two years moaning at doctors until diagnosed.two years on t4 levo, never felt any better, forced antibody test.....hashimoto's confirmed.
sourced t3 only meds, could only get 25mcg tablets, so never started on a low dose.did i manage to clear reverse t3 .... unknown stayed on t3 only trying various doses and protocols using 25mcg pills.
still felt same bipolar,terrible memory, tired, extreme fatigue, irritable, fat face, fluctuating weight,body aches. anxiety depession, gain and loss constant urge to sleep.
so 2022noticed testosterone at 300 on range when looking at blood test from 2012 practically bottom, re checked and now pay for trt and thyroid meds myself
test levels now top of range,so inflammation should be at minimum
thyroid levels now also good combined tablet t4/100 t3/20 mcg
ft3 / ft4 high end of range, tsh nearly fully suppressed.....still feel same as always.
waiting for results of reverse t3 test.
could i have stayed ill due to never correcting reverse t3 issue.
thoughts people!!!
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Maffster08
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'Reverse T3 is unlikely to cause problems, it is inactive and transient and is metabolised and excreted'.
Agree, but the deiodinase (D3) that drives RT3 (that's inert) also metabolises T3 to an inactive form of T2.
D3 inactivates both T4 & T3 at the same time without differentiating. Therefore, high levels of RT3 signifies less available free and active T4 and T3.
Every symptom/illness that gg has listed below can be caused by elevated RT3, that in turn is caused by an up-regulated deiodinase type 3 enzyme that also causes T3 to drop at the same time. We really don't want elevated RT3!
I’ve followed this thread as I have an interest in why rT3 attracts such a great deal of interest given that it’s generally agreed that it’s of little consequence in the thyroid world.
It’s seldom tested and when it is the results bear no relation to levels of FT3, FT4 or any thyroidal symptoms. Far more likely culprits are the conditions which cause the rT3 to be elevated in the first place.
Indeed, if one agrees that it’s inert then it makes no sense to assert that it causes a whole shopping list of problems because of the activity of D3. That would infer that the deiodinase D3 itself, not rT3, is the miscreant. rT3 is in fact the innocent bystander.
In conclusion, it would be more helpful to look at what actually causes elevated rT3. greygoose has summarised these conditions / symptoms in her post below.
The OP is clearly frustrated by what he perceives as the ‘hijacking’ of his post by a scientific discussion which doesn’t relate much to his problems.
Maffster08 When your rT3 results arrive, they may or may not be elevated If they are, look at the list compiled by greygoose and consider whether you have any issues in these areas. rT3 is not your enemy even if levels are high. Look for the enemy within 😉
'Indeed, if one agrees that it’s inert then it makes no sense to assert that it causes a whole shopping list of problems because of the activity of D3. That would infer that the deiodinase D3 itself, not rT3, is the miscreant. rT3 is in fact the innocent bystander.'
Yes, exactly correct 👏. D3 is indeed the driving force of inactivating thyroid hormone but remember the RT3 signifies D3's activity. D3 can not be tested by the layperson (maybe in research 🤷♀️) and so I guess those who wish to investigate further choose an RT3 test.
My replies neither advocate nor oppose an RT3 test but were given to direct the O/P to further credible information as to what elevated RT3 can represent given his interest.
I'm not sure of the tests usefulness as its complexities make it difficult to unpick and offer no clues as to its cause. However, I don't think offering a list of probable RT3 causes longer than my laptop page is helpful (lucky dip? 🙄) but far better to offer informative resolutions - see my reply to O/P earlier this morning.
Thanks for your reply - and for the 👏. I don’t get many of those 😉
This is such a complex subject. I think to know and be able to eliminate possible causes of rT3 is very helpful. That list is quite multifunctional anyway, irrespective of whether it’s long or short and whether it relates to an rT3 discussion.. It draws attention to many issues which impinge upon thyroid health. As such it’s quite a useful checklist for all thyroid folks who can’t understand their lack of progress.
I think we all want the same for members of the forum. Clarity of information and concrete suggestions of how to move forward.
