Recent labs and Reverse T3 (rT3)

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I have three sets of labs at this point and see that my rT3 continues to increase while my t3 and t4 stay on the lower end of optimal. I feel better and some of my symptoms have improved (less dry skin, increase in energy, hair porosity has improved, etc). It was stated that I could get off of my NDT and go to Cytomel only to help decrease my rT3. However, I am not sure if that is the right direction to go. I also wondered what could happen if I decreased the NDT to .5 grain which would lower my T4 dosage and possibly decrease the rT3. Thoughts?

May 2018
TSH - 2.64 mU/L (.34 - 5)
Free T3 - 2.72 pg/mL (2.5 - 4.30)
Free T4 - .90 ng/dL (.58 - 1.64)

July 2018
TSH - 3.010 ulU/mL (.45 - 4.5)
Free T3 - 3.0 pg/mL (2.0 - 4.4)
Free T4 - 1.32 ng/dL (.82 - 1.77)
Reverse T3 - 17.1 ng/dL (9.2 - 24.1)
TgAB - 8.8 IU/mL (0 - .9)
TPOab - 20 IU/mL (0 - 34)

November 2018 (started Nature Thyroid after labs in July and worked up to 1 grain)
TSH - .543 ulU/mL (.45 - 4.5)
Free T3 - 2.9 pg/mL (2.0 - 4.4)
Free T4 - 1.10 ng/dL (.82 - 1.77)
Reverse T3 - 20.3 ng/dL (9.2 - 24.1)
TgAB - 5.3 IU/mL (0 - .9)
TPOab - 19 IU/mL (0 - 34)
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Defy Medical TRT clinic doctor


mabell I'm no expert but it looks like since you have added the Nature Thyroid your Free T3 has declined from 3.0 to 2.9 and your RT3 has risen from 17.1 to 20.3 which means the T4 in the Nature Thyroid is converting to RT3 which is bad..... here is a good explanation of high RT3 and how to treat it. You need T3 med only like Cytomel which will lower you RT3. Optimal ranges for Free T3 is 3.8 and higher so, you've got room for improvement.

Reverse T3 Treatment Guide + How to "Flush" it out of Your Body

Here is another good link that explains what ALL thyroid test are and how to interpret them.

All Thyroid Tests + What They Mean & How to Interpret Them
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New Member
Thanks for the response and the article (I read that link earlier this week). I also am looking at this: Circadian T3 Method. I think it would probably be of benefit to take a cortisol test/iron test and see the results.

From the STTM site:
"And though rising cortisol has a good purpose, we run into trouble if it stays high too long. High cortisol promotes T4 to convert to more and more RT3 (reverse T3), the inactive hormone. Uncontrolled high cortisol can also lead to weight gain, problems falling asleep or staying asleep, depression from the rise of RT3, fatigue, blood pressure problems, cortisol resistance, and even anxiety, since adrenaline goes up with cortisol."

From Tired Thyroid by Barbra Lougheed:
"Really poor converters will show Total T4 in the upper half, but Free T3 in the lower half (This seems to be what I see in the above labs). These people have underlying conversion problems that should be addressed. Are ferritin and cortisol optimal?"

"Desiccated thyroid contains a much higher proportion of T3 to T4 because it is made from pig thyroids, not human thyroids. In fact, the T4:T3 ratio is 4:1 in pig thyroid, but 15:1 in the human thyroid gland.”

"Anyone taking desiccated thyroid would then be ingesting some amount of rT3, which is a normal metabolite of thyroid conversion. They should not be surprised if their rT3 levels rise as their desiccated thyroid dose rises."

"Many people who take desiccated thyroid end up with high rT3 levels and then are told they need to take T3 only to correct it. Desiccated thyroid’s high T3 levels suppress TSH, which then suppresses the D2 enzyme which degraded rT3 to T2. So it’s not that more rT3 is made, rather that less is degraded, and the lack of TSH causes this imbalance. Hyperthyroid patients have the highest levels of rT3 and they also have a TSH close to zero.”
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