62

How to Increase Free T3 Levels Naturally: 8 Step Guide + Trips & Tricks

Free T3 levels are THE most important measure of thyroid function. 

Why?

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...

More...

Step by Step Guide on how 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.

Factors that affect thyroid function

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: 

7 steps to increase Free T3 naturally

1. ​Optimize your Nutrient Levels

​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. ​

Thyroid diet 4 week plan side bar

2. ​Get your Gut Health in Order

​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.

​For instance:

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 Soil Based Organism Probiotic - Soil based organisms are better for patients with Hypothyroidism and SIBO because they are non fermentable by bacteria. If you've ever experienced constipation after taking a probiotic you are likely suffering from SIBO. (Up to 54% of Hypothyroid patients have a positive breath test for SIBO) 
  • 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. Make sure your Reverse T3 Levels are as LOW as possible

​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. Make sure your Iron levels are in the "sweet" spot

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 your 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.

Liver function tests

​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 your Adrenal function and Manage your stress

Constant stress causes adrenal fatigue

​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. Make sure your Iodine levels are high enough

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!​

thyroid metabolism reset poster for side bar

8. Revamp your diet and exercise routine

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: 

You can find it here

​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!​


Dr. Westin Childs
 

I'm Dr. Childs and I write these posts. I'm a physician that specializes helping patients lose weight, have more energy and FEEL better. My practice focuses on hormone imbalances, thyroid issues and weight loss resistance. My goal is to provide the BEST information out there on the internet that is both actionable and trustworthy. Get my free ebook: Hashimoto's Diet Guide here. You can also find more about my personal journey back to health here.

Click Here to Leave a Comment Below 62 comments
Jenny - March 29, 2016

Thank so much for sharing this information. I read an article you wrote last week on iodine and selenium supplementation. I am iodine deficient but when I supplemented, within a few days was then taking too much and my thyroid was inflamed. The two together work marvelously. My daughter checks the dose daily through kinesiology and it is making a big difference. Thank you so much!

Reply
    Westin Childs - March 29, 2016

    Hey Jenny,

    You are very welcome! I’m glad it worked out for you! Supplementing with iodine can be tricky, and I like to do it – it just needs to be done cautiously. And it sounds like you are in good hands 🙂

    Let me know if you have any other questions.

    Reply
Lynne Tulip - March 29, 2016

Hi ~ I was diagnosed with under active thyroid in 2013 and put on levothyroxine. In the last 18month my symptoms have become significantly worse. I have chronic groin/pelvic pain which has changed me from an extremely fit active slim 53 year old to an overweight inactive jobless 56year old. I paid for a thyroid scan last week (due to regular choking episodes) and it was confirmed that I had hashimotos (I was told by the radiologist that my thyroid was shrivelled ~ and had I heard of Graves or hashimotos ) my most recent bloods came back saying I was now suffering from hyperthyroidism and it was recommended that I reduce my levothyroxine to 100 from 125 (I haven’t done this yet as I think I am on the hashimotos roller coaster of hypo/ hyper) I have asked to see a endocrinologist and will take all that I have read from your Facebook page and hope he will listen. I was diagnosed with osteitis publis after an MRI scan but I now think the chronic pain which stops me from even walking very far (hence the job loss) could actually be due to Hashimotos. My main request will be for desiccated thyroid to be added to my regime. Thank you for all the information you have provided. You have been a life line and I intended to knock down as many doors as possible in the hope that our great NHS will listen and react accordingly. I will keep you posted re my journey.

Reply
    Westin Childs - March 29, 2016

    Hey Lynne,

    I would definitely dig a little deeper into the “hyperthyroid” component. With a shriveled up thyroid from years of damage due to autoimmunity, it’s unlikely that you are suddenly producing large amounts of T3 hormone causing hyperthyroidism. It’s far more likely that your TSH is suppressed from the T4 dosing, but that doesn’t necessarily mean you are “hyperthyroid”.

    NDT may improve your symptoms, but you would also benefit from extensive blood testing and repletion of any and all nutritional deficiencies.

    Good luck and keep me posted!

    Reply
Honora Renwick - March 31, 2016

Great information and diagrams. Very grateful for this. I’m a bit puzzled though when the text above refers to “Get on T3 only medication (Like liothyronine or NDT)”. My understanding is that NDT contains T4, T3, T2, T1 and calcitonin. Correct me if I’m wrong.

Thanks.