Every symptom/illness that gg has listed below can be caused by elevated RT3, that in turn is caused by an up-regulated deiodinase type 3 enzyme that also causes T3 to drop at the same time. We really don't want elevated RT3
I think that greygoose made the point that the symptoms/illnesses which she has listed can cause rT3 - not the reverse? Are you refuting that they are the result of of high levels of rT3 and saying that rt3 causes these conditions? It’s really important that there’s clarity in this. If they cause rt3, then improvements can be made to limit the occurrence of rt3. Conversely if they are caused by rT3 we must assume that dealing with rt3 per se is a priority and that is far more difficult to deal with.
I hope you don’t mind my being analytical about this. I think it’s so important. The best treatment I ever had following a total thyroidectomy was from a German Endocrinologist. The use of Liothyronine (T3) in Germany is much more common than here in the UK. During one consultation I asked him if I could have high rt3. He tutted and muttered and told me that high rt3 would only ever occur if my nutrient status was not optimal and if I had underlying health conditions. He refused to test rt3 and I was nurtured back to health by appropriate medication with a combination of Levothyroxine and T3 - and I didn’t even have to ask for T3.
The link below is quite useful in providing a contextual understanding of rt3
the list is vast and i don't think anybody with hashimoto's could rectify all them at once, its impossible, even people who don't have hashimotos would have some of those issues and feel perfectly well. inflammation in me was high due to low test
i now inject and have levels of a 21 yr old man as test keeps inflammation low.
been on it for two yrs same with the novothyral 100t4/20t3
anti-thyriod pero abs 181 should be less than 34
ft4 high end of range ft3 high end range
hbac1 normal
no dairy/ gluten free
been on all types of medications still feel same.
waiting for latest bloods then take it from there.
Steroid hormones help control and normalise inflammation but the auto-imflammation created by Hashi is chronic (not normal) and raises high amounts of reactive proteins that can be difficult to control.
If you have elevated antibodies you still have a certain amount of chronic inflammation going on which has the power to make enormous alterations and suppress the HPT axis, decrease the number of thyroid hormone receptors and conversion. .
I don’t mind at all. I love discussion Everywhere2,
Don't forget we are referring only to elevated levels of RT3 and not the normal levels the body uses for keeping homeostasis.
As the O/P was referring to RT3 and his meds my first sentence reads ‘RT3 can be both the driving force but also the result of meds not working well' but could equally be expanded to 'RT3 can be both the cause and result of all those conditions gg has listed below'.
This is because elevated RT3 has the power to alter deiodinase behaviours to de-active thyroid hormones and disallow our meds from performing well. This can exacerbate illness and/or create new conditions, and prevent us from ever achieving well being. Hence illness can create RT3 but also RT3 can create illness.
Just as the repercussions of elevated RT3 are bio-directional, so is the remedy - to stop further elevated levels of RT3 being metabolised, and to invite conditions for RT3 to be cleared from the body. Both can be encouraged by optimising thyroid meds, nutrients and iron, healthy lifestyle, all the usual recommended on here. Hence your German endo indicated RT3 can be created or reduced by nutrients and iron.
Whether someone succeeds is influenced by other health conditions that drive RT3. I haven't read all your link although notice it comes with references 👍, but try reading the Tania Smiths blogs in the link I gave above. They are absolutely fascinating and explain how multifaceted RT3 really is.
conversion of t4 to rt3, if higher than t3 means less t3 is able to enter the cell, meaning poor uptake of t3.
Are you saying that rT3 blocks T3 receptors? That is an out-dated belief. We now know that rT3 has its own receptors so doen't block T3 receptors.
I doubt you'll find many people with the same experience as you on a British forum. rT3 is never tested for on the NHS, and people don't often get it done privately, either.
stated t3/t4 at top of range tsh is at low end of range meaning nearly suppressed. also if i new my conversion was good,i wouldn't be waiting for results.!!
If both your T3 and T4 are at the top of the range, you don't have a conversion problem. A conversion problem would be when your FT4 is high, but your FT3 is low. rT3 doesn't cause poor conversion, it is the result of poor conversion. Unless, of course, it is caused by one of the many other health problems I listed above.
i was under the impression that it doesn't matter how high or low/ in range or out of range your levels are as long as rt3 is noticeably higher then it points to conversion issues.
