How to Increase Free T3 Levels Naturally: 8 Step Guide + Tips & Tricks
Free T3 levels are THE most important measure of thyroid function.
Because T3 is the active hormone.
EVERYONE wants to increase free T3 levels, because that's how you feel better!
But the big question is:
How do you do it?
And that's the frustrating part...
There's an easy way to increase Free T3 levels and there's a not so easy way to do it.
The easy way is to do it is by adding T3 medication to your regimen.
I know, I know - this can be impossible depending on the type of Doctor you are working with...
And that's why I'm going to talk about the not so easy way to do it:
Taking the natural approach and doing everything in your power to increase your T3 levels.
So sit tight, grab some note paper and let's talk about how to increase free T3 levels naturally...
Step by Step Guide to Increase Free T3 Levels Naturally
In just a second I'm going to go through the steps I take (in addition to adding T3 medication) with my patients in the office.
The best part about these topics is that you can start taking action on them at home.
But before we get into it, I do want to make a note about getting on the right type and dose of thyroid medication.
After treating literally hundreds of hypothyroid patients I can confidently say that over 90% of patients out there do better when some form of T3 medication is added to their regimen.
This can come in the form of Natural Dessicated thyroid (which is a combination of both T4 and T3) or by simply adding liothyronine to whatever T4 medication they are already on.
Because of this I think it's worth talking to your doctor about potentially adding this type of medication to your regimen.
Ok, now that that's over...
Let's dive in:
In order to optimize your free T3 levels you really need to optimize several systems in the body...
I like to use the following image as a guide.
Just by looking at this image you can see where you need to work on.
The first place is the production of T4 hormone.
The second place is the conversion of T4 to T3.
The third place is the conversion of T4 to Reverse T3.
And the final area is the action of T3 at the cellular level.
Each of these areas needs to be optimized completely in order to have as much free T3 as possible.
So now that we know what we need to do, let's break it down into manageable systems:
1. Optimize Key Nutrients
There are many nutrients that are required to create thyroid hormone in the body, in addition several are involved in the conversion of T4 to T3.
When you are deficient in these nutrients your body will not convert thyroid properly!
For this reason it's critical to optimize these nutrients.
Of the many nutrients (> 15) several are ones that people are commonly deficient in.
The most common being: Zinc, Selenium, and Vitamin B6.
Yes, vitamin C and Vitamin A are important - but for the most part people aren't commonly deficient in these.
Nowadays almost everything has vitamin C in it.
But, not everything has high quality zinc, selenium or B6 in it.
For that reason I recommend that patients supplement with these nutrients.
Here's why they are so important for thyroid function:
- Zinc - Zinc helps convert T4 to T3 so inadequate levels will make your body more likely to convert T4 into Reverse T3 and may make your thyroid function worse! Zinc is also a powerful anti inflammatory and it helps regulate the immune system. It's also great for your skin.
- Selenium - Selenium helps convert T4 to T3. It can also help balance the immune system and has been shown to be effective in helping reduce antibody levels in Hashimoto's.
- Vitamin B6 - Vitamin B6 helps create thyroid function and it also helps create and maintain neurotransmitters in the brain. In addition it's required for normal and healthy brain development! (I recommend you get B6 in your Adrenal Supplement).
Your specific condition may differ, but in general I've found that the majority of hypothyroid patients are deficient in these supplements.
But, as always, I recommend testing so you know for sure.
2. Maximize Gut Health
Here's the deal with gut health:
Around 20% of T4 is converted to T3 in the gut.
It turns out that the composition of the bacteria in your gut matter a lot when it comes to optimal thyroid function.
And here's the deal:
Almost every hypothyroid patient has some gut issues because thyroid hormone acts on the kinetic movement of the GI tract.
When thyroid hormone is low your intestines move slower (predisposing you to constipation) and making you more likely to develop conditions like: SIBO (small intestinal bacterial overgrowth), Yeast overgrowth and Reflux.
Gut issues can also further worsen nutrient deficiencies as stomach acid falls due to low thyroid hormone.
It really is a recipe for disaster.
All of these conditions predispose you to developing leaky gut.
When your intestinal barrier becomes less effective (AKA you develop leaky gut) an endotoxin known as LPS can get through into your blood stream.
LPS directly lowers T3 levels in the blood.
Do you see why your gut is so important for thyroid function?
The next big question is:
What can you do about it?
Treating Gut Imbalances
The first step is diagnosis.
Usually a thorough history is enough to diagnose gut imbalances.
Are you experiencing bloating, gas or abdominal pain 30-60 minutes after a meal? You are likely suffering from a combination of SIBO +/- Yeast overgrowth.
