Your T3 level is probably the single most important measure of thyroid function, more important than even the TSH.
Why?
Because it represents the amount of active thyroid hormone in your body.
The more of it you have, the better you will feel.
This then begs the question:
Can you personally do anything to influence your T3 level?
Absolutely.
And today we are going to talk about how to do just that with the use of some natural treatments.
Let’s jump in:
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#1. Take Zinc and Selenium
There are a ton of different vitamins and minerals that your body needs for optimal thyroid function but few are more important for T3 than zinc and selenium.
In a world where the soil is depleted of nutrients (1) and where we often eat unhealthy and processed foods (2), there’s a very high chance your diet isn’t providing enough of either.
And the research supports this.
According to the data, approximately 20-40% of hypothyroid patients are deficient in zinc and 30-50% are deficient in selenium.
This means that about 4 out of 10 thyroid patients reading this fall into one or both of these groups.
And that’s exactly why we are talking about them today.
Both of these essential minerals act as cofactors for the enzymes that your body uses to convert T4 thyroid hormone into T3 thyroid hormone (3).
If you are deficient in either then these enzymes still work, but they work less efficiently.
In a practical sense, what that means for you is that you will be creating less than T3 than you would otherwise.
How big of an impact do they have on your T3 level?
That depends on the person, but it can range from mild to severe.
To illustrate this fact, we can look at some studies.
One in particular looked at overweight women with hypothyroidism (4) and found that replacing low zinc not only increased free T3 levels but also helped reduce TSH.
The only catch here is that in order to see these pro-thyroid benefits when taking zinc, you need to be deficient.
In other words, taking them when you aren’t may not provide the boost to T3 seen in this study.
But given that such a high percentage of hypothyroid patients are deficient in them, as we already discussed, the chances are high that you will see some benefit if you do.
If you determine that you’d like to try one or both of these minerals, here’s what you need to know:
Not all forms of zinc and selenium are ideal for thyroid patients and not all supplements are dosed appropriately.
As someone with a thyroid problem, here’s what you want to look for:
- Zinc – Look for zinc as zinc chelate, zinc monomethionine, zinc gluconate, zinc acetate, or zinc citrate. Avoid all other forms as they are inferior to those just listed. As far as dosing is concerned, you only need 5-15 mg in any given serving as higher doses tend to cause GI distress and will not be absorbed anyway.
- Selenium – Look for selenium as selenomethionine or selenium glycinate complex. As far as dosing is concerned, you won’t need more than 50 to 150 mcg per serving. Some people will advise thyroid patients to use higher doses (as high as 400 to 500 mcg per day) but these higher doses increase your risk of selenium toxicity and provide diminishing returns.
And by the way, if you’re going to take one, you might as well take the other given that deficiencies often coexist with one another.
For that reason, this is my recommended supplement for thyroid patients.
It comes with both ingredients and has the right formulation and dose of each.
#2. Improve Your Gut Health
As a thyroid patient, you should care about your gut health for one important reason:
Approximately 20% of T4 to T3 conversion occurs there (5).
This means if you have intestinal problems or symptoms your ability to create T3 will be impaired.
This impairment may not be as significant as what happens if you are deficient in zinc or selenium, but 20% is nothing to scoff at either.
And given that your thyroid has a direct impact on gut health, through its impact on stomach acid (6) and peristalsis (7), there’s a very high chance that you are not creating as much T3 there as you should be.
This means that improving your gut health is one quick way to potentially increase your T3 level by a significant margin.
But how do you do that?
There are many ways but my preferred method is through your diet.
If you follow my dietary recommendations for improving thyroid function then you will not only improve your gut health, but you will also improve your thyroid at the same time.
This strategy works for most people because as your gut heals your thyroid function will increase which will further improve your gut health which will then further increase thyroid function. And so on and so on.
But there will be some people who need more targeted gut health treatments like the use of probiotics, prebiotics, antifungals, and even antibiotics.
No matter what, though, changing your diet will improve your gut health and is always the first step.
#3. Reduce Reverse T3
In case this is the first time you’re hearing about reverse T3, let me fill you in on the basics:
Reverse T3 is an anti-thyroid metabolite that competes with T3 (8).
The more reverse T3 you have in your body the less active your free T3 will be.
So if you want to banish your thyroid symptoms, you want your free T3 to be as high as possible and your reverse T3 to be as low as possible.
For this reason, it’s important to not only optimize your free T3, but your reverse T3 as well.
For most people, this just means keeping an eye on your reverse T3 level with some simple blood tests.
While this test is simple to interpret, it can be difficult to obtain as most physicians are unaware that it even exists.
So you will most likely need to ask for it by name.
As far as interpretation goes, you want your reverse T3 level to be less than 15 ng/dL.
Anything higher is a very likely indicator that your body is preferentially creating reverse T3 instead of T3.
The good news is you can push down that reverse T3 level with some specific treatments including:
- The use of T3-only medications like liothyronine or Cytomel – Nothing will push down your reverse T3 faster than the use of these medications. While they are the most effective treatment, they are also the most difficult to get, especially in any meaningful dose. But if you have access to them, they are definitely the way to go.
- The use of intermediate-intensity exercise – Research shows that you can improve your T3 level by exercising at the right intensity. If the intensity is too high, it can actually hurt your T3 and if it’s too low, it just won’t have any impact at all. For optimal T3 function, exercise that pushes your heart rate to 50-70% of the maximum is ideal.
- And eating enough calories – Calorie restriction is a powerful signal to the body to create more reverse T3 but you can fight this by simply eating enough. It sounds simple but so many thyroid patients starve themselves in an effort to lose weight which, unfortunately, only serves to make their thyroid worse in the long run.
#4. Check Your Liver
Remember when I told you that 20% of your thyroid is activated and converted in the gut?
Well, even more is converted in your liver. And I mean a lot more.
Some estimates put it as high as 60% (9).
This makes your liver the most important organ for ensuring optimal T3.
And, unfortunately, liver dysfunction is very common among thyroid patients.
Research indicates that approximately 20-50% of hypothyroid patients have some level of liver dysfunction from non-alcoholic fatty liver disease.
Compared to the average population, which is set around 25-30%, this is up to 20% higher, depending on which study you look at.
And this dysfunction in liver health absolutely impacts thyroid health!
What makes this condition even more sinister is that it often goes undiagnosed until there is significant liver damage.
This means there’s a very high chance that you are walking around with some level of fatty liver without realizing it.
One of the easiest ways to test for this is with simple liver function tests.
These tests assess the level of liver enzymes in your blood which can be used as a marker of overall liver health.
As a thyroid patient, it’s critical to keep an eye on your liver, just like you would keep an eye on your thyroid.
So the next time you get your thyroid tested, make sure your doctor is also testing your liver.
The two tests you want to get are AST and ALT. For optimal T3 status, you want both of these values to be less than 20.
If you find that your liver function tests are even slightly elevated then you will need further evaluation to find the cause.
For most thyroid patients, the underlying cause will be insulin resistance.
And just like gut health, changing your diet to improve your thyroid will also improve your insulin status which will almost always improve your liver.
To give you an idea of just how important this one is, you should know that optimizing your liver function will probably result in the highest increase in T3 compared to any other therapy we’ve discussed so far.
#5. Check Your Iron & Ferritin
Iron deficiency is a problem that you may not connect to your T3 level, but it’s more important than you probably realize.
Inside your thyroid, the enzyme thyroid peroxidase uses iron as a cofactor to create both T4 and T3.
If you don’t have enough iron then the creation of both hormones will be compromised.
While it is true that iron deficiency is not as common as some of the other problems we’ve discussed so far, it’s still very important because iron deficiency is often missed by doctors and can cause confusion when someone is trying to optimize their thyroid.
To make matters worse, you don’t need to be grossly deficient in iron for it to impact your thyroid.
So it may very well be the case that you are walking around with a “low-normal” iron level that is negatively impacting your T3.
You can test for this by looking at both your serum iron level as well as your ferritin level.
Your serum iron tells you how much iron is in your blood while your ferritin is a marker of iron storage in the body.
A common scenario that I see among thyroid patients is one where their serum iron level is normal but their serum ferritin is low.
But just having a low ferritin is enough to compromise T3 and should be treated.
For optimal T3, you want your ferritin to be in the range of 40-60 ng/mL (10).
If either are low, you can replace them with the use of over-the-counter iron-containing supplements.
But a word of warning:
Do not take iron unless you need it! Always test first as taking too much iron can make your thyroid worse and cause other problems.
#6. Take an Adaptogen
Another way to improve your T3 status is through the use of adrenal adaptogens.
These natural botanical-based compounds help your body adapt to and manage stress.
And as far as your thyroid is concerned, stress is a killer of T3 levels.
The more stress you are under the more cortisol will be released from your adrenal glands.
If released in excess amounts, as in times of chronic stress, cortisol will reduce T3 levels by blunting T4 to T3 conversion (11).
Adrenal adaptogens like rhodiola, ashwagandha, and maca root, fight this effect by normalizing cortisol.
A little bit of stress is actually healthy, but you can tell if your stress is starting to impact your T3 level because you’ll experience these symptoms:
- Fatigue even after a good night’s rest
- The sensation of feeling wired but tired
- Reliance upon caffeine and sugar as a way to temporarily boost your energy
- And both high and low energy at the wrong times of the day
If you have these symptoms then it’s probably time to consider taking an adaptogen.
Each adaptogen has a slightly different benefit on top of its ability to regulate cortisol so you can match the adaptogen to your specific needs.
For instance, maca root will help with energy but also sex hormones and libido.
So if you have low energy and a low sex drive, this is probably your best option.
Ashwagandha, on the other hand, is great for both energy and weight loss.
So if you need more energy and you’re overweight, this is probably your best option.
Rhodiola, another adaptogen, will help with energy and mood.
So if you have low energy and you’re feeling depressed or anxious, this is a great option.
#7. Take Iodine
Iodine intake seems to always be controversial, but it doesn’t have to be.
Here’s what we know about iodine and T3:
Because iodine forms an essential component of the T3 hormone, iodine deficiency impairs its production.
In terms of magnitude, this one is huge.
Your body can get by with a suboptimal level of zinc and selenium, you just might feel a little run down.
But if you don’t have enough iodine, you will experience huge problems.
Whether it’s a physical change to the size of your thyroid gland (goiter) or a gross decline in thyroid hormone production (iodine-induced hypothyroidism), iodine deficiency isn’t going unnoticed.
So the real question is less about whether or not iodine is important for T3 levels and more about whether or not you need more of it.
Unfortunately, that data is about as clear as mud (12).
So instead of diving into the controversies of iodine intake, here’s what I can tell you:
Research has shown that iodine intake in the range of 150 mcg to 300 mcg per day is quite safe.
And taking iodine in this range will ensure that your thyroid has what it needs to create enough T3 without increasing your risk of iodine-induced thyroid problems like autoimmune thyroid disease.
Some people feel better when taking more but I would caution against this approach as the pros do not outweigh the risks.
Likewise, minimizing your intake of iodine may improve your thyroid function if you were previously taking too much, but that makes the big assumption that you were overconsuming it which may or may not be true.
So far maximizing the benefits while minimizing the risks, stick to 150-300 mcg per day.
The best way to do this is through supplementation because iodine concentration in foods can vary dramatically.
If you want to get exactly the amount of iodine you need then check out this supplement.
When Should You Use T3 Medication?
What if you’ve tried these therapies before and they haven’t worked?
What are you supposed to do then?
If you’ve reached this point then it may be time to consider the use of T3 thyroid-containing medication.
Up until this point, we’ve talked about a whole bunch of natural treatments that can help your thyroid produce more T3 on its own.
But there’s another way to get T3:
Take more of that thyroid hormone directly.
T3 is found in several thyroid prescription medications including:
- Cytomel & Liothyronine – These medications are considered T3-only and do not contain T4. Liothyronine is considered the generic and Cytomel is considered the brand name.
- Compounded Sustained Release T3 – This formulation of T3 is the only sustained-release version of T3 and is only available through a compounding pharmacy.
- And NDT formulations (Armour Thyroid & NP Thyroid) – NDT formulations contain a combination of T4 and T3 thyroid hormones.
Some people get angry because I spend so much time talking about natural therapies instead of the prescription option but there’s a reason for it:
The natural option is always preferred because it’s far better to support the natural production of T3 than it is to take exogenous T3.
It’s not that taking T3-containing medications is harmful, but, like any medication, they do carry risks, they can be difficult to obtain, and they can be expensive.
So why wouldn’t you at least try the natural option first before entertaining the prescription route?
That’s my philosophy, but you can choose whatever option suits you best.
By the way, if you are someone who likes the idea of taking control of your thyroid through natural treatments then I’d recommend checking out this article next.
Scientific References
#1. https://www.ncbi.nlm.nih.gov/pubmed/14653505
#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403271/
#3. https://pubmed.ncbi.nlm.nih.gov/11215512/
#4. https://pubmed.ncbi.nlm.nih.gov/25758370/
#5. https://www.sciencedirect.com/science/article/pii/0024320589901793
#6. https://www.ncbi.nlm.nih.gov/pubmed/7435122
#7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2833301/
#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075641/
#9. https://www.ncbi.nlm.nih.gov/pubmed/6313798
#10. https://pubmed.ncbi.nlm.nih.gov/12463104/
#11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8109250/
#12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816468/
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