This is from paul robinson himself in a discussion with dr Weston childs.
, all of what yourself and others have stated i understand being researching and treating myself for years.
i have spent thousand's private blood tests and medications, taken supplements selenium, b12, d3 you name it i've tried it.
im looking to go back on t3 only,so researching t4/rt3 purging before starting low dose t3, when on t3 previously test was extremely low vits and minerals poor. like recommended they need to be optimal..... might this have been a reason it didn't work back then and why i couldn't raise up byond 25mcg.
information on people who have gone through this or similar is what i look for.
I joined this site to gain info,talk to people who suffer or suffered similar to me and might find my holy grail info..
not see comments like this......
" The OP is clearly frustrated by what he perceives as the ‘hijacking’ of his post by a scientific discussion which doesn’t relate much to his problems. "
So sorry, i love scientific discussions which don't relate to the reason i started this thread....on this thread😆😆😆😆
Anyway all things aside, regarding rt3 there is much contradicting evidence on the web...
It’s not ok to have thyroid levels out of range. Never. Have you considered the possibility that your levels are a bit too high for you. I can be ‘in range’ and levels are too high for me. A reduction normally helps. I don’t think you have an rt3 issue.
Can you post your last thyroid blood results pls Maffster? That will help a lot.
I made the comment that I’m sorry your post has been hijacked by in-depth discussion which is neither completely accurate or helpful.
I’m sorry this has happened. The purpose of this forum is to help and support not blind people with science.
greygoose has made some very helpful suggestions of things you could check. This list applies to everyone who is not medicating successfully. If you feel that none of the things on her list apply to you, then you should start to consider other issues.
We haven’t yet seen your blood results. If both FT3 and FT4 are at top of range, this isn’t considered a ‘good’ blood result. You’re overmedicated and need to reduce T3
I’ve had experience of a dose very similar to yours. I knew immediately that I had to reduce T3. I felt much better then.
Sometimes we’re so sure that T3 is the answer to all our problems that we’re very reluctant to admit we’re taking too much.
Unfortunately the symptoms of over and undermedication are very similar. I think some of the symptoms you mention are clearly those of overmedication
Forget reverse T3. It’s leading you down a blind alley
Yes, I think there's a missing comma there: FT3 top of range, also FT4, TSH low end... would be clearer and correspond to later information about a high FT4.
Maffster08 always, always give the actual numbers: results and ranges. So that we can see what's really going on. It does happen that people think their results are high when they're actually only mid-range. Giving the numbers avoids that sort of misunderstanding.
Oh, and by the way, the list of other conditions that cause high rT3 also applies to people who don't even have a thyroid problem, so they are never aware that they even have high rT3 - nor what it is. But the rT3 is high - and therefore D3 is high, causing T3 to be converted to an inert form - in order to save energy. You can't, for example, have people on a starvation diet trying to rush around going to the gym and things. They wouldn't survive very long. And, it's all about survival.
Well said. I’ve tried to make the point that the list you gave applied to all thyroidites and is not therefore exclusive to people who have issues with rT3.
i was under the impression that it doesn't matter how high or low/ in range or out of range your levels are as long as rt3 is noticeably higher then it points to conversion issues.
Well, now, that's rather a broad statement, isn't it. I would say that it doesn't matter as long as it's right for you. But, that has nothing to do with rT3. The best way to tell how well you convert is to be on T4 mono-therapy, with TSH down to 1, and compare the percentage levels. If you convert well, there will only be a slight difference between the two, with the FT4 slightly higher.
We all have different needs where thyroid hormones are concerned. And, the 'ranges' are just a rough guide to what other people find right for them - or not. The whole system of fixing the ranges is flawed - you might find this article of interest:
So, what we need to aim for is the level that makes you well, providing that all your other ducks are in a row. Some people - like me - do need their FT3 over-range. My FT4 and TSH are zero, and that's the only way I can feel well. But, that's just me. And, we should never compare ourselves to others.
But, I have never had my rT3 tested. Obviously on T3 mono-therapy it will be zero, But, when I was on T4 mono-therapy, comparing my FT4 with my FT3 levels showed that I was a very good converter. And yet I felt like death warmed up! I cannot tolerate any amount of T4. And I suspect that on T4 mono-therapy, not only could I not tolerate the T4, but trying to keep my levels within the range meant that I never got enough T3 to make me well. I suspect that I have some measure of thyroid hormone resistance.
All that to say that ranges are arbitary at best, useless at worst and you have to listen to your body to know what it needs.
i have spent thousand's private blood tests and medications, taken supplements selenium, b12, d3 you name it i've tried it.
Oh, tell me about it! lol I've seen all sorts of whacky therapists that cost an arm and a leg, and only made me feel worse! I've tried just about every supplement in existance, I think - but I'm always ready to try anything new, just in case... I've tried acupunture, and aromatherapy. I had one nut job hang me upside down and rubbing my tummy! (God! I'm ashamed to admint that!) None of it did anything for me.
I think one of the best things I've done is eliminate soy from my diet and another was to optimise my B12 and my zinc. But nothing else has done much.
im looking to go back on t3 only,so researching t4/rt3 purging before starting low dose t3
Well, of course, if you cut out the T4, you won't get any rT3. So, I really don't think it needs purging - how would you even do that? And, remember that rT3 is inert - i.e. it doesn't cause symptoms. All this talk about D3 gives the impression that the rT3 causes high D3, but it's the other way around. So, if I were you, I'd just start the low dose T3 and the rest will sort itself out. Why prolong the agony?
when on t3 previously test was extremely low vits and minerals poor. like recommended they need to be optimal..... might this have been a reason it didn't work back then and why i couldn't raise up byond 25mcg.
Could be. But, have you considered cortisol? Ever have that tested?
information on people who have gone through this or similar is what i look for.
Yes, I understand that. But, as I said before, that is going to be very hard to find on a British site as rT3 just isn't tested much. And, how can they go through a thing that isn't a thing? If you go onto the StopTheThyroidMadness site, you'll find many discussions on rT3, but they are hopelessly behind the times where rT3 is concerned.
not see comments like this......
But we believe in free speech on this forum - up to a point - so you're going to find all sorts of comments that have little to no bearing on your question, as well as a lot that are extremely helpful. The best thing to do, if the comment doesn't interest you, just acknowledge that you've read it and thank the person for taking the time to respond. They're only trying to help you in any way they can. And, remember, we're all sick people on here, and sometimes making the effort to respond can be enormous. Don't take it personally as someone trying to put you down or whatever. 99.9% of comments are made with good intentions.
Anyway all things aside, regarding rt3 there is much contradicting evidence on the web...
Yes, but that's usually because a lot of sites don't keep up with the latest research. If you want up-to-date info on all things thyroid related, read the posts of our resident researcher: diogenes :
Can you give us exact thyroid results so we can make a better assessment?
RT3 is not relevant these days for thyroid as there are so many things not linked to thyroid that can cause effects on it.
It's more likely that your free thyroid numbers weren't optimal. Also almost certainly unless you have tested and supplement low/deficient key vitamin levels your thyroid hormone won't work well.
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
There is also a new company offering walk in & mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
It's ideal if you can always get the same brand of levo and T3 at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Do you know if you had positive thyroid antibodies? Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsly elevated result and your GP/Endo might change your dose incorrectly as a result.
I would think that the T4 - was never really working well within in your body and not converting to T3 - the active hormone that runs the body - since you say you never really felt any different when taking Levothyroxine and it probably did build up in your body as an excess of thyroid hormone.
It is a fussy hormone and good conversion needs optimal levels of ferritin, folate, B12 and vitamin D and down regulation of thyroid function can also be caused by inflammation, antibodies, any physiological stress ( emotional or physical ) dieting, depression and ageing.
Excess T4 can build up within the body and is then referred to as reverse T3 and broken down and recycled out through excretion.
What was your reverse T3 reading - if well over the range it makes sense to stop taking more T4 and switch to a different treatment option.
You did this and presume your next reading for reverse T3 will be much lower.
You know T4 doesn't suit you, so have switched to a combo T3/T4 tablet and say your blood tests now look good - and have a good high T3 level and a lower T4 reading - but say you still feel the same - so are you saying this combo tablet is not working for you ?
What are you taking - Novothyral ?
You've listed the breakdown as a 1/5 ratio T3 / T4 - maybe this is not a good ratio for you ?
The most well known and original treatment option used successfully for over 100 years and long before the science of blood test, ranges and guidelines is Natural Desiccated Thyroid which is derived from pig thyroids dried and ground down into tablets referred to as grains with a known measure of T3 and T4 in each grain at around a 1/4 ratio T3/T4 :
I had an over range reverse T3 reading back in 2017 and believe this was because I had been diagnosed with Graves Disease - and post RAI thyroid ablation 2005 and was very unwell with the consequences of this toxic substance, through 2015-17, and treated solely on T4 monotherapy which wasn't working for me, and about when I fell into this amazing forum while researching low ferritin.
Once refused both T3 and NDT through the NHS in 2018 I started self medicating and adding in a little T3 to a reduced dose of T4 - and it was the way forward.
I have now been on NDT for the past 5 years and much improved - and presume my reverse T3 is back in range - my T4 intake is around 50% less than when on T4 monotherapy - and with the addition of the T3 I am converting well the NDT though still needing to supplement all the core strength vitamins and mineral, to stay well.
tried amour thyroid for a short time but had to stop so expensive,about 2012-13 but then that also contains t4.
never felt well, but then would have barely any testosterone too and be full of inflammation.
2021 i was using uni pharmer pure t3 from greece, cant get anymore.
hoping its a case of dropping combined pill and starting low and slow on t3 only, if i can source it, combined pill through pharmacy, through using balance my hormones NOVOTHYRAL german i believe
got this feeling if i was back on the uni pharma pure t3 with my test and infammation all in check like now id be feeling good.
'reverset3 is only thing i can think could keep me symptomatic'.
RT3 can be both the driving force but also the result of meds not working well. If the combo you are presently medicating is the right amounts for you, then RT3 will naturally clear but it takes time.
Medicating T3-only to clear RT3 is outdated practice. As noted in my supplied link above to other members, it is D3 (enzyme) that blocks T3 from entering the cell and not RT3. This deactivating enzyme works on both FT4 converting it to RT3 whilst at the same time converting FT3 to an inactive form of T2. D3 does not differentiate between the two hormones but inactivates them congruently.
Therefore, although we don’t want elevated RT3 (which signifies bad news), only medicating our ‘sweet spot’ will reduce the amount of RT3 converted, and great working thyroid hormones will also encourage improved detox for RT3 to clear.
The other big driver of RT3 on this forum is the chronic inflammation that often accompanies Hashimotos. Many find their meds work more effectively with a g/f diet, optimising nutrients and improving life style. Natural anti inflammatories include Vit D, fish oils and curcumin.
It is common for testosterone to drop when thyroid hormones are inadequate (or not working effectively), or when sudden high amounts of introduced T3 increases SHBG, binding too much free. Your cortisol will also have been elevated in support of unmanaged Hashi-hypo ( if it hasn't already started to fall), and it is usual for testosterone to reduce when the body experiences chronic inflammation/stress.
Both SHBG and CBG (corticosteroid [cortisol] binding globulin) are such strong regulators of steroid hormones, they too are thought of as biologically active. For all these hormones/carriers to 're-normalise' takes time but ‘sweet spot’ thyroid med’s will help.
If you are sure thyroid meds are right, iron and nutrients are optimal, Hashi inflammation is being controlled, then I think you just need to wait.
reverse t3 is only thing i can think could keep me symptomatic.
You clearly have made up your mind as to the cause of your symptoms so good luck with that research.
Also, I note your comment to me
thanks for your input,but....( don't take this as hostile) looking for comments from similar cases.
Hostility plays no part in this forum and in all the years I've been here it has always been a friendly, supportive and informative group.
You asked...
could i have stayed ill due to never correcting reverse t3 issue.
thoughts people!!!
