# Reverse T3 results please help me understand



## snowhite (Nov 12, 2012)

I have received my full thyroid plus panel results but don't understand the ranges as they seem very different to others on the internet.

I have Hashi's diagnosed last year with high TPO antibodies, I have many hypothyroid symptoms but my endo will only treat me if my TSH goes above 10. Even though I have an absolute rubbish quality of life.

Here are the results.
Total Thyroxine(T4) *93.1*  58-154 nmol/L
TSH *3.4 *0.4-4.0 mIU/L
Free T4* 16.1* 10-22 pmol/L
Free T3 *5.04 *2.8-6.5 pmol/L
FT4:FT3 Ratio *3.2* 2.0-4.5 
Reverse T3 *0.45 *0.14-0.54 pmol/ml
Thyroglobulin *23.3* 0-40 IU/ml
Peroxidase TPO *52.7* 0-35IU/ml

I cant seem to work out the reverse T3/Free T3 ratio as my results are in the wrong measurement. Can someone please help me to work this out.
Thanks


----------



## snowhite (Nov 12, 2012)

I think it might be Free T3 5.04 divided by Reverse T3 0.45 which is 11.2.
Which is well under the recommended 20. Can anyone confirm my workings out. I am living in a fog and can't think straight.


----------



## bigfoot (May 13, 2011)

You are right, it is by dividing Free T3 by Reverse T3...

Example Link

If you aren't optimal, the next step is trying to figure out why, and what to do about it. Some have gone the route of taking only T3 for a period of time, and some folks only subsequently take T3 to combat it. It just depends on your own situation. From personal experience, my Reverse T3 was over 500, and an ND helped me by way of a custom compounded sustained-release T3 med, then I switched over to Nature-Throid. Supposedly, high Reverse T3 can also be a marker for inflammation.

Good Info Site on RT3


----------



## snowhite (Nov 12, 2012)

Thanks Bigfoot, those websites look good. I will be seeing a Doctor soon who actually treats these problems exactly so hopefully he will get me on track.

I finally know my problem, I think I might cry.


----------



## snowhite (Nov 12, 2012)

Well although I clearly have a problem with my thyroid the NHS doctors wont treat me as they don't recognize reverse T3 problems so I am no further forward with treatment. I have ordered T3 from the internet and will be attempting to treat myself asap. When I am better I will write a long letter of complaint to the supposed 'leading in endocrinology' hospital and tell them what I think of them.


----------



## snowhite (Nov 12, 2012)

Only been taking T3 for 3 days but already am having periods of no fogginess, less aches, less fatigue.

Think I started on too high a dose for me, I'm only small. Now on 1 eighth of 25mcg tablet twice daily, which is pretty hard to cut up but I try my best. What a difference a tiny fleck of T3 makes. 
Feeling positive for the first time in over a year.

I urge everyone to take control of their own health, if one more doctor tells me that my TSH of 3.4-9 is normal I swear I won't be responsible for what I might do. I'd like to inject endocrinologists with a bit of how I have been feeling, see if that changes their minds.


----------



## Andros (Aug 26, 2009)

snowhite said:


> Only been taking T3 for 3 days but already am having periods of no fogginess, less aches, less fatigue.
> 
> Think I started on too high a dose for me, I'm only small. Now on 1 eighth of 25mcg tablet twice daily, which is pretty hard to cut up but I try my best. What a difference a tiny fleck of T3 makes.
> Feeling positive for the first time in over a year.
> ...


It's too bad you have not received the proper medical intervention over there in the UK. Please be careful and I am glad that you have wisely chosen to cut those pills into 8's!!

If a lot of us had your numbers, we would be zombies! I am sorry you have to treat yourself.

Please let us know how we can help you moving forward.


----------



## snowhite (Nov 12, 2012)

It's been over a year. Some things have improved but still suffering some symptoms. Allergies are increasing, sinus issues, infections, fatigue.