Do you get a metallic taste in your mouth when you lay down at night or do you get a burning in your chest after eating certain foods? You are likely suffering from reflux or GERD.
Do you suffer from chronic constipation, pain with bowel movements or alternating diarrhea and constipation? You are likely suffering from Intestinal Dysbiosis.
Are you have Depression, Acne, seasonal allergies or asthma, autoimmune disease + any of the above symptoms? You may be suffering from Leaky Gut or Increased intestinal permeability.
Treating each of these can be very tricky and may take anywhere from 3-6 months (or longer!) depending on the severity.
But I do have some recommendations to get you started right away:
- Use a digestive Enzyme - Digestive enzymes help your body break down food and help absorb nutrients. They can also help to break down immune complexes in the blood to help treat autoimmunity.
- Get on a Ultra potency, multi strain probiotic - High potency, multi strain/species probiotics can dramatically reduce local inflammation in the gut and even reduce systemic inflammation. Patients with hypothyroidism/Hashimoto's should ALWAYS use a high quality probiotic for 2-3 months and then switch to a daily probiotic for maintenance.
- Use Essential Oils to kill off bacteria and yeast - Essential oils have been shown to be as effective as antibiotics in treating SIBO. I recommend using a combination of Oregano oil, Thyme and Berberine. You'll need two separate supplements to get them - Here and here.
Use these to help get you started, but realize you may need further testing to completely fix your gut.
3. Reduce Reverse T3
In case you aren't familiar with Reverse T3 I will fill you in.
Reverse T3 is basically the anti thyroid hormone, and it acts by directly inhibiting your free and active T3 thyroid hormone from working properly.
It is supposed to act as a natural "brake" to your thyroid in case of emergency.
Unfortunately, it can very easily get out of balance due to a number of conditions including: Insulin resistance, Leptin resistance, inflammatory states and the use of certain drugs (anti-depressants, beta blockers, mood stabilizers and pain medication).
When this happens reverse T3 levels rise and they directly BLOCK your free thyroid hormone.
Because of that you want this guy as LOW as possible.
In order to treat you really need to look at your level so you have something to follow.
I recommend always ordering Reverse T3 levels whenever you check your thyroid function (you may have to ask for this test).
I like to see numbers as low as possible, but anything higher than 15 indicates a problem.
You can lower high levels of reverse T3 in a couple of ways:
- Get on T3 only medication (Like liothyronine or Cytomel) - When you use T3 only medication you can "flush" out the Reverse T3 that has built up. The reason this happens is because your body can only produce Reverse T3 from T4 - and if you remove the source of T4 from your body, there isn't any substrate to create Reverse T3 from.
- Adding in High intensity interval training - Adding HIIT will help your body create a demand for thyroid hormone and help "push" T4 down the T3 path.
- Stop restricting your diet - Calorie restricted diets create a "starvation sate" which tell your body to create MORE reverse T3. This is NOT what you want.
- Reverse Leptin and Insulin Resistance - High levels of Leptin and Insulin tell your body to create MORE reverse T3. Read this guide on how to reverse Leptin Resistance here and how to reverse Insulin Resistance here.
4. Optimize Iron
Adequate iron levels are REQUIRED for optimal thyroid function.
Too little iron levels will lead to a reduced effectiveness of thyroid hormone.
And too much can lead to inflammatory states caused by iron overload.
That's why I refer to Iron as a "goldilocks" kind of nutrient.
I've written about how important iron is to thyroid function here, but I will point out some of the most important parts in this article:
- Low Iron makes Thyroid medication less effective - Iron is required for proper T4 to T3 conversion. Low iron = low conversion.
- Iron is required for proper adrenal function - When your adrenals aren't working they put increased strain on the thyroid and lead to adrenal fatigue and adrenal burn out.
- Hypothyroidism leads to Iron deficiency - Thyroid hormone is required for proper Iron absorption. When thyroid levels are low it leads to iron deficiency which in turns worsens thyroid function. It's a vicious cycle.
- Hypothyroid patients do better on Liquid Iron (instead of Iron tablets) - Remember when I said that Hypothyroid patients tend to get constipation? Well iron tablets can actually make constipation worse. For that reason I always recommend liquid iron for hypothyroid patients because it is easier on the stomach and it is better absorbed.
Make sure to read the article above on how to check for and treat iron deficiency.
In general you want to be checking your Ferritin levels.
Optimal ferritin levels for women are between 70-80.
I also recommend checking serum iron and TIBC levels as well.
5. Optimize Liver Function
Remember when I told you that 20% of your thyroid is converted in the gut?
Well a large majority of what's left is converted in the liver!
Some estimates put it as high as 60%.
For this reason it's critical to make sure that your liver is functioning optimally.
To assess this I like to order liver function tests on every patient with thyroid disease.
The most common reason that patients have a sub par liver function is due to fatty liver disease or non alcoholic fatty liver disease.
Fatty liver disease is caused by insulin resistance.
In order for optimal liver function you will want your liver function tests in the following ranges:
- AST: < 20
- ALT: < 20
I also recommend checking your fasting insulin levels and Hgb A1c as well.
Other conditions can cause liver issues, but by far insulin resistance is the most common.
Optimizing your liver function may result in the highest increase in T3 levels of any other therapy.
To treat insulin resistance and fatty liver disease use the tactics found here.
6. Optimize Adrenal function & Manage Stress
The connection between your thyroid and your adrenal glands is well known.
As cortisol increases so does your TSH (making thyroid function worse).
In addition, as thyroid function decreases your adrenals have to work extra time to try and make up for the deficit.
This scenario eventually leads to adrenal fatigue and a number of symptoms:
- Debilitating fatigue even after a good night sleep
- "Wired but tired"
- Sugar and salt cravings
- Increased energy at night and no energy in the morning
- Constant weight gain
Because these symptoms are so common, and because I've never seen a hypothyroid patient who DIDN'T have adrenal fatigue I recommend that most hypothyroid patients start on an adrenal supplement.
Follow these tips to help get your adrenal fatigue under control:
- Take an Adrenal Supplement - You can use glandulars, adaptogens or a combination of both. In more severe cases I prefer to start with Glandulars (unless there is an allergy).
- Cut out Caffeine - Especially if you are reliant upon caffeine for an "energy" boost.
- Eat extra salt - Salt helps to nourish the adrenals and is required for the creation of certain adrenal hormones.
- Calm down with Yoga or Meditation - This will help to lower cortisol levels and cut down on the demand from your adrenals.
- Replace other nutrient deficiencies - Other nutrients can make adrenal fatigue worse. Check out this post for my recommendations.
7. Ensure Adequate Iodine Concentration & Saturation
Iodine levels can be tricky in Hypothyroidism.
Especially if you have Hashimoto's.
But there is no escaping it...
Iodine is required for the creation of thyroid hormone.
So adequate iodine levels are REQUIRED for optimal thyroid function.
I've gone back and forth on this in treating hundreds of hypothyroid patients in my practice and here's what I've come up with:
- If you are going to trial iodine it's best to start low and increase your dose slowly - Further elaboration below.
- If you have Hashimoto's and you want to trial iodine make sure you take Selenium supplementation with it - It seems that sometimes an increase in antibodies after iodine supplementation is only present in cases of concurrent selenium deficiency.
If you've tried other supplements and have symptoms of iodine deficiency (like fibrocystic breast disease) then I recommend starting with a low dose of Iodine.
I use 325mcg to start and I recommend you stay at this dose for 10-14 days. After that you can slowly increase by 325mcg every week. If you notice a difference then you can continue to increase your dose slowly until you get into the miligram doses.
I recommend using this supplement to start.
If you notice worsening symptoms then discontinue use immediately!
8. Revitalize Diet & Exercise
I can't overstate the importance of lifestyle changes when it comes to improving thyroid function.
I use lifestyle changes as a broad term to include the food that you eat, how often you move or exercise, the amount of sleep you get and how stressful your life is.
In my opinion these 4 lifestyle factors create the foundation upon which everything else is built.
You absolutely have to have a firm foundation to build upon with supplements, medications, and the other therapies listed in this blog post.
Failure to set this foundation will severely limit your results! And in this case will result in decreased T4 to T3 conversion.
Because of how important these factors are I've already created a guide to walk you through the basics:
Remember that these guidelines represent the beginning. Ultimately it may take you months to years to hash out the details for your body, but you need a place to start.
Putting it All Together
It can be frustrating to deal with doctors who aren't willing to change your medication.
If it's impossible to find a doctor who is willing to work with you then you can use this guide to help increase your T3 levels naturally.
I won't lie to you:
It will take some work and there is a lot to digest.
My recommendation is to take 1 thing and work on that for the next week.
It's probably easiest to start with optimizing your nutrition first.
No matter what you decide, pick an area and stick to it for 1 week.
After you've dealt with one area move on to the next and so on and so on, until you've done everything above.
It may take several months but you will get there!
The bottom line is this:
The patients that get better are the ones that take ACTION.
Now it's your turn:
What have you done to increase your T3 levels naturally?
What has worked and what hasn't?
Leave a comment or question below and I will answer it!