oMeds
All comparisons
Comparison · hormone optimization

Free T3 vs Reverse T3

Free T3 is the active thyroid hormone. Reverse T3 is the inactive isomer produced during stress, illness, or caloric restriction. The Free T3 / Reverse T3 ratio reveals conversion quality and is decisive when TSH and Free T4 look normal but symptoms persist.

Reviewed by Dr. Laura PurdyMay 29, 2026
Attribute
Free T3
Reverse T3
Activity
Active
Inactive
Rises during stress/illness
No, often falls
Yes
Ratio decisional
Free T3 / Reverse T3 ratio
Same ratio
Caught by TSH alone
No
No
Use case
Conversion quality
Stress / non-thyroidal illness signal
Choose Free T3

Free T3 is decisive for active thyroid status and symptom correlation.

Choose Reverse T3

Reverse T3 is decisive for ruling out non-thyroidal illness, chronic stress, or caloric-restriction-driven conversion suppression.

Educational. Final pathway selection is provider-reviewed via synchronous video consultation against your biomarkers, history, and goals.

Frequently asked

What is a healthy ratio?

The ratio is interpreted by the reviewing provider against symptoms and the rest of the panel — it is not a single number.

Will TSH-only catch this?

No — TSH-only cannot detect conversion defects.

Next step

Take the optimization assessment.

The adaptive assessment maps your symptoms, history, and goals to candidate pathways — and routes you into provider review.

Begin assessment