transferrin saturation, total iron binding capacity plus ferritin. If you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
B12 350 ( range 170-650)
What is the unit of measurement for this - pmol/L or pg/ml or ng/L. It seems low.
Thank You for your very informative reply. B12 is pmol /L , bit too low I guess . I will request full iron panel next month , all the iron test you mentioned were done in 2021 with results showing :
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
So at 474pg/ml your B12 is a little below the 550 where deficiencies could appear in the cerebrospinal fluid and it would probably be best to raise your level to nearer 700pmol/L which would be close to 1,000pg/ml.
You could supplement with a B12 sublingual 1,000mcg along with a B Complex. One bottle of the B12 should be enough to raise your level to over 550 and then you could continue with just the B Complex alone.
Suggestions for B12 supplements which include two forms of bioactive B12 - methylcobalamin and adenosylcobalamin which you might want to check out:
Note that the Nature Provides supplement contains a much higher dose than the Cytoplan one.
For B Complex I have used Thorne Basic B for a long time and always been happy.
If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
Your serum iron and saturation were quite low with your last test, come back with new results when you have them for further comment.
Which levothyroxine do you use? Many people find ones like Teva do not suit them, I think because of additives etc. I have Mercury Pharma 150mcg a day and cope well on that, but my tsh levels are very low at about 0.1, which most people say is fine, if you feel good. Your dose seems very low, but my TSH was over 100 when I was diagnosed about five years ago now.
Many GP’s have no idea about Hypothyroidism (I don’t know if they are better in Sweden) so I have to debate long and hard with them, not that I have seen a GP for 2 and a half years as ours are, literally, impossible to see or even speak by phone.
I am fortunate I have been quite well since Covid reared its ugly head. I have always been grateful for the help, support and advice from the wonderful people on this forum, so you have some to the right place.
Yes, this forum is gold. I have gone through all of available medicines (almost) during last 5 years. None of them being optimal. Here in Norway we can choose between NDT (have to pay out of pocket) or levo+lio if you GP is feeling adventurous as not all of them are willing but usually they help out with a prescription. I use L-Thyroxine SERB which suits me best of all synthetics. Tirosint makes me retain water like a swamp. Euthyrox gives me rashes. Thybon (T3) made me soooo sleepy, almost drugged like. Earlier I used NDT but 1.5g was not enough and 2g was too much 😂🙈
So yes I wondered if rt3 test will enlighten me but I guess not. I will try 75mcg thyroxine again or maybe combine NDT with some thyroxine.
My GP lets me be flexible as long as free T4 and T3 are within range.
Wish you all the best, we will eventually find something that works.
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