Reverse t3

[Catgirl22]

I am thinking of ordering a private blood test to check my full thyroid status, as I am having symptoms but not sure it is thyroid related, or something else. My gp currently only tests my tsh to check up on my levels, I am currently taking Thyroid-S, which are always in the reference range. So I have looked at the private tests which include Ft3 and Ft4, but I wanted to know if Reverse t3 is necessary as well?

[Lalatoot]

No need for RT3. If you have TSH, ft4 and ft3 from the same blood draw you can interpret conversion from that. For example my tsh was 0.19 (0.25 - 4.75) My ft4 was 60% through its range and my ft3 17% through its range. This shows poor conversion. If conversion was good then ft3 percentagewise should lag just slightly behind ft4. Knowing my RT3 would not have added any more info. Indeed I would assume that my RT3 would have been high as that t4 that wasn't being converted had to go somewhere but knowing that wouldn't have given me any helpful info..

[SlowDragon Administrator]

Reverse T3 not necessary

But you should test vitamin D, folate, ferritin and B12 at least annually

what vitamin supplements are you taking

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 or NDT …..day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Timings of testing

healthunlocked.com/thyroidu...

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/testing/priva...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

[Catgirl22 in reply to SlowDragon]

thanks for all that info, I can probably follow all that advise before the test, except have it drawn before 9am, as I don’t live near a blood drawing clinic, so would be later morning, unless I get a nurse to come to the house, but then it’s more expensive.

I am currently taking Vitd3 + k2, B12, folate, magnesium, omega 3, evening primrose, coq10.

[Catgirl22 in reply to SlowDragon]

Just had a thought.. so would it be still ok to take my ndt the night before the blood test?

[SlowDragon Administrator in reply to Catgirl22]

Yes last dose 12 hours before test

So test before 11am if possible

TSH will be low or suppressed on NDT anyway assuming you are on high enough dose

[Catgirl22 in reply to SlowDragon]

So is it worth testing if the results will just be low or suppressed?

[SlowDragon Administrator in reply to Catgirl22]

It’s ESSENTIAL to always test Ft4 and Ft3 on any replacement thyroid hormones….but especially when taking anything that includes T3

Also ESSENTIAL to test all four vitamins at least annually

[Catgirl22 in reply to SlowDragon]

Thankyou I have just ordered the full panel plus vitamins.

[pennyannie]

Hello Sal :

Did you run a TSH, Free T3 and Free T4 before switching to Thyroid S so you have some bench mark readings to compare to and are you monitoring yourself on blood pressure, pulse and body temperature twice daily while you find your best dose on NDT ?

Blood test results when on NDT present differently to when on T4 only - and you may well find your TSH is low suppressed and your T4 lower than when on T4 but your T3 should be proportionately much higher than when on T4 monotherapy.

How long have you been taking Thyroid S and what dose are you taking and do you split your dose or take it all in one go, on an empty stomach and wait around an hour before eating or drinking anything ?

No thyroid hormone replacement works well until your core strength vitamins and minerals - those of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels - might be worth running these as well if in any doubt ?

P.S. Just read your back history and see you have been on Thyroid S before so guess you know the routine and what to expect -

I'm not sure Private blood companies offer a Reverse T3 any longer - I got one run by Medichacks when I first joined the forum and I was very over the range but then I had Graves and post RAI thyroid ablation, poor conversion and very high levels of excess T4 - which I presume has now resolved itself as I take Thyroid S and my dose of T4 now 1/2 that which I needed when on T4 monotherapy to get a minimal T3 reading.

[Catgirl22 in reply to pennyannie]

Yes I think I did as I remember paying for some thyroid tests before, I will have to see if I can find the results. I have been on Thyroid-S a while now, as I couldn’t take levothyroxine, it always made me feel so ill and like I was being poisoned, so moved over to ndt.

I take 1 tablet of Thyroid-S on a night before sleep on an empty stomach. I didn’t realise blood tests were different on ndt, I think my t4 was low now you mention it. Is that ok? I have been getting a lot of palpitations recently that’s why I was thinking of doing the full private test.

[pennyannie in reply to Catgirl22]

On NDT you track on the T3 not the T4 - and T4 can be low -

my results are now a T3 at around 90/110% through the range with a T4 at around 25/30 % through the range.

I 'm much improved from when being on T4 monotherapy and take my low T4 to mean that I've converted most of the T4 into T3 and that's ok with me -

some people run with a high T4 and I take that to mean that they are needing more NDT than me and more reliant on just the T3 content and not converting the T4 as well as me.

T4 is a pro-hormone and pretty much inert until the body converts it in the liver into T3 which is the active hormone that runs all the body's functions from your physicality through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

Palpitations can be both a hyper and hypo symptom - so best get a blood test and please do the co-factor vitamins and minerals so you are fully prepared for further questions when we see and explain the blood tests to you.

I'm with Graves Disease and post RAI thyroid ablation in 2005 and have been taking Thyroid S since 2018 having then wasted a further couple of years trying to get help through the NHS and ultimately I refused both NDT and T3 by my surgery and hospital and very unwell.

[Catgirl22 in reply to pennyannie]

thanks for explaining that and I am sorry you have been so unwell, it’s so frustrating with the nhs and the time it takes to get anything done and that’s if they do anything at all!

I have just ordered the full thyroid panel plus vitamins, so when I have had it done I will come back and post the results.

[Glendalough7 in reply to pennyannie]

Ulta Labs offers RT3 along with TSH, FT3, FT4 in the same test - $78.95

FT3, FT4, RT3 and TSH Panel - 4 Tests (5 Biomarkers)

[pennyannie in reply to Glendalough7]

Thank you - but where are they - looks like the States ?

[Sat2 in reply to pennyannie]

Blue Horizon blood tests do RT3, but it doesn’t sound as though really necessary.

[pennyannie in reply to Sat2]

Oh - thank you - I'm just curious to know if my own thinking about my situation correct :