Why iron is so important, milk thistle for RT3, and send the revised STTM book as a Christmas present!

NOTE: though this post was originally written in 2012, it has been updated to the present day and time! Janie, hypothyroid patient and site creator


It all too common with hypothyroid patients: finding themselves with low iron levels. I probably had insufficient iron my entire adult life, remembering that my doctors always told me I was borderline, yet nothing was done about it. So when I finally got on desiccated thyroid and got optimal (which can also happen with use of T4 and T3) and my iron needs increased due to better health, I finally fell into true anemia, and twice. Miserable, let me tell you. I was breathless, achy, depressed and had horrific fatigue.

And why is iron so important?

  • Iron carries oxygen from your tissues to your lungs (so if iron is low, you can be breathless and your heartrate has to go up in response to less oxygen. Link here.)
  • Iron helps raise dopamine and serotonin in your brain (so if iron is low, you can feel depression or hyperactive i.e. attention-deficit hyperactivity disorder. Link here.)
  • Iron assists with the cortisol secretion after ACTH stimulation (so if your iron is low, the cortisol secretion is decreased, lowering glucose in your cells, and that might cause the pooling of T3 in your blood. Link here.)
  • Iron promotes good conversion of thyroid hormones T4 to T3 (so if iron is low, your storage iron T4 will build too high. Link here.)
  • Iron balances your autonomic nervous sytem (so if your iron is low, you can end up in a frequent state of fight-or-flight with accompanying adrenaline surges and nervousness due to heightened sympathic activity. Link here.)
  • Iron protects women from breast tumor growth (so if your iron is low, a benign tumor can become a malignant cancer tumor. Link here.)
  • Iron improves your immune system (so if your iron is low, you are most susceptible to infections and illness. Link here.)
  • Iron supports brain cell health (so if your iron is low, you can have brain cell death contributing to dementia and possibly Alzheimers. Link here.)

How to discern if your iron is too low

We used to think testing one’s storage iron called ferritin was enough. But it’s not enough! Yes, it can be low with low iron, but it can be low with HIGH iron!! So we learned that we need four labs at the minimum : ferritin, % saturation, serum iron, and TIBC. Go here to read what we look for in our iron results.

Raising poor iron levels

Hypothyroid patients tend to “dry up” and that also causes lowered levels of hydrochloric acid in the stomach, which lowers absorption. For better absorption, try adding 1 tsp to 1 tbsp of Braggs Apple Cider Vinegar to each large glass of water or juice you use to swallow your iron pills, or use Betaine, which is an OTC hydrochloric acid supplement.

To learn more, go to the following page. And for even more details, read the Odds and Ends chapter in the revised STTM book.


Because of low iron or adrenal dysfunction, many thyroid patients have found themselves with high levels of Reverse T3…or more common, a poor RT3 ratio. And too much RT3 can mean the thyroid hormone T3 won’t adequately work in your cells, and you can feel miserable. The solution for most has been to switch to T3-only, but that can have a host of difficulties. It’s not easy to dose with T3 alone.

Recently, though, patients are discovering an alternative way to lower one’s excess RT3: the use of a good liver cleanse/support product, and most especially those with the herb called Milk Thistle. It’s an herb which, for hundreds of years, has been used as a liver tonic. In supplements, it’s the milk thistle seeds which are used because they contain silymarin–the powerful part of the herb which does the trick. And doses in the 400 mg’s of milk thistle extract supplements seem to be doing the trick, say patients who are reporting on it, taking it twice a day at 200 and 200 minimum. Some studies state you can go higher, if needed. Be careful with its use, as it can lower iron levels to some degree. So we tent to be on a small amount of iron supplementation when taking milk thistle. You can work with your doctor on this.

HO! HO! HO! SEND THE UPDATED REVISION STTM BOOK or Hashimoto’s: Taming the Beast TO A FRIEND OR LOVED ONE FOR CHRISTMAS OR THE NEW YEAR! It can be the BEST gift they will ever receive, since they are Patient-to-patient books! laughinggrapepublishing.com/

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Important notes: All the information on this website is copyrighted. STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website's information or outcomes. See the Disclaimer and Terms of Use.

