Reverse T3- What You Need to Know about High Reverse T3 and Thyroid disease

If you have have hypothyroidism something you need to be aquatinted with when it comes to your health, is your reverse T3 levels. High levels of reverse T3 is a sign your thyroid is in trouble.

In today article and video we unpack everything you need to know (almost everything) about High reverse T3 levels, what causes elevated levels and what you can do about it. As with all glands and hormones in the body, the thyroid gland is a finely tuned organ that responds to various feedback mechanisms. This is why if you are currently taking Thyroid replacement and you still feel lousy, you want to learn more about this important thyroid blood marker called reverse T3.

How Your Thyroid Makes Thyroid Hormone and More Importantly How It Makes reverse T3.

Here’s how it works: the pituitary gland in the brain produces thyroid stimulating hormone, or TSH. This travels through the blood to stimulate the thyroid to produce thyroxine, or T4.

T4 is a protein with four iodine molecules attached to it, and is not the active form of thyroid hormone. T4 needs to be taken up by the cells in the body and have an iodine molecule cleaved off, converting it to T3. The conversion of T4 to T3 requires zinc, selenium, and iodine, so if you are low in these minerals, this conversion will not be adequate. T3 is the active form of thyroid hormone that travels through the body, stimulating the metabolic rate of all of our cells.

Here’s the kicker: T4 can also be converted to a molecule called REVERSE T3. Reverse T3 is the MIRROR IMAGE of T3, and as such can bind to the T3 receptor sites. Instead of producing stimulation, reverse T3 just parks there and has the ability to cause low thyroid symptoms.

It actually prevents T3 from binding, which makes your entire metabolism slower. If you have a lot of reverse T3, even if your TSH looks good, you may still feel hypothyroid and have all the low thyroid symptoms. When a patient sends me their blood work and I see a High Reverse T3, or changes to T3/RT3 ratio on a patient’s blood work, there are a couple of things that immediately come to mind in terms of why this RT3 is elevated.

#1. High reverse T3 Levels and Cortisol Levels-

Many people see cortisol as an “evil” hormone that stores fat, shrinks muscle and causes anxiety and insomnia. The Fact is, Cortisol is required for optimal health in so many ways. Cortisol keeps inflammation in check, it is involved in maintaining blood sugar levels, it influences the immune system natural killer cells, cortisol plays a role in metabolism and when released at the right time in the right amount it helps burns fat. But what does cortisol have to do with my thyroid you might be asking? As it relates specifically to the Thyroid- Cortisol is very important because it sensitizes the Thyroid receptors. It allows T3 to bind to the thyroid receptor and do its thing.

The problem is… when you have too much or too little cortisol.

Too Much Cortisol

Too much Cortisol increases reverse T3 levels. Cortisol impacts thyroid physiology in multiple ways. Elevated cortisol can reduce or suppress the Hypothalamic-Pituitary-Axis (HPA) reducing levels of TSH. Lowered TSH can reduce T4 and T3 production. Chronic elevations of cortisol can reduce the conversion of T4 to T3 and increase the conversion of T4 to rT3.

Too Little Cortisol

Too little cortisol will reduce the number of T3 receptors. I did an entire video on (Low T3) also known as thyroid under conversion. So bottom line is this, you don’t want too much… or too little cortisol. This is how and why caffeine, cortico-steroids, asthma inhalers, and high intensity-training can have a negative impact on thyroid.

#2. High reverse T3 and Low Iron Levels –

Low iron or anemia causes extreme stress not only on your adrenal glands but your Thyroid gland as well.

Low iron or iron anemia will cause an elevated reverse T3.
Low Iron levels will also cause low TSH.
Low Iron-deficiency anemia robs the cells of oxygen necessary for basic metabolic functions.
Low Iron or anemia is a deal breaker when it comes to your mitochondria. All cells have mitochondria, which are like little power plants. The mitochondria produce (ATP), molecules that store and release energy, functioning like rechargeable batteries. This process is necessary to create new tissue, eliminate old tissue, convert food to energy, dispose of waste materials and toxins, and communicate with other cells.

Healthy mitochondrial function and ATP production are vital to managing hypothyroidism, and they require oxygen to work.

What is a good Healthy Iron Level Range for People with Thyroid Disease?

When it comes to your serum Iron Levels, you want to shoot for an iron level between 85-130. You want your Iron Saturation % of 35-45% and you want your Iron stores (Ferritin) between 80-100.

This video explains everything you want to know about Low iron levels, symptoms and its association with Thyroid disease.

If you are struggling with ongoing low iron levels, I recommend that you take an iron supplement that contains Iron Ferrous bisglycinate chelate. It’s a very “Gut friendly” iron supplement that is absorbed better than other forms or iron.

Low Iron Can be a Warning Sign of an Underlying Gut Problem

Sometime Low Iron can be a warning signs of Celiac disease, Gluten Sensitivity or Small Intestinal Bacterial Overgrowth– This infection or overgrowth of bacteria in the small intestines causes malabsorption of nutrients. Something also worth consider is that if you continue to have low iron levels after taking Iron supplementation, you will want to consider the possibility of low stomach acid. Low stomach acid can impair absorption of many vitamins and minerals including Zinc, Magnesium, calcium and Iron. Symptoms of low stomach acid include; bloating, constipation, belching, reflux, and bad breath.

#3. High Reverse T3 and Vitamin Deficiencies-

High Reverse T3 is also associated with numerous vitamin deficiencies. I have done so many videos on this topic that I will just leave a few links to these articles, If you really want to know more about them. If you have elevated reverse T3 and have hypothyroidism and are not already taking B12 or Vitamin D in a liquid form, I suggest (at a minimum) this for B12 and this for Vitamin D

#4. High Reverse T3 Oxidative Damage/Free Radical Damage/and Chronic Inflammation-

Inflammation is the root of all chronic disease, and the link between thyroid disease/ Hashimotos and chronic inflammation is no longer debated. When inflammation becomes systemic, not only will your reverse T3 levels go up, the thyroid gland produces less T3 as well. Remember, that reverse T3 blocks T3 from binding and getting into the cell. So if you cant get T3 into the cell, you will experience all the symptoms of low T3.

Remember, reverse T3 (rT3) is the metabolically inactive form of T3. Reverse T3 contains the same number of iodine molecules as T3 but attached to different areas. Reverse T3 and T3 will then compete for receptors’ at the cellular level.

For more information on Low Thyroid and Inflammation, you can watch “Inflammation- Your Thyroid worst enemy” This is a two part video series.

#5. High Reverse T3 And Environmental Pollutants, Heavy Metals and Toxins

Some of the heavy metals and other environmental pollutants seen with people who have problem include BPA, afflatoxins, cadmium, mercury and lead. If this is the case you will want to work with a doctor who understands how to support Liver Detoxification, Thyroid connections to MTHFR defects and the steps needed to support those pathways. Do not chelate heavy metals if you have problems with your liver, Gut or Brain.

In the meantime, while you’re trying to clear these toxic metal stores to bring the reverse T3 down, opinions are mixed on whether you should be treated with thyroid medication or not. Clearly, this is a process you’re not going to be able to do by yourself. Find yourself a Certified Functional Medicine Physician who has the understanding to perform these relevant tests and procedures and who can prescribe the appropriate supplements and monitor your thyroid levels. So these are 5 of the most common reasons “WHY” you would have elevated Reverse T3. I hope you enjoyed the information feel free to share it with your friends, family and loved ones.

Is There a Test for reverse T3?

If you’re experiencing symptoms of a thyroid disease or you’re thyroid levels just don’t seem to be balancing out and normalizing, you’ll need to get a thorough picture of your thyroid health. For example, testing for reverse T3 alone may not be enough. In fact, many healthcare practitioners wouldn’t recommend it.

Reverse T3 is a controversial test that not many doctors know how to interpret or know what to do if it is elevated, especially if it is tested as a stand-alone, therefore, it should always be interpreted with T4, T3, thyroid antibodies, and TSH — along with an assessment of the patient’s symptoms.

Restore Your Thyroid By Lowering Your Reverse T3