Calculating Reverse T3 Ratio: 8 Steps You Should Take

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Have you ever wondered about calculating your reverse T3 ratio? Read on to learn the essential steps you should take to know the health status of your thyroid gland.
RELATED: Everything You Need To Know About Reverse T3
In this article:

  1. Understanding Reverse T3 Ratio Is the First Step to Know Thyroid Health
  2. Learn the Ways to Lower Reverse T3
  3. The Relationship of Non-Thyroidal Illness Syndrome (NTIS) with Reverse T3
  4. Understanding Chronic Stress as a Major Factor to Reverse T3 Production

Calculating Your Reverse T3 Ratio in 8 Steps

Understanding Reverse T3 Ratio Is the First Step to Know Thyroid Health

Calculating your reverse T3 ratio is your first step in understanding your thyroid condition. Knowing this important ratio will indicate if your body is giving off a dysfunctional response, which in turn leads to health issues and stress.
To avoid these symptoms, your reverse T3 ratio should stay somewhere within the healthy range as much as possible.

Step 1: Understand Why Reverse T3 Is Bad for You

A healthy thyroid gland produces these essential hormones needed for body function: T4, T3, T2, T1, and calcitonin. T3 or triiodothyronine is an active hormone that possesses more of the hormone “strength” needed to convert oxygen and calories into your body’s much-needed energy.
If your doctor suspects that you have an underactive thyroid, it means your thyroid is producing an unnecessary hormone: reverse T3.
Reverse T3 is not good for your body because it can lead to thyroid problems. As your T4 (thyroxine) hormones convert reverse T3 to get rid of unwanted T4, your body reacts adversely.
Remember, reverse T3 is essentially an inactive hormone, and the more you have it, the more your body will experience hypothyroid symptoms.

Step 2: Learn Why Your Body Produces Reverse T3

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Studying reverse T3 function to learn more

Learning the function of reverse T3 is also important. This hormone is present in your body because it primarily acts as a “brake” to your metabolism during periods of intense stress.
Your body’s natural response to stress and other bad elements is to conserve more metabolism and energy by slowing down the production of energy and distributing energy to your organs. This makes your body produce more reverse T3 as it reacts to stress and can even go higher when you experience chronic stress.

Step 3: Know the Causes or Risk Factors of High Reverse T3 Levels

Your high reverse T3 levels could also be the result of the following causes:

  • Extreme Dieting

Diet programs that promote very low calories can trigger the reduction of your metabolic rate, reducing active thyroid hormones and increasing the inactive one.
When you take fewer calories than what your body requires, it can significantly affect how your body digests food, considering you need some calories to metabolize and digest what you eat properly.
These diet plans can also affect the basic functions of the body, such as the proper functioning of the heart, lungs, brain, and kidneys.

  • Long-Term Use of Beta-Blocker Medication

This type of medication may inhibit the conversion of T4 to T3, the active one, increasing the chances of producing more reverse T3.

  • Increased Stress

Stress is never good for the body. When stress increases, your body produces more of reverse T3, and the conversion of T4 to T3 lowers.

  • Untreated Gut Issues

Gut issues like acid reflux, yeast overgrowth, and inflammatory bowel disease (IBD) can also raise your levels of reverse T3. This is because up to 20% of the conversion of T4 to T3 happens in the gut, so when the gut is not properly functioning, the conversion power reduces.

Inflammatory Bowel Disease Definition: The general term used in describing chronic inflammation disorders in the digestive tract.

Step 4: Consult with Your Doctor First About Your Suspicions

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Communicating regularly with your doctor to keep healthy

If you suspect you have hypothyroidism symptoms, don’t fret yet. You may be feeling sick because of other reasons.
Your doctor will only issue a hypothyroidism diagnosis if you are found to have either of the following as well:

Step 5: Your Doctor Will Order Reverse T3 Function Tests (RT3 Tests)

A reverse T3 test is a blood test ordered by a doctor to determine how much-unwanted reverse T3 you currently have. If you have a well-functioning thyroid, free of any illness or conditions such as those in Step 4, your reverse T3 ratio should be in the 10-24 ng/dL range.
Keep in mind that if your doctor’s focus is for you to achieve optimal hormone balance, a higher ratio means you have higher chances of getting diagnosed with hypothyroidism.

Step 6: Know Other Conditions That Can Affect Thyroid Test Results

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Tell your doctor upon check-up if you have these conditions because they play a significant role in the accuracy of your test results:

  • Coronary artery bypass grafting
  • Heart attack
  • Bone marrow transplantation
  • Surgery
  • Starvation

Step 7: Look for These Clues in Your Thyroid Lab Tests Results

Your doctor will look into the following clues to reinforce your initial diagnosis:

  • Your RT3 results moving from 11 ng/dL above, as this corresponds to increasing RT3 hormones.
  • The ratio between your RT3 and your free T3 (free triiodothyronine) or total T3 (total triiodothyronine) determines whether you have hyperthyroidism or hypothyroidism.

To determine each of the ratios:

  • For FT3/RT3 ratio: divide your free T3 number by the reverse T3 (Free T3 ÷ RT3)
  • For total T3: divide your total T3 by the RT3 (total T3 ÷ RT3)

Step 8: Interpret Your Results by Taking Note of These Levels

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Studying T3 test results to learn about your health

If you have extremely low free T3, it means you have excess RT3 leading to cellular hypothyroidism. This means you have a much slower metabolism, especially in times of stress or chronic illness.
On the other hand, an above-the-range free T3 will result in a better ratio. But, this is not necessarily good, as it only means you are pooling.
Pooling means your free T3 is not making its way to your cells. While it does not cause increased RT3, it indicates you most likely have an overactive thyroid.
If you are computing the FT3/RT3 ratio, you should aim for a ratio of 20 or higher for optimal health. If you used your total T3, then you are looking at a ratio of 10 and higher.
RELATED: Understanding TSH Levels: Important For Your Thyroid Function

Learn the Ways to Lower Reverse T3

After finding out you have high levels of the reverse T3 hormone, you can try these few methods to help manage it:

1. Change Your Lifestyle to Balance Hormone Production

An unhealthy lifestyle is one of the common causes of various illnesses, including thyroid disease. Chronic stress, for example, is just one of the possible causes of increased reverse T3.
To achieve a healthy lifestyle, you can follow these simple changes:

    • Follow a balanced diet with real, whole foods and lots of fruits and vegetables.
    • Perform regular workouts, daily low-intensity and once to thrice a week high-intensity.
    • Eliminate your stressors.
    • Sleep for at least eight hours a day.

2. Eat Anti-Inflammatory Foods

Inflammation promotes the increase of the production of reverse T3. One study showed that the elevation of inflammation, such as during starvation, can lead to problems like a decreased level of T4 conversion to T3, allowing the production of more reverse T3.
You can eat foods with anti-inflammatory properties to lower swelling in your body, such as the following:

    • Cherries
    • Tomatoes
    • Dark chocolate
    • Extra virgin olive oil
    • Turmeric
    • Grapes
    • Mushrooms
    • Peppers
    • Green tea
    • Avocados
    • Broccoli
    • Fatty fish
    • Berries

3. Take Thyroid Medications to Lower Reverse T3 Levels

This can be the easiest and fastest way to reduce reverse T3 levels. You can take bioidentical hormone formulations with pure T3 like liothyronine as prescribed.
When you take T3 directly, it automatically suppresses T4 levels, which lowers the substrate your body utilizes to produce reverse T3.

4. Consume Zinc and Selenium

Both zinc and selenium are important nutrients in the body. They provide various health benefits including improving hormone levels and thyroid function.
Selenium specifically supports the metabolism and synthesis of the thyroid. You can take this nutrient naturally from foods, such as the following:

  • Eggs
  • Turkey
  • Beef
  • Chicken
  • Lamb
  • Scallops
  • Sardines
  • Salmon
  • Shrimp
  • Tuna

Zinc plays a significant role in converting T4 to T3, enhancing T3 levels. You can get zinc from foods like the following:

  • Nuts
  • Legumes
  • Meat
  • Mollusks
  • Shellfish

The Relationship of Non-Thyroidal Illness Syndrome (NTIS) with Reverse T3

NTIS is a condition where there is an abnormal thyroid level but is not caused by the thyroid gland. Normally, when there is thyroid dysfunction, the levels of T4 and T3 get low.
With NTIS, there is enough T4, but T3 is too low. So, how does this relate to reverse T3?
In some cases, having high levels of reverse T3 is the result of NTIS, as a symptom. This is because the syndrome primarily causes an abnormality in the thyroid levels of a patient, which can significantly affect T4, T3, and reverse T3.
One major factor that increases reverse T3 in the body is the blockage in the conversion of reverse T3 to T2, an active stimulating hormone, which prevents the body from eliminating reverse T3. This blockage happens when you have NTIS.
The lack of normal T2 formation eliminates the pathway by which your body removes reverse T3, which causes the hormone to build up.