Reply
    Westin Childs - March 31, 2016

    Hey Honora,

    You are correct, the sentence should say “Get on medication containing T3”. Liothyronine is a T3 only medication, whereas NDT contains all of the other components you mentioned including T4 AND T3. Thanks for bringing it to my attention!

    Reply
      Honora - April 1, 2016

      Cheers.

      Reply
      Terri - May 23, 2016

      Is it correct that NDT, like Armour, while it contains T3, it may not be enough and it would still be beneficial to supplement with Cytomel? Do you have any thoughts on ordering Liothyronine online if doctor won’t prescribe?

      Reply
        Dr. Westin Childs - May 23, 2016

        Hey Terri,

        Yes many of my patients are on a combination of T3 + NDT or T3 alone. I don’t recommend using liothyronine without the assistance of a Doctor, you don’t know what you are getting and too much T3 can be dangerous.

        Reply
Anne - April 1, 2016

Dr. Westin Childs,
An impressive Website !
Thanks, Anne

Reply
Christina - April 2, 2016

Hi Dr Childs, what I’ve read from your sight and blogs makes alot of sense! My Dr is brilliant and we have been working together for at least 3 years trying to tweek my thyroid & Hashimotos. She has me on20mcg T3 and 70mg of thyroid extract which has put my TSH, T3 & T4 in the normal range. However every now and then my thyroid goes out of Whack and it’s back to playing with dosages to get it right.

I am a coeliac and have 2 of the C strain MTFHR Gene, with high estrogen levels so I take a progesterone troche (had a hystorectomy @ 34 due to a begnin tumor. I am seeing a naturopath and she had me do a hair strand test that shows what triggers inflamation for me and she has been helping me with adrenal fatigue and liver tone.

She has recomended going Paleo but I struggle with red meat, I’m ok with small amounts of chicken and fish even though my blood type is o positive. I eat alot of salads and vegies, little fruit. My Dr says my diet is brilliant but I can’t seem to shift weight! I only need to lose 6-10kg and occasionally when the plumbing is working well I shift 2kgs and then it suprisingly comes back! Grr!

I kind of feel like I’ve hit a wall as I’m doing what’s recommended and I seem to progress and then it all goes pear shape and I can’t work out why? Any other suggestions?

Keep up the good work in helping people understand what’s happening to them and why. 🙂

Reply
Kimberly - April 2, 2016

The first time I was diagnosed with hypothyroidism was 27 years ago. After being placed on medication for a short period of time, it supposedly resolved. In 2013, I was again diagnosed with hypothyroidism. It took until mid 2015 to get my level within a “normal” range. Only a tsh level was ever drawn throughout the year. In January, my level was abnormal again, tsh only. Since I started receiving your insightful information, I decided to give it to my PA at my endocrinologist. I’m hoping she will work with me. I am diagnosed celiac disease, so I eat a healthy diet, no dairy products, and already take the supplements you recommend. What complicates my situation is that I am in chronic pain everyday. These are other conditions not being adequately managed due to severe allergies to the medications normally given. Due to this, they tell me to “deal with it”. Unfortunately, when you’re dealing with several conditions, it becomes debilitating. I’ve gained 60 pounds in two years, gone from being very active nd healthy to barely able to do anything, decreased appetite. To complicate matters, none of my doctor’s understand celiac disease, including my primary doctor. Do you have any suggestions?

Reply
    Dr. Westin Childs - April 2, 2016

    Hey Kimberly,

    I don’t recommend trying to get treatment in the insurance model, 99.9% of the time you will just be ignored – even if you give them information. Endo’s and most doctors aren’t interested in being educated by patients. The other big issue is that even if you ask for the right tests, they won’t know how to interpret them or treat you based on the results. I would recommend looking for a functional medicine doctor near you.

    In regards to your other issues you can take a look at these articles, and they may very well be related to your thyroid:
    https://www.restartmed.com/hypothyroidism-chronic-pain/
    https://www.restartmed.com/lose-weight-hashimotos/

    Reply
Marci - April 29, 2016

Thank you for this information! I’m so glad to see a Dr who is truly into helping people be their best.
I have had labs run for most of the things you stated but as you have also stated I received the results in “your labs were normal” form without any levels showing. Very frustrating!!

I would love to get on top of my Hashimoto’s and feel better again. My brain wants to go go go and my body says no no no. I do know I am insulin resistance and have adrenal fatigue on top of Hashi’s. Could I just start taking selinium and iron without a test? Or is that dangerous?

I am currently taking 48.75 mg of NatureThroid. I have been taking that dose for 2 weeks now and my throat seems to feel tight. Could be allergies as those are bad right now too. 3 years ago I was on 80mcg of Synthroid and 10mcg of Cytomel which the Synthroid made me feel horrible.
I’m really not sure where to go from here except that I want to feel better!!! I am so tired of being so extremely tired!!

Thanks so much! I would drive the miles just for you to be my Dr!! LOL! Do you have any good recommendations for the Ft Worth TX area?

Marci Pruitt.

Reply
    Dr. Westin Childs - April 29, 2016

    Hey Marci,

    You are welcome! You can try selenium, but I wouldn’t recommend taking iron without lab testing as too much can be toxic to the body. The combination of cytomel + synthroid can work for some people, but the T3 dose needs to be high enough.

    Unfortunately I don’t know any doctors in the ft worth area – I am sorry!

    Reply
Kim - May 19, 2016

I had a thyroidectomy last week. I’m talking calcium carbonate now but still the tingling in my hands doesn’t go away. I also take vit D3.
I have no energy and my stomach is very upset so I can’t eat. At this moment, I regret the surgery (I had Graves).
Would it be beneficial for me to take selenium, perhaps magnesium to help with the muscle weakness and fatigue? Thanks.

Reply
    Dr. Westin Childs - May 19, 2016

    Hey Kim,

    They probably won’t hurt but I don’t think they will help either. You need to fix your calcium levels first and manage your thyroid medication – both are more likely causing your symptoms.

    Reply
Alyssa - May 24, 2016

I tried Cytomel with low amounts of Naturethroid and I had too much heart palpatiation. So my doc keeps on increasing natuthroid.
I am now taking 1 97.5 in morning, and 1 97.5 in late afternoon. I take selenium, zinc, Vit D, raw adrenal from standard process, magnesium at night. My Reverse T3 is 11.9, Free T3 is 2.8. My Free T4 is .91. I know my Free T3 should be around 3.8 and Free T4 shoudl be 1.3.. seems that even though they keep slowly increasing my meds nothing really works. I am really afraid to try cytomel again and I had full panic attacks.. Its been a rollercoaster since 2011 diagnosis of Hashimotos. Large nodule on thyroid, however, it is benign. Thyroid is shrivled as well. gluten free, dairy free, grain free most of the time until I just want to have corn taco ! LOL. any ideas ??

Reply
Robin - November 3, 2016

I recently read this article and purchased several of the recommended supplements. I am trying to Kickstart my thyroid naturally before trying the medication route. I am been suffering with constant fatigue, foggy memory and trouble losing weight. I am a 37 year old female and my labs show:
TSH = 2.3
FREE T3 = 2.8
FREE T4 = 1.12
My question is when should I take the supplments and should I follow the dose recommend on the bottle. I purchased:
DSF Formula – Nutri-West
Gastrointestinal Support
Zinc 30
Selenium
Super Enzymes
All products were linked in the article above. Thank you for your help!

Reply
    Dr. Westin Childs - November 3, 2016

    Hey Robin,

    It really depends on your symptoms and other lab tests (not just your thyroid), it really requires a comprehensive look at everything.

    Reply
      Robin - November 3, 2016

      OK, I guess I will just follow the instructions on the bottles.

      Reply
        Jenny - March 10, 2017

        Hey Robin!

        I know your comment is over a year old, but I thought I’d just ask, how are you doing? How is your thyroid, energy levels, ability to lose weight, brain fog? I was struck by your comment because our situations are very similar. I am almost 36 years old. Same symptoms as you. I just had Thyroid blood work done. My Free T3 is 2.9, my Free T4 is 1.1, so very similar to yours. Though my TSH came back as 1.1. My Total T3 is 93. From the research I’ve done, it seems my T4 – T3 is not converting well, which led me to this article . Super helpful info!!!! I have my list of supplements I’ll be starting. Anyway, just thought I’d reach out. I hope you are healing and thriving!

        Jenny

        Reply
Simon - November 4, 2016

Hi there doc. I am in NZ and understanding of thyroid issues here seems to be fairly stone-age (at least among conventional medicine, funny that) compared to alt medicine. I am currently treating leaky gut (only been 1 week so far). I had suspected hypothyroid and convinced my doc to give me tests. Symptoms are fairly mild but classic (however with a strong asthmatic reaction) – this is a chronic condition triggered whenever I live somewhere with chlorinated water).

TSH levels are 3.23mU/L, FT4 is 206 ng/dL (16.3 pmol/L) and FT3 is 64 ng/dL (4.9 pmol/L – I hope I got the US conversions right!). For me the high TSH means my body is asking for more energy; there is a lot of T4 however my thyroid is struggling to convert this to usable T3 for energy.

My Ferritin level is 135 ng/ml (normal) and my cholesterol isn’t great (I am quite skinny): total 149 ng/dl; HDL 36 ng/dl; HDL ratio 121 ng/dl; Random triglycerides 45 ng/dl and LDL 93 ng/dl. For me these readings are indicative of underactive thyroid. Also, CRP is at “less than 3” on a scale 0-5.

Anyway I am taking 1 x Piping rock Ultra Thyroid complex per day. Can I increase to 2 x per day? I see this contains desiccated thyroid and I think I could do with trying to boost T3 levels if possible?

Many thanks!

Reply
Katie - November 18, 2016

Hi Dr. Childs!
I wanted to say how much I appreciate your online articles on thyroid health. I am a thyroid cancer survivor, so I have to monitor my T4, free T3 levels often. My free T3 is typically low, and so I am taking NDT. However, I continue to have fatigue and weight gain.

I know that iron is very important for the T4 to T3 conversion, I wanted to ask you about a recent iron panel I had done (see below). From what I read, Ferritin is needed to transport T3 into the cell, and it looks as though my level is low-normal. I have read that the optimal Ferritin level for a female on thyroid hormone is 80-90, while mine is at 19. This tells me my iron stores are not too strong. Do you have some thoughts on this lab? I’d like to increase my Ferritin to an optimal level while not pushing the other measures over the range.

Iron 137 ug/dL (50 – 170 ug/dL)
Iron Binding Capacity 313 mg/dL (265 – 497 mg/dL)
% Saturation 44 % (15 – 50 %)
Ferritin 19 ng/mL (7 – 270 ng/mL)

Best,
Katie

Reply
Barbara - December 1, 2016

Dr Westin,
Just want to say this is one of the most impressive and thorough articles that I have ever read on how to increase T4 to T3 naturally.
Thank you so much!
Barbara

Reply
Sharon - January 7, 2017

Best info I have read yet. I pray I can get a dr who will prescribe T3
I am so frustrated I started zinc. Selenium
Just ordered oil of orgegano
So it’s a start
Now I need T 3. Thinking about ordering online

Reply
    Dr. Westin Childs - January 7, 2017

    Hey Sharon,

    I’m glad you enjoyed it. I would caution against ordering medications online, however – you never know the quality of the medication and dosing T3 can be difficult and dangerous (which is why many providers are scared to use it).

    Reply
Christine green - January 8, 2017

Thank you great articles. I was diagnosed with 4th stage liver disease in 2004 but functioning well now. I because of it had anemia and hypothyroidism. I was put on liquid iron and levothyroxine. Since I have gained 50 lbs. I have a very active exercise plan everyday, and eat at home right. Moderation on everything. I have tried everything to lose this weight in my stomach area. Never had it my whole life I was average. Also I find somedays it is hard to swallow. My dr. Is great but says my levels ar great were at 9.5 now <1. What should I try do you think the ntd. Or add in. T3 only med. thanks Christine g of austin mn

Reply
    Dr. Westin Childs - January 8, 2017

    Hey Christine,

    I’m sorry but I really don’t understand your question. There are multiple thyroid lab tests so you will have to elaborate on which test you are referring to for me to be able to help you further.

    Reply
      Christine green - January 9, 2017

      Hi Dr, sorry my tsh level is all my Dr says I need and it’s great. But like I said I never had weight gain until I started the levothyroxine. Same thing happened to my father and my sister. Fortunately my Dr is a great guy and is willing to work with me as he knows I am proactive on my health so if I were to ask him I’m sure he would help me. But I want to have as much info as I can because he is such a busy guy. So my question is in order to figure out if this is my thyroid meds should I try the naturethroid or have him add on a t3 med to my levothyroxine. Or go straight to the t3 alone. Or have him order tests first? Thank you so much Christine g

      Reply
        Dr. Westin Childs - January 9, 2017

        I understand, but unfortunately there is no easy way to answer that question. There is no easy way to predict the type or dose of thyroid medication that any given patient will need for optimal results. Lab results can be used as a guide, but they don’t always tell the complete story – that’s why it can be difficult (or impossible) for a patient to treat/dose themselves.

        A good place to start is with a complete thyroid panel + fasting insulin + fasting leptin + estrogen/progesterone + Testosterone. This will give you a starting point to base other decisions off of, but again this is just the start.

        Reply
          Christine Green - January 12, 2017

          Dear Dr, thanks I talked with my Dr, and sure I can try this nt, so he sent me a prescription which I had to,pay for as insurance doesn’t pay for. Anyway, I was switched from 100 mcg to 97.5 mcg naturethroid. And I feel fine all day until after dinner I feel like my head is pounding and a little off not quite dizzy but off. I also feel cold in the evening. Should I have did a 50/50 dose for awhile? In other words 50/ levo and 50% nt? And gradually ween myself off of levo? My dr says we will do bloodwork in a month. I’m not sure he works with nt a lot so any help you can give is great. Thanks Christine g

          Reply
          Dr. Westin Childs - January 13, 2017

          Hey Christine,

          You can check out my guide for naturethroid on this page here: https://www.restartmed.com/naturethroid/

          Hope it helps!

          Reply
Kerry avis - January 21, 2017

Hi. I was diagnosed 5 years ago with under active thyroid. I was very slim and active and never needed to diet. Now 5years later I am 5 stone heavier even though my THS levels have been normal for 3 years or so my weight continues to rise and still very tired. Been to an endo and was told by one endo then the weight gain and fatigue is ME (how) and the other endo told me that my fatigue is to do with my weight as I am now 103kg and 5ft 4in and very over weight. None of the endos agreed with me that I need to change my meds to T3 only. I was told that I should have gastric surgery as my weight gain and fatigue still continues even though I eat very well and and am very active and I have tried orlistat, nothing is working for me. I just don’t know what to do anymore.

Reply
    Dr. Westin Childs - January 21, 2017

    Hey Kerry,

    The best thing you can do is find someone who specializes in what I do and have them evaluate your lab work and provide treatment recommendations. Most PCP’s and endocrinologists have a very cursory understanding of what it takes to lose weight so they are not the best place to look for answers.

    Reply
Elena - January 21, 2017

Hi Doc,
I am writing from Bulgaria to thank you for the very useful information on your blog. I have had Hashimoto for almost 20 years and have been struggling with waight, brain fog, fatigue and so on. As I was always very busy I did not pay much attention and just took my meds (88 mg Euthirox). Over the last few years however I had a thrombus, my prothrombin time was off, my triglicerides were high and I have a fibrocystic breast disease.So I started paying attention and reading. My FT3 is low, FT4 – high, so obviously I am not converting. I am currently on AIP trying to fix my gut and have been gluten free for almost an year. I excercise, walk and do yoga. FT3 meds are not sold in Bulgaria and, even if I bought them from abroad, I doubt that I will find a doctor who can work with me and fix an appropriate dose. So is there anything more that I can do to help conversion?

Reply
    Dr. Westin Childs - January 21, 2017

    Hey Elena,

    The easiest recommendations are listed in this post, further recommendations would require help and specific advice regarding your situation from a knowledgable physician or provider. This post is meant to be a starting guide.

    Reply
Rachel - January 27, 2017

Hi there!!
I don’t have hashimotos but when I did a blood test a year ago my fT3 was 2.9 and now it’s 2.8. All of my other numbers looked fine. They were in the normal range. It’s just my fT3 that is off. That and my vitamin D was low. But those were the only two things. Would you recommend the same treatment for just fT3? She wanted to put me on nature thyroid but I have some reservations about it if it’s only my fT3 that is a little low. Wouldn’t that affect my other levels? I know I’m late to the post but hopefully you’ll have some insight for me. Thank you!!!

Reply
Kathy - February 1, 2017

I have a real low t3 and adrenals. My eyes burn turn red and runny . I have tried everything. Any ideas

Reply
    Dr. Westin Childs - February 5, 2017

    Hey Kathy,

    The best thing you can do is search for someone to help guide you, it can be impossible to figure much of this out on your own.

    Reply
Heather - February 12, 2017

Hi Doctor Childs,
I have had a crazy year with health problems. I had a surgery which led to a C. diff infection, which led to Reactive Arthritis. I seem to have overcome those issues now, and I have been trying to heal my leaky gut, eating mostly Paleo, and my doc has me on a small amount of T3 and LDN. I quit taking the T3 because sometimes it made me sweat, but mostly because it gave me diarrhea. Do you have any recommendations so that I don’t get diarrhea when taking the T3? I quit taking it, and can’t seem to lose weight, despite eating a really strict Paleo diet. Also, can taking T3 cause your body to produce less of it’s own?

thanks,
Heather K.

Reply
    Dr. Westin Childs - February 12, 2017

    Hey Heather,

    Most hypothyroid patients will not lose weight by changing their diet alone, they will need to test for and balance other hormones that the thyroid influences.

    Reply
Jenny - February 16, 2017

Hi, I have hypothyroidism since several years, and take levothyroxine (T4) and liothyronin (T3) . We have the same problems here in Sweden with low knowledge among physicians, but mine prescribed T3 :))) I found your site since I still have remaining issues. But I acutually do not want to ask about them, but give a tip about something that helped me tremendously. I had a lot of issues with twitching and stiffness and pain in muscles, joints and tendons, among them plantar fascitis (I do think it is connected to hypo, I have heard the same problems frpm other hypopatients) . I started taking MSM, and now I only have pain and stiffness when I get tired r stressed, not a constant pain. Also I take fluid magnesium before bed. Now I know that I should look into zinc as well, maybe that is will help. I am on anti-depressants, is there any study on that they inhibit conversion of T4 in body? I eat glutenfree and milk free, and mostly raw food, (maybe raw should be on your diet list? ) Thank you for your informative site and all the good work.

Reply
Alyssa - February 21, 2017

Hi Dr. Child’s,

After 10 years of using birth control pills I finally quit and my body has been out of whack ever since. My most debilitating symptom is air hunger and chest tightness which I’ve read can be a progesterone deficiency or hypothyroidism. My latest thyroid test result shows
TSH 1.2 (.4-4.5) range
FT4 1 (.8-1.8) range
FT3 2.9 (2.3-4.2) range
RT3 15 (8-25) range

Do you believe I could benefit from an increase in FT3? I have other symptoms as well but my naturopathic doctor noted my thyroid looked great. What are your thoughts on the levels? Thanks!

Reply
susan - February 23, 2017

I’m curious why when my Naure Thyroid was increased 1/4 grain (from 1 1/4 grain to 1.5 grains) my Free T3 and Free T4 plummeted as did my iron levels despite my taking an iron supplement during this same six week time period. My total iron is 58 and the iron saturation is 27%. My ND does not feel the ferritin is a good marker for me since it seems to fluctuate with my level of inflammation and the ALT, and AST. Needless to say I feel extremely fatigued and my mood is not great. Now she has decreased me to the lower dose (1 1/4 grain a day). She can not offer an explanation as to why my iron dropped so much even with the additional supplementation. I might add that since Oct. I have been eating clean, having done a liver cleanse, and now a candida cleanse. I exercise regularly. So I’d be very interested in your suggestions as to how to proceed.

Reply
Joanne - February 28, 2017

Hi Dr. Childs – Thank you for this article. Still making my way through it and I’ll be discussing with my doctor.

Is it possible to have low T4 or RT3 and not really have symptoms? I learned I had low T4 over 20 years ago from routine blood work, but I didn’t have symptoms (that I’m aware of). At the time, testing for RT3 wasn’t done. I just had my RT3 tested and it is low (203), but again, I don’t feel that I’m having symptoms… or maybe I just don’t know what if feels like to be fully functioning! Do you have any thoughts on that?

Note: Please check the first diagram, Factors that Affect Thyroid Function. Seems the top and bottom columns may not be on the correct sides, and the lower left column should read, “Factors that decrease (not increase) Conversion of T4 to RT3.”

Thanks.

Reply
    Dr. Westin Childs - February 28, 2017

    Hey Joanne,

    It’s important to follow the patient and just not the labs. Whatever is “normal” for you may not be the standard “normal” for everyone else.

    Also, the diagram is accurate. Stress, trauma, etc. increase conversion to T4 to reverse T3 which necessarily reduces T3.

    Reply
Catarina - March 5, 2017

Dear Dr. Childs,

What a great website, I am so glad I found it! I wish there were doctors like you in Europe…but they seem few and far between.

I have been on natural desiccated thyroid for the past five years. I started on Armour, then switched to Erfa which, unfortunately, also seems problematic and does not seem to work like it used to. So I decided to order NDT from Thailand, at a fraction of the cost of prescription NDT where I live.

Regardless of brand, I seem to require a lot of NDT for complete symptom relief (I am currently taking 7 grains which means 266 mcg of T4 and 63 mcg of T3 daily). Yet, I have no hyper symptoms, and both my free Ts are in range (FT4 at the very bottom of range, FT3 midrange 24 h after latest dose). TSH completely suppressed, but I understand that is normal when taking T3. Also, I understand I can expect my FT3 levels to be about 20% higher on the previous day, as I only take NDT once a day (in the morning). My FT3 levels were 2.9 (ref 1.7-3.7) 24 h after taking NDT, so about 3.4 the previous day…?

My question is: could I be suffering from rT3 dominance? Many claim you need less T4 when taking both T3 and T4, but I seem to need even more T4 now compared to when I was on levothyroxine only; back then, I took 200 mcg daily…which kept my FT4 levels at the upper normal limit, but my FT3 levels were never more than midrange.

I have considered switching to another brand of NDT; I am currently on Thyroid-S which contains a lot of fillers, including cellulose, which could possibly decrease absorption of thyroid hormones.

In your experience, is it unusual to need as much NDT as I seem to do? If my FT4 levels are low (0.9, ref 0.8-1.5), does that point to a potential rT3 problem? If so, I will ask for that test to be included next time I go to the lab.

Thanks a lot in advance,
Catarina

Reply
    Dr. Westin Childs - March 6, 2017

    Hey Catarina,

    I’ve found most people feel like they need 3+ grains of NDT likely have contributing issues, are getting too much T4, or have other hormone imbalances contributing to their symptoms.

    Reply
Leeanne - March 6, 2017

Hi Dr Childs,

Hoping you could comment on what you think would be the cause of reduction in FT4/FT3 levels?

TSH = 12
FT4 = .73
FT3 = 3.8
R3 = 13
TPO in range

I changed my diet recently to reduce inflammation, low carb/low sugar (was also gluten, dairy, soy -free for 2 yrs) within 3 weeks of new diet and new sleep schedule (actually getting sleep!) I felt better but my levels changed to:

TSH = 6.6
FT4 = .62
FT3 = 2.9
TPO 34 (out of range by 6 pts)

Just wondering why I would feel better, cut TSH almost in half, but have lower levels of FT4/3 and increase TPO? Any ideas on why this would happen?

THANKS! Leeanne :))

Reply
    Honora - March 7, 2017

    Hi Leeanne

    Were the blood tests taken at the same time and both after you had withheld your morning dose?

    To illustrate this, I experimented with having a blood sample taken at half past eight and then again in the same day at 1pm recently. I think I took my morning dose after the first blood test (brain fog!!)

    my first results were:
    TSH 0.44 (0.40-4.00)
    FT4 9.45 pmol/L (10-24)
    FT3 4.3 (2.5-6.0)

    The second results were:
    TSH 0.32 (this triggered the lab to measure FT4 and FT3!)
    FT4 10.00
    FT3 6.5 which is out of range suggesting either T3 ingestion (yes), or T3 toxicosis.

    Low carb/low calorie diets can trigger increased conversion of T4 to RT3 instead of T3 and aren’t a good idea for us folks with hypothyroidism.

    For my part I am now alternating WTE with Thyrovanz and will see if the FT3 levels drop. I feel the same as I ever did (asymptomatic). I think if the FT3 is too high, it demineralises the bones which I don’t want.

    Reply
      Leeanne - March 7, 2017

      Honora,

      Thanks for reply. I’m not taking any thyroid meds. Trying to treat naturally and get thyroid working again on its own. I was happy to see TSH drop — so right direction there but wasn’t happy about FT3/4 dropping also.

      Reply
Tanya - March 17, 2017

Hi, thanks for this, it’s very thorough. Do you have any thoughts on how helpful Tyrosine is / would be in this situation? It certainly makes me feel better but I’ve seen mixed opinions on it. I currently take Gaia Herbs Thyroid Support which has a couple different adaptogens including schisandra and ashwaganda plus 50 mcg iodine and 100 mcg tyrosine per capsule. I’d be curious to know if you have written anything on tyrosine. I would search the blog but can’t find a search bar… Thanks for your response!

Reply

Leave a Reply: