Thyroid UK
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How do I treat excess Reverse T3? Patients have had success with three strategies:

1 Lower your NDT! For years, we thought that the only way to lower high RT3 was to be on T3-only. But we then discovered that one can simply move down on their NDT and accomplish the same thing, such as 1 1/2 grains or less. Some then add in some T3. It can take anywhere from 8 – 12 weeks to fully lower high RT3. If one was on synthetic T4 with synthetic T3 with high RT3, patients tend to scrap the T4 totally and just use the T3.

2 Identifying the causes and treating them: After either lowering our NDT or being on T3-only, we then treat the causes. You can read about iron, or cortisol, and how we treat them. See the Odds and Ends chapter in the revised STTM book for more about iron, and Chapter 6 on the use of HC or Adrenal Cortex. Also, changing your lifestyle can be key, as well, such as greatly improving your food choices, facing an alcohol addiction, stop smoking, and avoiding high stress.

3 Using a good liver cleanse/support product, plus Selenium: Since the bulk of RT3 is made in the liver, some have lowered their high RT3 by using a good liver cleanse, especially those with Milk Thistle. You may have to DOUBLE the recommended amount to get the lowered RT3. Milk Thistle can supposedly lower ferritin, so patients are adding iron to their supplementation, or raising what they are already on. Also make sure your Milk Thistle comes from the seeds. Milk Thistle not from the seeds can have an estrogenic effect. Also, there is a lot of research which proves that low selenium can increase RT3. So patients supplement with Selenium to stop that fact.

2 Replies

Good article cc120.

85% of free T3 is produced by monodeiodnation of T4 so lowering NDT (or T4) makes good sense when all (or most) T3 is not converting (for numerous reasons).

The article states only optimal selenium is required for the process but most say zinc too.

Remember RT3 can occur from fasting or not consuming the correct nutrients needed for conversion. The higher RT3 also inhibits further T4 - T3 conversion, producing even more RT3..... Vicious cycle.

I can't take milk thistle....just bad reactions every time I have tried but there are other liver supports available.

Thank you for posting, it's good to remind oneself,


1 like

Glad it was of interest to you Flower007 x.


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