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24 Responses to “Why iron is so important, milk thistle for RT3, and send the revised STTM book as a Christmas present!”

  1. Andrea

    I tried milk thistle for some time and I went to get my lab work last week thinking this was doing great things for my liver. well my TSH was off the charts, super high for me (9.86), and my peroxidase was over 900, shooting up from the last time which was 195.
    This situation is drastic for me because when I first got diagnosed with Hashimoto’s in 2014 these levels were very similar, it’s as if I wasn’t taking any Synthroid. I’m now on 50 MCG of Synthroid. So for me I believe milk thistle raised my immune system which is bad for autoimmune disease in general and made everything worse. I’ve stopped taking the milk thistle now for one week and my TSH has gone from 9.86 to 7.99, let’s see if it keeps going but I don’t think milk thistle is great for everyone. This scared and derailed me. It made me shocked and upset that that something that is supposed to be so good for for you can take you down the complete opposite path. now I’m not saying this will happen to everyone but I definitely think a naturalist, doctor, or even you, yourself should be testing often.

    • Janie Bowthorpe

      That’s too bad!

      It could have also partly been because you are on the worst treatment for hypo. https://stopthethyroidmadness.com/t4-only-meds-dont-work

    • Magan Edinger

      I started taking Milk Thistle to do a liver cleanse and my TSH was higher than the previous test even though my synthroid had been increased, There are a lot of studies that show that silymarin extracts from milk thistle significantly block the uptake of thyroid hormones into cells. In particular, milk thistle’s silycristin compounds are particularly potent inhibitors of thyroid hormone uptake by cells. I stopped taking it so we will see what the next tests show.

  2. Deanna

    Thank you for the information on milk thistle for higher Reverse T3. I couldn’t figure out why my functional doctor suggested I take it as it just seemed to be for liver issues. You clarified it for me. Maybe he reads your information as well.

  3. Lisa P

    Janie, could you please share your opinion on the theory that our iron stores should be zero? This thought from a FB group. It just does not make sense to me. But there are more and more people getting on board with this. I have followed your work and book from almost right after it was published. I have tried virtually everything to get my Ferritin levels and Iron Saturation percentage where it needs to be. Got Ferritin to 72 a year ago in December, then in July, it plummeted to 42 by July and I have no idea why. I’m really desperate to figure this out. Cause I’m back in severe RT3 after beginning to take NDT and starting to feel well! Have checked Cortisol levels, they’re okay, so, please if you have any input on this, I’d appreciate your advice. Thank you.

    • Janie Bowthorpe

      Hi Lisa. Honestly, patient experiences and wisdom have found that to be the most ridiculous goal they ever heard of. There are just “strong opinions” out there which end up harming, not helping.

      As far as working on your iron levels, it’s never about trying to get the ferritin up. It’s about getting serum iron up. Ferritin will follow over time as you do that. If we get our serum iron up, and ferritin stays low, it’s about this: https://stopthethyroidmadness.com/mthfr

  4. lin

    Reverse T3 issues can be handled with a therapy know as Wilson’s Reverse T3 therapy. The T3 is a time released capsule made by a compounding pharmacy. The pharmacy that has been making this for many many years is Medhaus. Find Wilson’s T3 therapy on line and read his manuel t’s free online download or just read it from his website..Find doctors that are certified in this therapy on Dr. Wilson’s website look for the tab at the top that reads doctors. if your daily body temp is below 98.6 this therapy may be what you need. Body temp s taken 3 hours after you wake and then taken for a total of 3 times, all 3 hours apart and recorded. Digital thermometers suck by the way they are not accurate because of the battery. Just don’t use them.

  5. Theodora Chirapa

    Hello Janie.I have low iron and TIBC I have been on 15mg of iron for two years and have just cleared high RT3 with a liver cleanse in November as well as adding T3 to NDT.What is the way forward.If I take liver support is it for life

  6. Beth

    Im low in iron and ferritin is at 33…..I take NDT, HC amd Florinef….ok, so doc upps my iron to 120mgs of elemental iron from 90mgs…..took that for two nights in a row…..the nect morning, I tool my 10mgs of HC, 1 1/4 tab florinef and 60mgs of NDT….I became panicky, sick to stomach, weak……does increasing iron for low ferritin and iron level, actually increase the efficiency of these meds???? I was a mess yesterday……would this mean that I should drop back on the florinef, or cortisol or ndt??? I have been experiencing panic attacks……Im so lost on all of this…any input would be appreciated…..

  7. serdo

    No. Milk Thistle actually increase the body of iron. because it contains in high level iron and I used almost six months milk thistle seeds in yoghurt a grinded table spoon, my ferritin and iron levels boost to double levels and my hemoglobin levels increased. I am not a Patient who have hemochromatosis. The links for several published articles below.
    1. Journal of Basic and Applied Sciences Vol. 7, No. 1, 45-49, 2011
    2. Can Fam Physician. 2007 October; 53(10): 1671—1673.

  8. sage

    Is there any way I can supplement suspected low iron that wud not negatively affect me if I’m wrong? I have no cash for labs 🙁

    (From Janie: the risk is if you have HIGH iron and not know it.)

  9. M

    Caution if you have low iron — Milk Thistle actually rids the body of iron!

    Not only does it inhibit absorption of iron in supplements or foods, it seems to actually wrest iron from body tissues. Some medical practitioners use it to treat people who have iron-overload/hemochromatosis.

    Not only did I discover that taking milk thistle for 2 months reversed my hard-won increases over the previous 6 months in my serum ferritin (I am on iron supplementation prescribed by my doctor due to very low serum ferritin levels), but there are many research articles about it. I will list the links for several published articles below, so you can read about it yourself.


    If you have low or even moderate iron stores, please think very carefully about taking milk thistle, or any supplement that includes silymarin (a component of milk thistle) — which I have just discovered is unfortunately in the new multivitamin I went to great expense 2 weeks ago to import a 6-months’ supply from the States — because it’s so effective in ridding the body of iron.

    • Wendy

      Thank you so much for this comment. I’m sure my husband’s low iron is from taking milk thistle for several months. He’s not taking it anymore and will supplement with iron.

    • Melanie

      hi there, i have been taking 500mg of milk thistle and this time my iron came back at 50 and it used to be 120. My rt3 is high so I wanted to get it down. Do you know if dandelion root takes iron out of the body? If not, Maybe I can try that instead? I already reduced my NDT and added in t3.

  10. newseum

    Diane posted the link at Facebook and then got a lot of likes…

  11. Ava

    Thanks for this good website. I am just finding out about Thyroid/Blood Sugar/Adrenal connection after a hospitalization for SIRS where I was asked if I had Diabetes (!) and sent home as normal. I started from scratch to research years worth of symptoms.
    I am so very appreciative of the great empowering information you present here. THANKS again and I will visit you again !!!:)

  12. JMR

    Thank you for a very informative post. I was diagnosed with iron deficiency as a child and took supplements for a few months. Nobody ever mentioned it again until a few years ago when I asked my doctor for an iron test when I was 40 yrs old. Undiagnosed hypothyroidism had caused me to gain weight and I tried to fix that by exercising a lot. A nutritionist giving a seminar to my marathon training group told me that many female runners are anemic and recommended getting an iron panel. Apparently, we lose iron through sweat, urine, and every time our feet strike the ground when running. My doctor refused to test my iron, but I ordered the labs online myself and found I was deficient. Over time, I became too ill to run so iron loss for that reason wasn’t a concern. But I do test my iron a few times a year and have found it necessary to continue supplementing as well as eating an iron rich diet and cooking with cast iron pans. I’ve learned that when my thyroid levels are not optimal, my iron drops like a stone, so fast it is shocking.

    So check your iron. Get a blood test. And if you are post-menopausal, don’t assume your iron can’t be low. It definitely can. But get it tested.

