Sign in →

Test Code LABT3R T3 (Triiodothyronine), Reverse, Serum

Additional Codes

 

Test Name in EPIC EPIC Test Code Mnemonic Mayo Test ID
T3 REVERSE, SERUM LABT3R T3 REVERSE RT3

 

Reporting Name

T3 (Triiodothyronine), Reverse, S

Useful For

Aiding in the diagnosis of the sick euthyroid syndrome

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Portions of this test are covered by patents held by Quest Diagnostics.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 0.8 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Specimen Minimum Volume

0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus OK

Reference Values

10-24 ng/dL

Day(s) Performed

Monday through Friday

CPT Code Information

84482

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RT3 T3 (Triiodothyronine), Reverse, S 3052-8

 

Result ID Test Result Name Result LOINC Value
9405 T3(Triiodothyronine),Reverse,S 3052-8

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

Clinical Information

Reverse triiodothyronine (rT3) differs from triiodothyronine (T3) in the positions of the iodine atoms attached to the aromatic rings. The majority of rT3 found in the circulation is formed by peripheral deiodination (removal of an iodine atom) of T4 (thyroxine). rT3 is believed to be metabolically inactive.

 

The rT3 level tends to follow the T4 level: low in hypothyroidism and high in hyperthyroidism. Additionally, increased levels of rT3 have been observed in starvation, anorexia nervosa, severe trauma and hemorrhagic shock, hepatic dysfunction, postoperative states, severe infection, and in burn patients (ie, sick euthyroid syndrome). This appears to be the result of a switchover in deiodination functions with the conversion of T4 to rT3 being favored over the production of T3.

Interpretation

In hospitalized or sick patients with low triiodothyronine (T3) values, elevated reverse triiodothyronine (rT3) values are consistent with sick euthyroid syndrome. Also, the finding on an elevated rT3 level in a critically ill patient helps exclude a diagnosis of hypothyroidism.

 

The rT3 is high in patients on medications such as propylthiouracil, ipodate, propranolol, amiodarone, dexamethasone, and the anesthetic agent halothane. Dilantin decreases rT3 due to the displacement from thyroxine-binding globulin, which causes increased rT3 clearance.

 

To convert from ng/dL to nmol/L, multiply the ng/dL result by 0.01536.

Cautions

Generally, reverse triiodothyronine tests are not necessary since triiodothyronine should not be ordered in hospitalized or sick patients.

Method Description

Reverse T3-carbon 13 is added to serum samples as an internal standard. Reverse T3 (RT3) and RT3-carbon 13 are dissociated with a protein precipitation and then extracted from the specimens using a solid phase extraction. The eluate is dried down under nitrogen, reconstituted with mobile phase and analyzed by liquid chromatography tandem mass spectrometry using multiple reaction monitoring in the positive mode.(Unpublished Mayo Method)

Report Available

2 to 6 days

Specimen Retention Time

14 days

Forms

If not ordering electronically, complete, print, and send a General Request (T239) with the specimen.