Reverse T3 Tips: HiI've recently had testing done... - Thyroid UK

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Reverse T3 Tips

Rachemmac profile image
18 Replies

HiI've recently had testing done including my reverse T3 which has come back high (0.51 nmol/ L). Everything else within normal levels apparently.

The GP recommended an increase in Zinc and selenium and b vitamins, magnesium and ALA. But I'm not seeing a massive difference in my symptoms. Has anyone with high reverse T3 tried anything else?

Thanks for any help / advice.

Rem

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Rachemmac profile image
Rachemmac
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18 Replies
DippyDame profile image
DippyDame

Is your FT4 high!

Is your T4 to T3 conversion good

If you're a poor converter, having your FT4 too high can make your conversion even worse

rT3 is basically excess T4, and is the inactive form of T3.

It is the body's way of preventing FT3 getting too high ...the rT3 converts to T2

This might help

paulrobinsonthyroid.com/rev...

Rachemmac profile image
Rachemmac in reply to DippyDame

Hi Paul and slow Dragon.Thanks both for responding.

My Free T4 was 14.41 pmol/ L

Free T3 was 4.8 pmol/L

total T4 was 153.0 nmol/L

Ft4 to Ft3 ratio was 3.0.

TSH 1.74 microU/mL

TPO and TG all less than 1 IU/mL

Not on any thyroid medication but considering metavive as someone recommended that GP didn't suggest any thyroid medication.

I'll be honest I don't have a clue what it all means!

DippyDame profile image
DippyDame in reply to Rachemmac

The link I posted was to one of Paul's articles....he didn't reply!

Can you please add reference ranges to those results

Rachemmac profile image
Rachemmac in reply to DippyDame

Apologies DD.

Here are the ranges-

1.74 - TSH - 0.40-2.50 microIU/mL

14.41 - FT4 - 7.86-14.41 pmol/L

4.8 - FT3 - 3.8-6.0 pmol/L

O.51 - RT3 - 0.14-0.54 nmol/L

153.0 - TT4 - 78.38-157.40 nmol/L

Ft4 to Ft3 ratio was 3:0

Thanks!

DippyDame profile image
DippyDame in reply to Rachemmac

OK so first question...

How do you feel?

FT4 is 100% through the ref range....so high

FT3 is 45.45% ditto. ....so on the low side.

TPO and Tg low so negative for Hashimoto's

You need to test vitamin D, vitamin B12 folate and ferritin....one or all of these may be low and negatively affecting thyroid function/ T4 to T3 conversion

Doctors know very little about the importance of good nutrition!

Your T4 to T3 conversion is poor....possibly raising rT3....but that should be transient.

If you take Metavive ( which has no stated homone content) you will potentially further raise your FT4 which is not advised as high FT4 can raise other serious health issues.

It may help to take a tiny amount of T3....but not before testing nutrient levels

Since you don't have Hashi's /inflammation I'm not sure ALA will help. I've read it can reduce hormone levels ( you don't want to reduce FT3!) and impair T4 to T3 conversion.

In your shoes I would test the underlined nutrients before trying anything else.

Your test results should help point the way forward

Rachemmac profile image
Rachemmac in reply to DippyDame

Thanks Dippy Dame. So symptoms - I feel exhausted all the time. Brain fog, I could sleep 12 hours a day without any issues. Muscle aches. Dry skin and frequent random rashes that pop up around my body. Brittle nails. Scalloped tongue.

I've had my female hormone tested and am receiving treatment for that. But the above symptoms no better hence a private thyroid test with private GP. I'd like to have energy again and feel 'well'. I'll check if I had the test for B12 results back too. I don't think she mentioned it but I might have missed it.

Thanks!

DippyDame profile image
DippyDame in reply to Rachemmac

I'd suggest that you need to deal with that low FT3.

For good health every cell in the body needs to be flooded with T3 by way of a constant and adequate supply....

Low cellularT3 = poor health

If T3 is low, metabolism slows down causing fatigue

Do you have an oximeter to measure oxygen saturation....

My O2 drops when my T3 is low.

T3 helps promote oxygen delivery to tissues.

Since you are not medicated we can assume your system is not achieving this.

I'm only another patient not a medic but I would deal with this by taking a little T3....say 2.5mcg to start, increasing every 2 weeks by 2.5mcg until hopefully symptoms resolve

Adding T3 will reduce both TSH and FT4

Have you ever been diagnosed with Fibromyalgia of ME/ CFS?

Does anything here ring any bells

healthrising.org/blog/2019/...

I don't know much about female hormones I had few problems during menopause (and no HRT)apart from excessive heat!! Are you taking estrogen?

Just another thought...Have you had cortisol levels tested? Elevated levels can reduce conversion of T4 to T3 and hinder the body’s ability to use thyroid hormones effectively, resulting in symptoms resembling hypothyroidism.

Hope something resonates.

Rachemmac profile image
Rachemmac in reply to DippyDame

Thanks DD.I haven't had cortisol checked - will have a look and see if that's something I can ask for through this private GP.

No never been diagnosed with Fibromyalgia or CFS.

My progesterone and estrogen see-saw through my cycle so they've put me on low dose combined on a 24/4 cycle.

How would I access T3 without a prescription? I've heard a little about natural dessicated thyroid but that also doesn't seem easy to obtain either?

Rem

rosie61 profile image
rosie61 in reply to Rachemmac

I had all those symptoms, my bloods showed low B12, so I was told to take B12 supplements. Which I did the following yearly blood test showed that my B12 was even lower and I had to have B12 injections 6 over 3 weeks, and now have injections every 12 weeks. I was told I was not absorbing B12. I feel great few days after I have my injection but about 10 weeks in the symptoms come back. The worst thing is I don't realise until one of my family or work colleagues say are you due your B12? as they have noticed my confusion, inability to cope, not finding the right words to say, and extreme tiredness. They just say "Ah I thought so........ "

I have been having the injections about 5 years now.

Rachemmac profile image
Rachemmac in reply to rosie61

Thanks for sharing that Rosie61. That's really helpful. Will definitely chase up the B12 test results.

SlowDragon profile image
SlowDragonAdministrator

welcome to the forum

Please add actual results and ranges on all thyroid and vitamin results

Are you on replacement thyroid hormone

If yes…..what and dose

Do you have autoimmune thyroid disease aka Hashimoto’s

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

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)

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

radd profile image
radd

Rachemmac

Welcome to our forum.

RT3 is eliminated form the body via excretion and conversion to other metabolites. The supplements your doctor has recommendeded should help lower elevated RT3 by improving deiodinase function (thyroid enzymes) that are selenium and zinc dependant, but only if you’re deficient . And if you are deficient in these nutrients you are likely deficient in others that risk raising RT3 levels higher. Have you have iron, folate, Vit B12 and Vit D tested?

RT3 is used by the body as a means of controlling the amount of active thyroid hormone we use, but also a form of imposing rest after for example, trauma, infection or during depression. It rises when hormones are out of sync and/or there are blockages and impaired detoxication such as issues caused by elevated oestrogen during peri-menopause. RT3 also raises in obesity or an excessively sedentary lifestyle with a processed/sugar laden diet. Think of elevated RT3 being the result of anything ‘unhealthy’ that is a level more than your body can tolerate.

You will help clear elevated RT3 by eating and sleeping well, but also considering if its actual cause is any of the above. Also, maybe taking a liver support to help pathways perform better. You must have quite an informed doctor to be suggesting these nutrients and especially ALA which helped me hugely. Lucky you 😊

Rachemmac profile image
Rachemmac in reply to radd

Hi Radd

Thanks for responding and explaining. That's really helpful.

Iron and folate were normal. B12 and Vit D low but not bad. They said to take the B complex and high dose vit D supplements too but didn't seem too worried about it.

Perimenopause is an issue and I hadn't realised they were linked so thanks again on that.

Rem

radd profile image
radd in reply to Rachemmac

High oestrogen is antagonistic. During peri-menopause levels rise and the opposing hormone that helps regulate oestrogen is progesterone that diminishes first. You could try a progesterone cream to replace but now a days women are going to menopause clinics and starting HRT to replace any missing hormones.

Be aware some misinformed doctors are diagnosing hypothyroidism when in fact it is elevated oestrogen having negative impact on thyroid physiology. In other words, if you treat the menopause systems the thyroid hormones will re-regulate themselves and no hypo!

Your labs look fine, you are negative for thyroid autoimmune disease, and RT3 isn't over range 👍.

RockyPath profile image
RockyPath

I had all the right nutrient and mineral levels. No Hashimoto's markers. On a moderate dose of levothyroxine my FT4 was in the second quartile (below 50% of clinical range) and FT3 in the bottom quartile. The more levothyroxine that was prescribed, the higher the rT3. As the levothyroxine dose was increased, the FT4 went down while other plasma hormone levels remained stable. I felt awful. I could barely walk outside to my mailbox. I certainly couldn't do much exercise.

I carry several deiodinase polymorphisms. The endocrinologist gave me a blank look. ("I'm supposed to care about that? My training says to look at TSH and FT4.")

I now take NTD. It took a frightfully long time to get to that juncture and then a lot of poking around in the dark with an endocrinologist who lacked a torch.

I can sleep pretty well, run around the neighborhood for a mile, work out at the gym, take university classes. The FT3 and FT4 usually hover in the first quartile. I take a basket full of vitamin and mineral supplements and digestive enzymes with every meal.

Some of us can't fit into all the boxes of clinically normal levels, but we get by nonetheless. It can be a very discouraging slog to find what works. The advice from the experienced admins and members above is the best practice for getting there.

Rachemmac profile image
Rachemmac in reply to RockyPath

Thanks for sharing RockyPath. It sounds like you're getting there which is so reassuring. If you're happy sharing, which vitamins and digestive enzymes do you take?

RockyPath profile image
RockyPath

I live in the U.S. so they may not be available in your market. I take 6,000 IU of vitamin D, 250 mg K, (for sleep maintenance) a product called Bone Up by Jarrow that's full of minerals for bone remodeling, and Strontium citrate for the same purpose; Vitron C slow-absorbing Iron with C; vegetarian digestive enzymes -- Garden of Life Q-Zyme, Dr. Mercola's Full Spectrum, and I alternate with them; Bentofiamine (for the brain injury), reduced glutathione (for a genetic defect that results in a lifetime need for supplementation); Algae omega 3, cod liver oil; Magnesium now and then; and a big slug of Quaterfolic l-methylfolate (for the methylation gene defect so common among people of northern European heritage.

Rachemmac profile image
Rachemmac in reply to RockyPath

Thanks so much for the info.🙏

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