  13. Leigh


    Janie, I love what you’re doing–sorry to repeat myself, I’ve said it before, don’t mean to sound like a broken record (did I just age myself?!). My iron experience is as follows: when my sex hormones shifted around the age of 12 and I started menstruating, all my internal systems got knocked off balance, and stayed rather deranged for the next 35 or so years until I stopped with the menstruation business last year. (Accurate as it may be, I hate to make this assertion openly, because immature men, hostile to women (who, sadly, have been controlling the allegedly-civilized world for thousands of years—-but I digress!), have gone mad belittling women, questioning our competence and even our sanity, on account of the challenges some of us face with our reproductive capabilities. So somehow I’m going to have to work on a way of stating my case without leaving myself open to attack from the peanut gallery.) I fell into a depression when I was 12, and it was really like being underwater for these past 35 years, occasionally breaking the surface for a time, only to sink again. I also became chronically anemic, but didn’t start supplementing with iron regularly until I was in my 20s, and by golly did that help! The iron mitigated symptoms of fatigue and poor sleep which contribute to feelings of depression. My favorite product, Thompson’s Blood Builder, went off the market, and in my 30s I became an avid devotee of Nature’s Plus HemaPlex, which has an astounding 85mgs of elemental iron in it, together with a synergistic blend of other supplements (no, I don’t work for the company!LOL). Oddly, when I started taking an antidepressant, Zoloft, in my mid-late 30s, my anemia began to resolve, and I could not tell you why. It’s not as if I started eating better because the depression abated, I don’t think my diet changed at all. But dealing with hypothyroidism has taught me that there is such an intricate and delicate balance between the 100s of hormones in our bodies, that a teeny-tiny shift in one can impact many, if not all, of the others. So maybe the shift in estrogen/progesterone and all the other sex hormones when I was 12 impacted the serotonin/dopamine levels which are theorized to control depression; and maybe taking iron boosted serotonin, and when I boosted serotonin with Zoloft, I didn’t need as much iron—yikes! Add in that in my early 40s I was diagnosed with subclinical hypothyroidism and started taking Armour thyroid—my brain is getting tired trying to keep track of all this stuff, it’s beginning to get like a mental Rubik’s Cube! Anyway, I’m always interested in things we can do to improve our health and quality of life without dependence on pharmaceuticals, as grateful as I am that they are available. So I like reading about diet & nutrition, and I have seen a lot of warnings about iron, and I didn’t understand what all the fuss was about until I read that, oddly enough, our bodies have no mechanism to eliminate excess iron, which is the weirdest thing in the world, because too much iron is a really bad thing, it’s quite toxic. The only way to get rid of it is to donate blood (which is a great thing to do in any event), or take some kind of inositol (IP6 if I remember correctly, but check that, if you need to). I’ve read that excess iron intake kills a great many children every year, though I haven’t yet bothered to Google that fact for back-up. But for men, and for post-menopausal women who are not losing blood every month any more, iron supplementation is a big no-no. The first time I visited my rheumatologist after my periods had stopped, I asked to have all the requisite iron-specific blood tests done because I had continued to take my beloved Hema-Plex, because I wasn’t sure if I was just skipping periods, or finished altogether. The hormone tests confirmed menopause, and not surprisingly, my ferritin level was well above range. So the new box of Hema-Plex sits in my kitchen cabinet, waiting for someone to come along who will be able to use it. 🙂 And I get a little bananas when I read food labels, because so much of our food is fortified with iron, and calcium, and all this stuff that I really wish they would leave to the consumer to choose. In any event, you get my point. 🙂

  14. Sandra

    I just sent this to my mom to read who is struggling with low iron but does not have a doctor who will treat as you’ve said above. Due to her age she second guesses her symptoms because the doctor told her her levels are fine.
    I take milk thistle all the time and know it has helped m greatly, liver wise. I no longer have a red nose (and I don’t drink!).

    Thanks for all your hard work and forever changing our lives!

    (From Janie: It’s my pleasure. I suffered SO deeply all those years that it propels me to NOT let this happen to others. Information rocks!)

  15. Christine East

    This list surprised me. I was diagnosed anemic at a very young age (around 13) then took iron until I was in my 30’s. When I started treating my hypothyroidism, the iron pills made me sick in my stomach and I actually vomitted them back. I do not have any anemia now nor the 20 years I have been treating my thyroid.


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