Reverse T3 to Total T3 Ratio and Treatment

Hi everyone!

I asked my Dr. to order reverse t3 with my thyroid panel at our last lab draw. I explained my reasoning today -- if RT3 was high I thought it might make sense to switch to a T3-only formulation. My results were back so we looked at them at today's appointment. RT3 came back in range, and she thought we should just bump up my armor to a full grain (sarcastic woot!). I should add that I have not felt any difference since starting on 1/4 grain of Armor.

After the appointment I realized that the lab only reported the absolute number of RT3, not the ratio of T3 to RT3. I've read the ratio is more informative than the absolute number, so I called her and told her what I read. I also said that I read that the ideal ratio for Total T3 to RT3 should be above 10. I used the Stop the Thyroid Madness RT3 Ratio Calculator and mine was something like 5. She agreed over the phone to add a small dose of Cytomel to my Armor Rx.

I'm wondering what the best course of treatment should be. Should I go to T3-only, or is 1 grain of Armor + a small amount of Cytomel OK for this kind of treatment?

Also, if anyone knows of any research papers about the RT3 RATIO that my Dr could read that would be fantastic!

One more thing. If anyone wants to take a look at my latest bloodwork that would be VERY appreciated. I want to make sure I'm interpreting it correctly (IE that there's a ratio of about 5/1 Total T3 to RT3). I was on 3/4 grain of Armor (none the morning of the blood draw) when this rounds of tests were done. (The lab that does RT3 does T3 Uptake instead of Free T3, so I didn't get Free T3 this time.)

TSH : 0.138 uIU/mL (0.45 - 4.5)
Total T3 : 112 ng/dL (71 - 180)
Reverse T3 : 21.2 ng/dL (9.2 - 24.1)
Total T4 : 7.5 ug/dL (4.5 - 12.0)
T3 Uptake : 31 % (24 - 39)

Thank you all for your continued help!!

You may try the following tpauk.com website:

http://tpauk.com/main/how-to-calculate- ... everse-t3/

I dunno if the link above would answer yourquestion however if you look deep into it, I'm pretty sure that you will get very useful infos.
This site was recommended to me by RP.

"The brain concentrates T3 from the serum, and may have a concentration 6 times higher than the serum (Goumaz, et al., 1987), and it can achieve a higher concentration of T3 than T4. It takes up and concentrates T3, while tending to expel T4. Reverse T3 (rT3) doesn’t have much ability to enter the brain, but increased T4 can cause it to be produced in the brain. These observations suggest to me that the blood’s T3:T4 ratio would be very “brain favorable” if it approached more closely to the ratio formed in the thyroid gland, and secreted into the blood. Although most synthetic combination thyroid products now use a ratio of four T4 to one T3, many people feel that their memory and thinking are clearer when they take a ratio of about three to one. More active metabolism probably keeps the blood ratio of T3 to T4 relatively high, with the liver consuming T4 at about the same rate that T3 is used." - Ray Peat

"Yes, it's probably induced by stress, with cortisol inducing the type of deiodinase that makes the inactive rT3. A low sugar diet can cause chronically high cortisol. If you are eating enough fruit and protein, I think the T3 of natural thyroid will help to correct the stress/inflammatory metabolism that is connected with the reverse T3." - Ray Peat