Sarah's was told her thyroid was "fine" but it wasn't!

My patient Sarah was super tired ALL THE TIME, she had put on 13 pounds over the holidays and then could not get them off even after going back to the gym in January. She was super depressed and frustrated about the whole situation, but what finally made her come see me was the hair loss! She told be she was losing “like handfuls of hair" every time she showered.

Sarah's symptoms strongly suggested her thyroid was not working well and that she has hypothyroidism...

Other symptoms of hypothyroidism include:

🚨 Fatigue & Low Energy

🚨 Weight Gain or Difficulty Losing Weight

🚨 Cold Hands & Feet (poor circulation)

🚨 Brain Fog & Poor Focus

🚨 Hair Thinning or Hair Loss

🚨 Depression or Mood Imbalances

🚨 Slow Digestion & Constipation

🚨 Low Heart Rate & Blood Pressure

Thyroid labs to check for hypothyroidism include TSH, FreeT4, FreeT3, RT3 and sometimes Thyroid Antibodies.

We ran labs and it wasn’t her thyroid, but it actually was her thyroid. Her TSH (thyroid stimulating hormone), Free T4 (thyroxine) and were all normal and her Free T3 (Triiodothyronine) was low-normal, but still normal. Her Reverse T3 hormone was abnormally high, like 8 points way to high. When someone has labs like Sarah's it means the body is slowing its metabolism and the cause could be any number of things. Sarah's weight gain might have been from the holiday celebrations but her in ability to lose weight was not it was because her body had put the breaks on her metabolism with making more her inactive thyroid hormone (rT3) and less of the metabolically active, energy giving thyroid hormone called Free T3.

If we had only run TSH and Free T4 and Free T3 we would not have found out how unhappy her thyroid was. Thankfully Sarah’s Reverse T3 dominance is completely reversible.

So what is rT3 Dominant Hypothyroidism?

It is the inactive form of T3 our active thyroid hormone. T3 is involved in boosting our metabolism and energy production. It is so important that we have receptors for T3 hormones in about every cell in our body (brain, heart, muscles, liver, fat cells, GI track) …

Reverse T3 binds to the same receptors as T3, expect it doesn’t give us a boost in metabolism or energy.

Revers T3 thyroid hormone acts like a break to slow down your metabolism.

When rT3 is too high it causes us to have Hypothyroid Symptoms just as if we had thyroid disease. Except we it’s reverse able!

To help Sarah fix her thyroid:

I asked Sarah to make some changes to her diet and to include cruciferous vegetables at 2 meals a day and to reduce her alcohol and coffee intake so her liver, a major detox organ in our body was better able to active her thyroid hormone to the T3 form.

We worked on addressing her high level of stress which causes your body to suppress activation of T3 and increase rT3. To do this Sarah used a combination of Supplements and Tools from my Free Guide (Stress Survivor to Thriver) which I will link in my bio to lower her cortisol (stress hormone) and, lastly I asked her to eat more. Part of Sarah’s weight loss attempts included an ultra-low calorie meal plan that left her starving and caused her body to slow it’s metabolism to conserve energy.

Well, it didn’t take long for Sarah to start having more energy and see progress at the gym losing weight. Her hair is not back to it’s usual thickness but last time we had an appointment she has a lot of baby hairs growing back. So it wont be long until she has a full head of hair again.

Many factors can cause our bodies to ramp up the production of reverse T3:

✅ Chronic stress (elevated cortisol suppresses active T3 and increases rT3)

✅ Caloric restriction or fasting (the body slows metabolism to conserve energy)

✅ Chronic illness or infections (like Lyme disease, viral infections, or autoimmune diseases)

✅ Inflammation (high cytokines & oxidative stress)

✅ Liver dysfunction (T4 to T3 conversion happens in the liver; poor function can favor rT3 production)

✅ Adrenal dysfunction (cortisol imbalance can drive up rT3)

✅ Low iron levels (anemia)

✅ Toxicity (heavy metals, mold, environmental toxins)

Sarah's labs provided the insight for the right diagnosis and the right treatment plan. Thankfully Sarah will have a full recovery and is now equip to avoid Reverse T3 Dominant Hypothyroidism in the future.

If you are struggling with a sluggish metabolism or other symptoms of an under active thyroid you owe it to yourself to get a full lab work up of your thyroid hormones. Call the office or schedule online if you'd like more help finding and correcting the cause of your health challenges.