We gave you our thoughts as requested, you are clearly entitled to either agree or disagree based on your own understanding of the issue.
But....I certainly didn't view your reply as hostile although I reserve the right to disagree with your views on rT3.
i was under the impression that it doesn't matter how high or low/ in range or out of range your levels are as long as rt3 is noticeably higher then it points to conversion issues.
Can you please give us a link to the source of this information?
It appears to completely disregard serum FT4 and FT3 levels.
We don't need an expensive rT3 test to confirm conversion issues
But, if your rT3 is consistently high then either your T4 dose due to over replacement, or your FT4 due to poor conversion, is likely too high
So, if FT4 is consistently too high along with low FT3, your T4 to T3 conversion is likely to be impaired
As another option...
Have you had a thyroid genetic test to check for the Dio2 polymorphism which will indicate if the variant is homozygous or heterozygous? If homozygous, research shows T4 to T3 conversion is further impaired
I need a self medicated, supraphysiological dose of T3-only to function, so, like others here, have have to learn a thing or two along the way.
I joined this site to gain info,talk to people who suffer or suffered similar to me and might find my holy grail info..
I doubt you will find another group whose collective knowledge and experience exceeds this one....your "holy grail" most likely lies here!!
It would help members help you, if you were to post results of a recent full thyroid test, including reference ranges.
rT3 , in a thyroid context, is a red herring... not a sign post pointing towards what you call, "my holy grail"
I will be very surprised if OP’s blood r esults show rT3. Even if they do, I don’t think rT3 is the cause of any of his outstanding symptoms. It’s an irrelevance.
Think OP is overmedicated but we haven’t yet seen his blood results which several people have asked for. I’m concerned that he thinks it’s ok to have levels which are above range.
I know that we all love a good discussion and that views on most subjects can be diverse. That said, perhaps we all need to make sure that our responses are directed to the OP and are relevant to the question he asked. I think that’s good forum etiquette whatever the subject.
I’m now exiting to sit on the prom and have an ice cream. Hoping the sea air will clear my head
could i have stayed ill due to never correcting reverse t3 issue.
No, because rT3 isn't an issue. rT3 is inert and only stays in the body for about 2 hours before it is converted to T2. It's a safety valve for people who are poor converters with too much T4, to stop you going 'hyper'. That is the only time rT3 has anything to do with thyroid. But, there are many other possible causes. Did you ever have high levels of T4? You say you don't now.
Testing rT3 is a waste of money because it doesn't tell you anything that testing FT4 and FT3 at the same time will tell you. Did you ever have that done when on T4 only? If so, what were the results?
High rT3 could be caused by:
* low ferritin
* an infection,
* low-calorie diets
* selenium or zinc deficiency
* cortisol issues : Increased cortisol (stress)
: Low cortisol (adrenal fatigue)
* stress
* chronic illness
* inadequate or low iron
* chronic inflammation
* liver issues
· Chronic fatigue
· Acute illness and injury
· Chronic disease
· Lyme disease
· Chronic inflammation
* excess physical, mental and environmental stresses
* Beta-blocker long-term use such as propranolol, metoprolol, etc.
Please add country on your profile, especially if not in U.K.
which brand of levothyroxine are you currently taking
Have you tried going strictly gluten free for at least 6 months
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
If not had coeliac test, get tested BEFORE cutting gluten out
GP should have tested for coeliac at diagnosis of Hashimoto’s
Similarly as separate experiment trial dairy free
Approximately 50% Hashimoto’s patients find it necessary to be dairy free
If FT3 is top of range and you have low FT4, you don’t have a conversion problem. What I am seeing in your blood results is the usual pattern of T3 reducing FT4 levels. This is very common.
I don’t think that you have a problem with reverse T3. Any problem that you may have had will have been eliminated by the use of a high dose of T3 along with your Levothyroxine.
Are you taking other medications eg for anxiety, depression etc?
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Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Testing of reverse T3. 
Reverse T3 and inflammation 
How useful is a reverse T3 test in diagnosing HYPOTHYROIDISM?
Blood Test Results Showing High Reverse T3
