Balanced Health 
When it comes to thyroid health, standard lab tests often focus on TSH (thyroid-stimulating hormone), Free T4, and sometimes Free T3. But what happens when these labs appear “normal,” yet you still experience fatigue, brain fog, weight gain, or mood swings? The answer may lie in a lesser-known marker: Reverse T3 (rT3).
At Balanced Health in San Francisco, we specialize in advanced clinical insights that go beyond basic lab panels. One of the most overlooked—yet critical—components in evaluating thyroid health is understanding Reverse T3.
🔍 What Is Reverse T3?
Reverse T3 (rT3) is an inactive metabolite of T4, the main hormone produced by the thyroid gland. While T4 is normally converted into the active hormone T3 (which drives metabolism and energy), under certain conditions, the body converts T4 into Reverse T3 instead. This biologically inactive form can bind to T3 receptors without activating them, effectively blocking the action of active T3.
🧠 Why Is rT3 Important?
An elevated Reverse T3 level can be a sign that your body is under stress—physiological, psychological, or environmental. This may include:
- Chronic illness or infection
- Inflammation
- Poor nutrition or crash dieting
- Adrenal fatigue or HPA axis dysfunction
- Chronic stress or trauma
- Liver dysfunction
- Heavy metal toxicity
In these states, your body enters a “conservation mode,” suppressing metabolism by increasing rT3 to prevent T3 from over-stimulating your cells.
📉 The Problem with “Normal” Thyroid Tests
Standard thyroid panels often do not measure Reverse T3, which means your TSH and T4 can look normal, even though you may still be suffering from symptoms of low thyroid function. At Balanced Health, we use comprehensive thyroid testing, including:
- Free T3 and Free T4
- Reverse T3
- Thyroid antibodies (TPO, TgAb)
- TSH
- Cortisol and adrenal markers
- Nutrient cofactors (zinc, selenium, iron, B12)
This broader picture allows us to detect functional imbalances before they progress to full-blown thyroid disease.
🧬 Our Functional Approach to High Reverse T3
We don’t treat lab numbers—we treat people. If you have high Reverse T3, our integrative approach may include:
- Targeted supplementation to support T4-to-T3 conversion (selenium, zinc, vitamin D, iron)
- Adrenal and cortisol support, if stress or HPA axis dysregulation is present
- Detoxification protocols to reduce liver congestion or inflammation
- Lifestyle modifications such as stress reduction, improved sleep, and nutrition
- Personalized thyroid hormone therapy, in select cases, using compounded T3 or combination T3/T4 formulas
📘 Q&A: Reverse T3 and Functional Thyroid Health
Q: What’s a normal Reverse T3 level?
A: While ranges may vary, an rT3 level over 15 ng/dL is often considered elevated, especially if the Free T3:rT3 ratio is low (under 20:1). We always evaluate your symptoms in context—not just your numbers.
Q: Can high Reverse T3 make me feel hypothyroid even if my TSH is normal?
A: Yes. Elevated rT3 blocks the action of T3 at the cellular level, which can mimic hypothyroid symptoms like fatigue, brain fog, depression, cold intolerance, and weight gain—even when TSH and T4 are in range.
Q: What causes elevated Reverse T3?
A: Common causes include chronic stress, illness, inflammation, liver dysfunction, crash diets, and nutrient deficiencies. It’s the body’s way of conserving energy during perceived “threats.”
Q: Is Reverse T3 testing covered by insurance?
A: Often, Reverse T3 is not included in standard panels and may not be covered by all insurance plans. At Balanced Health, we work with you to ensure cost-effective access to advanced testing when needed.
Q: How long does it take to rebalance high Reverse T3?
A: With the right support, many people begin to feel better within 4–8 weeks. Full resolution can take longer, depending on the root cause and complexity of your case.
🏥 Why Choose Balanced Health?
At Balanced Health, we combine the latest research in functional medicine, endocrinology, and genetics to get to the root cause of your symptoms. Whether you’re struggling with unexplained fatigue or a “normal” thyroid test that doesn’t reflect how you feel, our team is here to listen, investigate, and guide you to optimal wellness.
📞 Contact Balanced Health Today
Balanced Health
1819 Union St
San Francisco, CA 94123
📞 Phone: (415) 915-5454
🌐 balancedhealthsf.com
Don’t settle for feeling “off” when your labs are “normal.” Schedule your comprehensive thyroid and Reverse T3 evaluation with Balanced Health today—and start feeling like yourself again.
Empowered health starts with deeper answers.