Understanding Chronic Stress as a Major Factor to Reverse T3 Production

What Is Chronic Stress?

Stress is your body’s biological response to situations that require intense demands like a family problem. It increases adrenaline and cortisol levels in your body.
These hormones allow your body to prepare to take action like increasing breath and heart rates. If you’re in this state, you are in arousal mode or heightened alertness.
You will only experience the physical effects of stress in a short period. But, some may suffer from constant heightened alertness, which is chronic stress.
Several causes of this condition are:

  • Challenging relationships
  • Financial difficulties
  • High-pressured jobs

What Are the Signs and Symptoms of Chronic Stress?

The symptoms of chronic stress depend on each individual and can negatively affect your daily life:

  • Frequent illnesses or infections
  • Nervousness
  • Loss of sexual desire
  • Low self-esteem
  • A perceived loss of control
  • Feeling helpless
  • Changes in appetite
  • Digestive problems
  • Difficulty sleeping
  • Rapid, disorganized thoughts
  • Difficulty concentrating
  • Headaches
  • Fatigue
  • Irritability

What Are the Health Consequences of Chronic Stress?

Suffering from chronic stress can lead to developing various mental and physical disorders like:

  • Schizophrenia
  • Post-traumatic stress disorder
  • Anxiety disorders
  • Depression
  • Burnout
  • Insomnia
  • An autoimmune disease
  • Respiratory infections
  • Skin irritation
  • Gastrointestinal disorders
  • Sexual dysfunction
  • Weakened immune system
  • Obesity
  • Diabetes
  • High blood pressure
  • Heart disease

How Do You Manage Stress?

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Meditating to decrease stress and improve your health

Several methods to control stress are as follows:

  • Enhancing sleep quality – Lack of sleep and poor sleep quality can both lead to stress. This is why you need to sleep at least seven hours every night, follow a regular sleeping schedule, avoid intense exercise, eating, and caffeine hours before bed, and relax by listening to music, meditating, or reading a book before bedtime.
  • Try mindfulness meditation – Mindfulness meditation is a technique that builds awareness of your body and the environment. You can use deep breathing to lower levels of depression, anxiety, and stress.
  • Exercise regularly – Working out elevates your levels of endorphins, a hormone that reduces stress and regulates mood. You can play sports, run or jog, do household chores, or even walk at least 30 minutes each day.
  • Determine stress triggers – You cannot avoid all the triggers of stress but you can take note of those that help you develop management and coping strategies.
  • Spend time with loved ones – Spending time with them daily can help make you feel inspired and happy. They can motivate you to move forward with life and give emotional support.
  • Recognize the symptoms – If you know how to identify the signs of the condition, you can find ways to deal with them properly.

How Do Doctors Treat Chronic Stress?

If the natural ways to manage stress don’t help at all, your doctor may recommend to let you take a psychological therapy like cognitive-behavioral treatment. This therapy has structured sessions to make you modify feelings, thoughts, and behaviors related to stress.
It also helps you create coping mechanisms to control your stress.
Your doctor may also suggest taking medications like antidepressants to treat the symptoms. If you have sleeping difficulties, your physician may prescribe sedatives.

When Do You Need to Visit Your Doctor?

If dealing with stress is overwhelming, you can always visit your doctor. Your physician can give you advice about treatment alternatives and support.
They can also refer you to a specialized medical professional like a psychologist to help you deal with stress.
To calculate the reverse T3 ratio, you will be working with two sets of data. If your FT3 is a smaller number, you need to modify your factor number by 10 or 100.
Also, your reverse T3 ratio is just a helpful indicator for your doctor to determine whether you have a dysfunctional thyroid or not. Nevertheless, your doctor will take your reverse T3 ratio into account when reviewing your overall condition.
How do you maintain your thyroid health? Share practical tips with us in the comments section below!
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Calculating Reverse T3 Ratio: 8 Steps You Should Take
Editor’s Note: This post was originally published on July 26, 2018, and has been updated for quality and relevancy.

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