Reverse T3 Dominance (Hidden Cause of Low Thyroid)

By Dr Ernst
May 13, 2023

 Reverse T3 measurement is one of the important markers that need to be checked periodically while monitoring the thyroid supplemental hormone. Conventional medicine does not see any value in checking Reverse T3 elevation unless the person had a chronic disease. Functional, naturopathic and integrative medicine sees it as a valuable marker of thyroid disease and different kinds of stress on the body.

   When you have hypothyroid symptoms and all the other lab tests appear to be normal, it’s important to test for Reverse T3 so that you can see what’s really going on and assess your thyroid function. When your body wants to hold on – instead of burning energy – your body takes the active T3 and makes it into this inactive Reverse T3 form. This can happen when you are under lots of stress.

   Reverse T3 is similar to T4 in that it’s inactive and doesn’t bring energy to your cells. It attaches to the receptors inside your cells where Free T3 would be. If Reverse T3 is there, that means there is less room for Free T3.

   There are many triggers that cause your body to start over creating Reverse T3. The most common are: Chronic illness, medications, hidden gut infections/parasites, chronic cardio, insulin resistance increased, HPA-Axis Dysfunction, sluggish liver and heavy metals. Understanding what causes Reverse T3 and why is important because in order to fix the problem, you must address the underlying cause.

   Dieting and Calorie Restriction: The most common cause of high Reverse T3 stems from calorie restriction and dieting. So many thyroid patients struggle with weight gain. Having a sluggish thyroid reduces your metabolism which leads to weight gain. Cutting back on calories may cause a temporary benefit to your weight, but it comes at a big cost – decreased thyroid function from metabolic adaptation. Dieting causes several changes in thyroid function, including an increase in Reverse T3 and a decrease in Free T3.

   As a thyroid patient, the more you cut your calories, the slower your metabolism will become and the more likely you will be to gain weight once you resume eating a normal amount. How long it takes for the body and thyroid to recover from weight loss efforts varies, but some studies suggest it can take several years. The first step to losing weight is by restoring thyroid function.The easiest way is with the use of thyroid medication. Getting on the right type and dose of thyroid medication is enough to help many thyroid patients lose weight with minimal effort. Cleaning up your diet – not restricting calories – exercising, managing stress and taking supplements is a big help. Make sure to avoid all diets that require you to restrict your calories for a prolonged period of time. Fasting, when done correctly, does not appear to trigger the same response.

   Inflammation: Most people who have inflammation know they do, because of the way they feel, which includes fatigue, sore and achy, joint pain, headaches and rashes. It’s a good idea to get a lab test to confirm inflammation. A very common cause of inflammation in thyroid patients is from food intolerance. Foods high in sugar, processed foods and foods made with industrial seed oils are often the culprit. By cleaning up your diet you should be able to see a reduction in inflammation fairly rapidly if that is the primary cause. The use of anti-inflammatory supplements like fish oil, black seed oil, turmeric and alpha lipoic acid are good treatments. Cooling down inflammation is a quick way to help lower Reverse T3 levels and improve thyroid function overall.

   Nutrient Deficiencies: Vitamins and minerals are important for your body. The conversion of T4 into T3 is mediated by certain enzymes called deiodinases. As deiodinase enzyme activity slows, your body will start to build up Reverse T3 levels because it can’t produce T3 efficiently. The nutrients and vitamins most important for supporting thyroid conversion include zinc, selenium, vitamin E and vitamin A. Supplements are a great way to naturally improve thyroid function and you can learn so much about them by doing your own research. Include liver cleansing supplements such as Milk Thistle and Sweetish Bitters into your daily routine. Giving your body the appropriate amount of nutrients will also allow it to fight many chronic illnesses.

   Intestinal Dysfunction: This refers to any problem with your gut. Usually, there is an imbalance in healthy and unhealthy bacteria in your gut known as intestinal dysbiosis, but can also occur in increased intestinal permeability or leaky gut. Approximately 20 percent of all thyroid conversion in your body occurs in your gut. Your gut is a huge source of hormones, neurotransmitters, immune activity and thyroid conversion for the entire body. Irritable bowel syndrome, small intestinal bacterial overgrowth, acid reflux, yeast overgrowth, gas, bloating, constipation and diarrhea are all possible problems. Gut problems are much more common among thyroid patients, so if you already have thyroid dysfunction, then there is a good chance you are suffering from these gut issues as well.

   Stress: We already know that stress can lead to weight gain, increase insulin resistance, lower testosterone levels and cause premature aging. Stress increases your Reverse T3 levels and negatively impacts your thyroid. Cortisol is your stress hormone and it is secreted in times of stress as a compensatory mechanism. The more stress you are under, the higher your cortisol will be. Some stress is okay and even beneficial, but it can become pathologic when it reaches a certain point.

   If you can’t eliminate sources of stress then you will need to take steps to improve how resilient your body is to the stress. You can do this by taking certain supplements, using meditation or prayer, eating a healthy diet and supplementing with activated B vitamins. Exercise reduces levels of the body’s stress hormones.

   Lack of Sleep: If you are not sleeping enough, this will drive up your Reverse T3 levels. You should get at least eight hours of quality sleep each night. You may feel fine with less, but that doesn’t mean that your body can actually handle fewer than eight hours of sleep. Quality is also important, so take steps to sleep in a cool, quiet, dark environment each night that is free of interruption. Avoid sleeping aids and supplements, as these do not necessarily force your body into a restful sleep and in some instances may make sleep more difficult.

   Diet and lifestyle play a huge role in your overall health. Eat a rainbow of colors in vegetables every day, moderate protein and healthy fats. Avoid heavy metals. Do your best to get active and avoid a sedentary lifestyle.  By doing these things, you will allow your body to address high Reverse T3 naturally and avoid medications that treat what can be seen instead of getting to the root of the problem.

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