Here are my latest results

T4 88.7 nmol/L (58-154)

TSH 6.58 mIU/L (0.4 4.0)

Free T4 12.5 pmol/L (10-22)

Free T3 4.74 pmol/L (2.8-6.5)

FT4:FT3 Ratio 2.6 (2-4.5)

Reverse T3 0.44 pmol/L (0.14-0.54)

Thyroglobulin 23.7 IU/mL (0-40)

TPO 70 IU/mL (0-35)

So my TSH has increased along with antibodies but not as high as the first results. My Reverse T3/T3 ratio is not good and is worse than last year.

Can anyone offer any help with this at all. Last year I bought medication to help me (Armour) but couldn't tolerate it due to my low ferritin and poor adrenal function. It made me hysterical and I had palpitations. I have some left.

My ferritin is now 86 after 8 months of iron tablets and my adrenal stress profile is as follows.

all in nmol/L

Sample 1 23.9 high

Sample 2 7.7 in range

Sample 3 2.5 low

Sample 4 0.8 low

Total 34.9

DHEA sample 2 0.36 Low

sample 3 0.30

DHEA:cortisol ratio 0.95 low

Secretory IgA 153.6 (118-641)

This is better than last year but not brilliant.

Can anyone help me with this at all. I am unfortunately stuck with the NHS who will only treat a TSH above 10.

Thanks in advance of any help.


----------



## Andros (Aug 26, 2009)

Are you taking any thyroxine replacement at this time or during the time of your labs shown above?

What symptoms are you having?

Will get back to you!


----------



## snowhite (Nov 12, 2012)

I am not on any thyroid medication. I have bought T3 and also Armour online in the past but did not take it for long due to the anxiety and palpitations it caused which I believe is because my adrenals were in a mess and my iron was so low.

I now take iron tablets, vitamin C, B vitamins, magnesium and zinc.

The current symptoms are allergies to gluten, dairy and pollen. This is worsening all the time. Sinus congestion, hard to concentrate because of this, general aches and pains particularly neck pain. Dry eyes- wake up feeling gritty. Pick up infections easy. Pulsing in my left ear. Legs just feel exhausted at the end of the day. Wake up feeling un-refreshed after 8-9 hours sleep. Fatigue. Anxiety.


----------



## jenny v (May 6, 2012)

Did you ever have your adrenals checked (i.e., a saliva test)? Poor adrenal function can cause high Reverse T3.


----------



## snowhite (Nov 12, 2012)

Yes a few weeks ago, I have posted them above, they have improved from last year when my cortisol was in my boots. But still indicate an issue.


----------



## jenny v (May 6, 2012)

Can you post the ranges for those cortisol tests?


----------



## snowhite (Nov 12, 2012)

Sample 1 23.9 (12-22)

Sample 2 7.7 (5-9)

Sample 3 2.5 (3-7)

Sample 4 0.8 (1-3)

DHEA

Sample 2 0.36 (0.40-1.47)

Sample 3 0.30 (0.40-1.47)

DHEA: Cortisol ratio 0.95 (2-6)

last year all same values

Sample 1 14.9

Sample 2 5.3

Sample 3 2.0

Sample 4 0.5

DHEA

Sample 2 0.86

Sample 3 0.57

DHEA: Cortisol ratio 3.15

Year before 2012 when my symptoms started and I was really ill.

Sample1 25.5

Sample 2 7.9

Sample 3 5.5

Sample 4 2.1

DHEA

Sample 2 0.95

Sample 3 0.90

Ratio 2.26

Over the last year my TSH has been between 3 and 4 until now. I know I have Hashi's but the endocrinologist refuses to treat me.

This all started with Lyme disease which I now feel Is subsiding. I have also been diagnosed with CFS after EBV or mono but have recovered from this now mostly. I have a high viral load and am on acyclovir to help this. I put weight on after a couple of months of taking this and assumed it was a side effect of the tablet but it could be hypothyroid instead. I have changed my GP since last year and haven't mentioned my thyroid problems to her too much, I intend seeing her ASAP to ask for treatment. I do have medication here but would prefer to have it properly prescribed and monitored.

Thanks


----------



## jenny v (May 6, 2012)

> Sample 1 23.9 (12-22)
> 
> Sample 2 7.7 (5-9)
> 
> ...


You probably know this, but the ideal is to have our highest cortisol in the morning and it decreases throughout the day so that by bedtime, we're low and ready for sleep. Yours is kind of all over the place--it's too high in the morning, okay at mid-morning (sample 2), too low in the afternoon and too low at night. You definitely need to address this (I'm thinking adaptogens, but I'm not an expert)--I would look at Stop the Thyroid Madness's website and look under the adrenal fatigue section. They have links to some good online cortisol groups.


----------



## snowhite (Nov 12, 2012)

Ok will do. What about my thyroid though?

Should I get treatment for that?


----------



## jenny v (May 6, 2012)

The thinking is that treating the adrenals (and low ferritin and low Vitamin D, if you have it), comes first and then you start treating the thyroid issues, but I think Stop the Thyroid Madness will have more info on that than I do.


----------



## snowhite (Nov 12, 2012)

Finally got a GP to prescribe me treatment. Starting on 25 Mcg of levothyroxine. Have to have the expensive solution as the tablets contain lactose. Would of been cheaper to give me Armour as I requested though. I expect my reverse t3 will worsen on T4 only but have to show them this first.


----------



## snowhite (Nov 12, 2012)

I've now been on levothyroxine syrup for 2.5 months and have seen a very small improvement. I am on a baby dose of 25mcg daily.I take selenium to improve conversion and take the levo at night which apparently also helps. 
Been to see GP today, I changed GP about 10 months ago as old one was as useful as one book end. My latest tsh was 5.8 and the one before was about 5.6 so it has worsened despite my levo, surprise surprise. I did point out that as i have hashi's it will vary greatly even within a day but the GP who is very nice said i clearly knew more than him and he wants to refer me to an endo. I said no thanks after my last encounter when the endo just shouted at me to accept my cfs diagnosis and go and die quietly and let him treat sick patients.

Now i am thinking that maybe a referral to a knowledgeable endo or similar expert might be a good idea. I don't have loads of money but will happily invest in my health so can pay and travel .

Can anyone point me in the right direction to find a Dr in the UK who can help me get better treatment. My GP will treat me but doesn't know how by his own admission. In the meantime he has increased me to 50mcg but i worry this is just going to pool and make things worse. I still have t3 and armour in the cupboard but don't particularly want to self treat.
Thanks in advance.


----------



## KeepOnGoing (Jan 2, 2013)

I'm in the UK and have T3 on NHS prescription, so it is possible. However, I think it would be highly unlikely for a GP to prescribe - mine is only prescribed because the consultant oncologist has told them to do so. My GP was asking me about my experience on T3 (it dramatically improved my quality of life - but then again, I can take 20mcg and not notice any immediate effects, so I'm clearly not the sensitive type!) - she appeared to be wondering if that might be the answer for her hypo patients who refuse to feel better on just T4!

So you might well need to visit the endo in order to have a chance of getting any further on your journey.

If you were willing to say where you are in the UK, we could PM you if we had any ideas. There aren't many Brits on the site, but there are a few...


----------



## snowhite (Nov 12, 2012)

Thanks I'm in south wales. I've seen two local endo's both useless, wouldn't treat my tsh of over 9. I would like to find one who understands hashi's and reverse t3 etc.


----------



## KeepOnGoing (Jan 2, 2013)

I have never found a doctor in the UK who would test for (or believe in!) Reverse T3.

However, I gather that Exeter endos are willing to prescribe T3, so (if you don't mind a fairly long trek) it might be worth getting in touch with them to see what their approach is likely to be.

Sorry I can't suggest anything nearer - I'm in the west country so only know the local(ish) ones.

I never had hashis so don't know what they would be able to offer for that. I'm a thyca patient.

Hopefully someone will come up with a closer suggestion.


----------



## snowhite (Nov 12, 2012)

Thanks very much I will look into that. 
In the meantime my GP is asking the health board if he is allowed to prescribe Armour for me. He sent me away with a script for 6 bottles of levothyroxine syrup at £70 ish pound a go. Would be much cheaper to give me Armour.


----------

