Test Catalog

Test Id : RT3

T3 (Triiodothyronine), Reverse, Serum

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of the sick euthyroid syndrome

Method Name
A short description of the method used to perform the test

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

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

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

T3 (Triiodothyronine), Reverse, S

Specimen Type
Describes the specimen type validated for testing

Serum

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 0.8 mL

Forms

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

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.4 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

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

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of the sick euthyroid syndrome

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

10-24 ng/dL

Interpretation
Provides information to assist in interpretation of the test results

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
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

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

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Bowerbank SL, Carlin MG, Dean JR: A direct comparison of liquid chromatography-mass spectrometry with clinical routine testing immunoassay methods for the detection and quantification of thyroid hormones in blood serum. Anal Bioanal Chem. 2019 May;411(13):2839-2853

2. Moore WT, Eastman RC: Diagnostic Endocrinology. Mosby; 1990:182-183

Method Description
Describes how the test is performed and provides a method-specific reference

Reverse triiodothyronine-13C (rT3-13C) is added to patient sample as an internal standard. rT3 and rT3-13C are dissociated with a protein precipitation and then extracted from the specimens using a solid-phase cartridge. The eluate is dried down under nitrogen, reconstituted with mobile phase, and analyzed by liquid chromatography-tandem mass spectrometry using multiple reactions monitoring in the positive mode.(Zhang Y, Conrad AH, Conrad GW: Detection and quantification of 3, 5, 3'-triiodothyronine and 3, 3', 5'-triiodothyronine by electrospray ionization tandem mass spectrometry. J Am Soc Mass Spectrom. 2005 Nov;16[11]:1781-1786; Sakai H, Nagao H, Sakurai M, et al. Correlation between serum levels of 3,3',5'-triiodothyronine and thyroid hormones measured by liquid chromatography-tandem mass spectrometry and immunoassay PLoS One. 2015;10[10]:e0138864. doi: 10.1371/journal.pone.0138864. Erratum in: PLoS One. 2016;11[7]:e0159169)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 6 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

84482

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
RT3 T3 (Triiodothyronine), Reverse, S 3052-8
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
9405 T3(Triiodothyronine),Reverse,S 3052-8

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports