Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications.
However, this test can often time be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, the person affected may fluctuate between highs and lows.
Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations leading to an overly lax reference range.
This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.
In recent years, The National Academy of Clinical Biochemists indicated that 95% of individuals without thyroid disease have TSH concentrations below 2.5 μIU/mL, and a new normal reference range was defined by the American College of Clinical Endocrinologists to be between 0.3-3.0 μIU/mL (1).
However, most labs have not adjusted that range in the reports they provide to physicians and have kept ranges as lax as 0.2-8.0 μIU/mL. Most physicians only look for values outside of the “normal” reference range provided by the labs and may not be familiar with the new guidelines. Thus, many physicians may miss the patients who are showing an elevated TSH. This is one reason why patients should always ask their physicians for a copy of any lab results.
Functional medicine practitioners have further defined that normal reference ranges should be between 1 and 2 μIU/mL, for a healthy person not taking thyroid medications. Anecdotally, most patients feel best with a TSH between 0.5-2.0 μIU/mL.
It’s important to remember that reference ranges may not be applicable to everyone. What is normal for one person may be abnormal for the next. Reference ranges take into account the average values of 95% of the population. Thus, not everyone falls within the “normal” reference range. If you are in the 5%, you may experience symptoms of hypothyroidism or hyperthyroidism with TSH values that are considered normal. All doctors are taught the old adage “treat the patient and not the lab tests,” but unfortunately not many conventional doctors seem to follow this advice.
Some thyroid advocates may dismiss the use of the TSH altogether, but I disagree.
When considered in the right context and the right reference range, the TSH is one of the many tests that may be useful to optimize thyroid function. Other tests that I recommend include Free T3 and Free T4 levels. These reveal the amount of hormone available to the body.
Take Charge of Your Own Health!
Personally, I still have a copy of a TSH test that showed a value of 4.5 μIU/mL with a note from the physician that said “Your thyroid function is normal. No need to do anything.”
Meanwhile, I was sleeping 12+ hours per night, under two blankets in Southern California and wearing sweaters in the middle of July! I made the mistake of trusting another human being with my health, and I lost a year of my life because of it. Instead of pursuing my passions, I came home from work each day and collapsed.
I don’t want you to make the same mistake I did.
I encourage you to take charge of your health. Learn as much as you can about your condition. Always request a copy of your labs. Don’t be afraid to tell your doctor that you are not feeling well on current therapy and insist on getting better care.
There are plenty of Hashimoto’s doctors out there that will provide the care you need, so don’t be afraid to seek out a second opinion.
To learn more about addressing your thyroid symptoms, download my free Thyroid Symptom Hacker guide below!
I wish you the best of luck in your healing journey!
Here is a sample letter for your doctor…(scroll to read)
Liked this post? You may be interested in my other posts…
PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free here. You will also receive occasional updates about new research, resources, giveaways and helpful information.
For future updates, make sure to follow us on Facebook!
Reference
1. Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association [published correction appears in Thyroid. 2013 Feb;23(2):251] [published correction appears in Thyroid. 2013 Jan;23(1):129]. Thyroid. 2012;22(12):1200-1235. doi:10.1089/thy.2012.0205
This could indicate subclinical hypothyroidism, or an early stage of thyroid dysfunction… People in this stage often benefit from thyroid medications. Hope that helps 🙂
What would you say about someone who has complained of ongoing symptoms for ten years? I was fine ten years ago then all of a sudden I started gaining weight and couldn’t lose it no matter how hard I tried. I went from a size 0 to a size 10. I started wanting to sleep all the time and was miserable if I couldn’t. Started losing my hair- developed Raynauds- getting headaches. I am cold all the time and have to sit in the bottom of the hottest shower imaginable just to “semi warm” so I can crawl into bed. I can’t lose weight. My nails are brittle and I have next to NO eyebrows left. My TSH was 2.17/ but a few weeks ago was 2.91 even though 10 years ago before symptoms started I was 0.36ish and since I started gaining weight / I’ve never been below 2. My free T4 is 16, but again it used to be higher.
Carlee – thank you for following this page and I’m sorry to hear you are struggling. 🙁
Hashimoto’s is a complicated condition with many layers that need to be unraveled. While conventional medicine only looks at each body system as a separate category and is only concerned with the thyroid’s ability to produce thyroid hormone, Hashimoto’s is more than just hypothyroidism. I wanted to pass along these articles that I wrote. I hope they help 🙂
WHERE DO I START WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/
OVERCOMING HASHIMOTO’S
https://thyroidpharmacist.com/articles/overcoming-hashimotos-in-the-new-year
Hi Isabella! I (23, F) recently (a week ago) saw an endocrinologist for the first time. I have aquagenic pruritis, so I got a blood test and my TSH was a 5.6. Then a 6.4. My endocrinologist is confused because I’ve been losing weight, and struggling to gain it, which doesn’t line up with hypothyroidism. Have you ever seen this happen? I’m struggling to find anything about it online, and I have most of the symptoms of hypothyroidism I’ve come across, but nothing about losing weight. I purchased your book but I’d love your opinion about this since I’m worried and am not sure which path to go down. Thank you
Jen – thank you so much for sharing your journey. ❤️ Most people with Hashimoto’s will experience weight gain, and so, of course, that’s what gets the most focus, but some people actually experience weight loss, or they can’t keep their weight on. This is especially problematic when a person has multiple food sensitivities and needs to adhere to an autoimmune diet that restricts foods. Here are a few tips to keep in mind:
1. Get a calorie counting app like My Fitness Pal on your phone, to help you keep track of your daily calories. Eating real food can be more filling than eating simple carbohydrates and you may not be getting enough calories. Use the app to figure out your target weight and the number of calories per day you need to get there.
2. Supplement after dinner with The Root Cause Building Smoothie: 1 avocado (300 calories), 1 cup coconut milk (150 calories), 1 banana (100 calories), 2 egg yolks (100 calories, if tolerated), 1 scoop of protein of beef/pea protein (60 calories) – You can also add cooked sweet potatoes if you need more carbs.
3. Get tested for gut infections. Gut infections can prevent the digestion and assimilation of foods, leaving you underweight and malnourished. The 401H test or GI Effects test are my go-to tests.
4. Get your adrenals tested with an adrenal saliva tests. In some, stressed adrenals may actually lead to poor absorption of foods.
5. Be sure that you are not over medicated.
6. Work on reducing your antibodies with a selenium supplement
7. Stress reduction, when we’re stressed we don’t digest.
8. Add coconut oil in your beverages, this can add extra calories in your day
9. Avoid caffeine, it can make you less hungry and stress out your adrenals.
In case you would like to read more, here are the links to my books:
Hashimoto’s Root Cause
https://amzn.to/2XXCqcQ
Hashimoto’s Protocol
https://amzn.to/3cJ89T4
Hashimoto’s Food Pharmacology
https://amzn.to/2x6GRXW
I have a TSH of 1.5 and I am on my period in 37 and I have had diarrhea every day and anxiety fatigue lightheaded irritability and sleep issues. But this is supposed to be the optimal level? Do I take less medication? Idk what to do. My levels drop in the summer and rise in the winter
Hi Misty! I had/have (the lightheadedness/dizziness is the most unsettling) these same symptoms! I believe they are related to my seesaw adrenal function, hormones, and thyroid not quite being optimal – yet. Have you had a saliva cortisol test? I ordered one through BLT Systems to get the conversation started with my practitioner. Hope this helps in your investigation!
Misty – Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. As for your levels rising in the winter, This can absolutely be relevant for some – thyroid hormones help us to stay warm, so if you are exposed to cold, you may need a bit more. I recommend discussing with your practitioner. Here is an article I hope you find helpful:
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Colette- I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
My TSH is “normal”…
TSH=4
T3Free=3
T4Free=1.3
I know you can’t comment specifically on my situation but could such a profile still indicate early thyroid dysfunction? I have numerous typical hypothyroid symptoms and have been feeling progressively worse over the last year. I have started reading your book and am implementing dietary changes and use of supplements,and this has provided some relief , but am still having symptoms that interfere significantly with my quality of life. Additionally, my mother was diagnosed hypothryroid since her 20’s and my sister, maternal grandmother and two aunts have been diagnosed with other autoimmune disorders (Raynaud’s; Lupus; Scleroderma and Fibromyalgia).
I have expressed my health concerns to my primary care physician and she insists all of my levels are normal and all of my symptoms are simply menopause…even though I have been in menopause for the past 4 years and have only had these symptoms in the last year…
I will continue to implement your suggested protocols, but would you also still pursue trying to explore a pharmacological intervention, whether it be Synthroid, NDT or Armour or just continue with the suggested protocol? I am at my wit’s end and feel like my doctor thinks I’m just a hypochondriac!
Lisa – thank you for following this page. I understand how frustrating this all is. 🙂 Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. Every six weeks is usually a good schedule for testing your thyroid hormones.
These are the recommended labs from my book, page 32.
RECOMMENDED THYROID FUNCTION TESTS
* TSH
* TPO Antibodies
* Thyroglobulin Antibodies
* Free T4
* Free T3
* Reverse T3 (Optional)
Did you know that progesterone deficiency can surge into Th-1 dominance. This explains why the peak onset of Hashimoto’s occurs during menopause, when the body’s progesterone drops, or after pregnancy, when a rapid drop in progesterone occurs after the delivery. I do talk a lot about it and go into more depth in my book!! 🙂 You may be interested in my 12 week online program called Hashimoto’s Self-Management Program that covers all of the strategies that I go through with my one-on-one clients, in a self-paced format, so that participants have access to all of the things I’ve learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. In addition, any person that goes through the program will get access to a Quick search Q&A Database of 1000+ questions asked by past program participants, Root Cause Assessment based on 100’s of my clients’ root causes and triggers, 2-week Meal Plans, recipes, and shopping lists to get you started on the following diets: Paleo, Autoimmune Paleo, SIBO, Candida. Also, Discounts on lab tests, high-quality supplements, and consultations and much more to support you in your journey! There are a few requirements that you should pay attention to, such as my book which is a required read.
Hashimoto’s Self-Management Program
http://hackinghashimotos.com/
Denise- Some people with Hashimoto’s test negative for thyroid antibodies because their overall immune health is so weak they do not produce enough antibodies. I’ve tested negative for antibodies several times. Now I’ve insisted on a thyroid ultrasound. Given that Hashimoto’s is one of the leading causes of hypothyroidism worldwide, I wouldn’t stop until I know one way or another.
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well. Have you done all these tests?
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
This is brilliant. I’ve certainly felt the same lately! I spent two years insisting that though my TSH (on Synthryoid) “looked great on paper” I didn’t feel great in person. Finally, I decided to see an acupuncturist and I’m feeling much better! It’s refreshing to have someone believe what you say instead of trying to convince them. What is wrong with that picture? You shouldn’t have to convince your doctor you don’t feel well! “Doctor knows best” is NOT good advice to follow. No one knows your body like you do. If you believe something is wrong, something is wrong.
Great article.
I am so glad that you are getting the type of care that everyone of us needs and deserves! Wishing you all the best in your journey!
WHICH MEDICATION IS BEST?
https://thyroidpharmacist.com/1/post/2013/06/which-thyroid-medication-is-best.html
The doc said more hormone, but again my “frees” are not that low.
Should I just ignore the TSH altogether?
Free T4-10.5
Free T3-4.9
Total T3-1.6
Anti-Thyroglobulin antibody- 13.0
I was told by ENT specialist that everything is normal, but my symptoms have agravated….. Losing hair ++++, anxiety, nervousness, depression, insomnia, extreme fatigue, palpitations.I have been Off work for 7 months and not getting better. I have No family doctor and do not know what to do but can t live this way any longer…. Willing to travel to USA to get treated…… Can someone help me ….. Want to have my life back!!!! Ty
Dorothee- Fatigue was the most debilitating symptom I experienced with Hashimoto’s. It actually started 8 years before I was finally diagnosed in 2009, after I got Mono (Epstein-Barr Virus) in college. I needed to sleep for 12 hours each night to be able to function, and by “function” I mean after hitting the snooze button on my alarm clock for two hours (ask my poor husband), I would drag myself out of bed and then had to drink 4-6 cups of caffeine everyday to keep myself awake. I often had Red Bull and Pepsi for breakfast, and was the epitome of “wired but tired”. I hope my articles help you get started 🙂
OVERCOMING THYROID FATIGUE
https://thyroidpharmacist.com/articles/top-10-tips-for-overcoming-hashimotos-fatigue
THIAMINE AND THYROID FATIGUE
https://thyroidpharmacist.com/articles/thiamine-and-thyroid-fatigue
Jen- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Chris here. I agree it seems that many ,many sites seem to forget the whole of the Thyroid problem. I was Hyperthyroid for a very long time. And lost alot of weight,had the shakes,muscle wasting and nerve pain and was sweating all the time and hands shaked. YOu’re not alone. I never had a nodule on my Thyroid. But was extremely Hyperthyroid. I also developed Diabetes. Once I had radiation (Capsule treatment) they killed off my Thyroid. I then went Hypo and it is no fun as well. But I agree there seems to be alack of concern or topics on Hyper. Also one of the things less talked about is the fact that many Hyper and Hypo have Neuropathy nerve pain. Ether way feel free to join my Facebook support site. And you will not be left alone. https://www.facebook.com/groups/601250606660090/ I truly wish you well.
Chris- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Tricia- I know how frustrating it can be. You may find this article interesting!:)
DO YOU HAVE TO BE WEALTHY TO OVERCOME HASHIMOTO’S
https://thyroidpharmacist.com/articles/do-you-have-to-be-wealthy-to-overcome-hashimotos
I have a pituitary adenoma and was put on levothyroxine by an endocrinologist in TX. I moved and my new doctor said that I didn’t need it anymore. Since that time I have put on over 50 pounds and have had all of the symptoms of hypothyroidism. the only test my doctor ever does is TSH. I am tired of being sick all of the time. Is there anything I can do to help my symptoms?
Katrina- When it comes to weight gain these are a couple of things to think about.
1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.
2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.
3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.
BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism
HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos
Summer- Did you know that if you live in the United States, the UK, Australia, Europe and most developed countries that add iodine to the salt supply and take thyroid medications, there’s a higher probability that you do have Hashimoto’s?
Depending on the source, estimates are that between 90-95% of those with hypothyroidism have Hashimoto’s.
But most doctors will never tell people that they have Hashimoto’s, or that their own immune system is attacking their thyroid. People are told that their “thyroid is sluggish”, and that these things happen with age and “Just take this pill, you’ll be fine.” I hope you check out these articles that I wrote.
ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/
DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
My dr did the following test: TSH: 2.7 and Free T4: 1.0, because of my symptoms. She said those are optimal results and not to worry. However, my symptoms are still present. Should I ask for further thyroid testing or just wait and see?
Wendy – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress.Every six weeks is usually a good schedule for testing your thyroid hormones.
These are the recommended thyroid function tests from page 32 of my book:
– TSH
¨ TPO Antibodies
¨ Thyroglobulin Antibodies
¨ Free T4
¨ Free T3
¨ Reverse T3 (optional)
¨ Thyroid Ultrasound (optional)
Here is a research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Shay- I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. The thyroid gland has been called a thermostat for our body, as it helps to regulate heat. People with hypothyroidism are prone to having low body temperatures and cold intolerance. It’s one of those symptoms that we often brush off, don’t notice and don’t take seriously, but can be very distressful when we do not take the proper precautions. Here’s an article that I hope helps you.
THYROID AND COLD INTOLERANCE
https://thyroidpharmacist.com/articles/thyroid-and-cold-intolerance
Great article and well explained. I’m planing on printing the link above to show it to my doctor but I doesn’t work … Reference-(Print for your doctor)
1. 2012 Clinical Practice Guidelines for Hypothyroidism in Adults: Available at http://aace.metapress.com/content/b67v7mk73g3233n2/fulltext.pdf
Synthroid the day of blood work? I’m going to begin going gluten free but am worried about trying the elimination diet. Did you feel hungry during that time?
Amanda- Here are two articles you will find helpful! 🙂
HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications
ELIMINATION DIET FOR HASHIMOTO’S
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
Bk- Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications.
However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, the person affected may fluctuate between highs and lows.
Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations leading to an overly lax reference range.
This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.
WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
https://thyroidpharmacist.com/articles/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests
currently t4-is 8.4
free t-4 1.05
t3 132
anti thyroid abtibody 19
anti thyroid peroxidasw 32
newly married a lot of stress snoring of spouse
any recomondations?? have felt horrible for years always cold tired weight gain,
any suggestions MD ordered synthroid 25mcg to start and no other advise!!!!
Sharon- I’m afraid I can’t comment on your lab results due to liability. I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. Did you know that if you live in the United States, the UK, Australia, Europe and most developed countries that add iodine to the salt supply and take thyroid medications, there’s a higher probability that you do have Hashimoto’s?
Depending on the source, estimates are that between 90-95% of those with hypothyroidism have Hashimoto’s.
But most doctors will never tell people that they have Hashimoto’s, or that their own immune system is attacking their thyroid. People are told that their “thyroid is sluggish”, and that these things happen with age and “Just take this pill, you’ll be fine.” I hope you check out these articles that I wrote.
ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/
DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Melissa- There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
I have become gluten intolerant, lactose intolerant, iodine intolerant, etc., and am very careful about eating a healthy, organic diet. Could food sensitivities be preventing absorption of my Armour yet still allow it to influence my TSH levels? I am out of arguments with my doctor, but tired of feeling like this.
Leeann- Did you know that reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity in particular has been implicated in causing a Selenium deficiency, a well known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten?
Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people, will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.
FOOD SENSITIVITIES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos
AUTOIMMUNE PALEO DIET
https://thyroidpharmacist.com/articles/autoimmune-paleo-diet
Jen- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Gwen- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Jennifer- I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
Copy/paste with my symptoms. Only I have TSH now 2.5. The wierd thing when I had subclinical hypothyroidism I could function even with TSH 4. But after I was diagnosed with real hypothyroidism I feel really bad almost bed bound if my TSH is less than 1 or its more than 2. I was complaining to my doctor that my hair were falling out, and she couldnt find an explanation to it. My TSH at that moment was 2.2, and I was also considering that result as normal. And now when my TSH is 2.5 I can’t do even house chores. I was believing that I was ok with TSH from 2 to 2.5, now I think I need it to go down more. The problem is to find a doctor who would listen to you, but in Canada its not an easy thing either.
Olga – thank you for sharing your journey.❤️ I’m so sorry you are struggling with all of this. I believe that everyone needs to find a practitioner that will let them be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It’s a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
I am at a loss because I apparently do not understand how this works. If my thyroid was swollen and they prescribed medicine to help it out, why would they take and lower the meds to almost nothing when I am way below normal on the test. I asked for the T3 and T4 which they did not run.
Sandi- I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
Jayne- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Because of heart problem, they had to increase the Levothyroxin slowly. I’m now on 100mcg of Levothyroxin and still feel terrible. I’m wondering if my failing thyroid played a major part in my other health issues?
Carol- There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
Terri- Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually people with Graves have hyperthyroidism and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research in journey for overcoming my autoimmune thyroid condition.
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hara- When it comes to weight gain these are a couple of things to think about.
1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.
2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.
3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.
BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism
HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos
Gwen- Here are a couple of articles you may find interesting.
6 DIFFERENT ROOT CAUSES
https://thyroidpharmacist.com/articles/6-different-hashimotos-root-causes
INFECTIONS AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/infections-and-hashimotos/
Jennifer- When it comes to weight gain these are a couple of things to think about.
1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.
2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.
3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.
BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism
HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos
I recently had several thyroid tests run. TSH, FT4, TPO antibodies, RT3 all within normal limits. I ordered the FT3 from a chain lab. My FT3 was on the low end, but the lab considered it within normal limits at 2.7 pg/mL. I’ve read from other thyroid experts that this value is too low, however. Where do I go from here?
Jessica- I’m afraid I can’t comment on your lab results due to liability. I can tell you that while reference ranges of what’s “normal” may vary depending on the lab that produces the test reports, most thyroid patients feel best with a TSH between 0.5-2, and with Free T3 and Free T4 in the top half of the reference range. Hashimoto’s is a complicated condition with many layers that need to be unraveled. While conventional medicine only looks at each body system as a separate category and is only concerned with the thyroid’s ability to produce thyroid hormone, Hashimoto’s is more than just hypothyroidism. I wanted to pass along these articles that I wrote. I hope they help 🙂
WHERE DO I START WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/
OVERCOMING HASHIMOTO’S
https://thyroidpharmacist.com/articles/overcoming-hashimotos-in-the-new-year/
Thank you for providing such great resources!
From above, isn’t this a typo? What are the numbers that are missing? –“Anecdotally, most patients feel best with a TSH between mIU/mL.”
David – thank you for following this page. The sentence reads ” Anecdotally, most patients feel best with a TSH between 0.5-2.0 mIU/mL.”
My TSH has been running about 0.03, while taking “thyroid pro” and 2 droppers of thyroxidine. When I get off the iodine it goes to about 2.3 and ifeel very tired and unmotivated. How do I know which to back off of? And i’s it necessary with aTSH of 0.03? I have no hyperthyroid symptoms at this range and feel great
Chelsie – please, understand that due to liability issues, I am unable to answer specific medical questions.
I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
WHAT TYPE OF DOCTOR SHOULD YOU SEE IF YOU HAVE HASHIMOTO’S
https://thyroidpharmacist.com/articles/what-type-of-doctor-should-you-see-if-you-have-hashimotos
10 THINGS I WISH MY ENDOCRINOLOGIST WOULD HAVE TOLD ME
https://thyroidpharmacist.com/articles/10-things-i-wish-my-endocrinologist-would-have-told-me
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
My most recent labs are TSH of 1.9; T7 1.4; T3 uptake 25.2 and T4 5.6. I am sleeping excessively; with exercise and diet I am not able to lose weight; I am forgetting stuff like crazy; have always experienced hair loss and night sweats but most recently I like to be curled up under my blankets. I was diagnosed with PCOS in the early 90’s and have been monitored but no one can seem to figure out why I am having all these problems. My endocrinologist says my labs are normal. I had been on metformin for years but he determined that since I was not diabetic or trying to get pregnant it was no longer necessary for me to take the medication. I need some answers. Can someone here direct me further?
Ty – I’m sorry to hear that you are struggling. 🙁 Please, understand that due to liability issues, I am unable to answer specific medical questions.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
WHAT TYPE OF DOCTOR SHOULD YOU SEE IF YOU HAVE HASHIMOTO’S
https://thyroidpharmacist.com/articles/what-type-of-doctor-should-you-see-if-you-have-hashimotos
10 THINGS I WISH MY ENDOCRINOLOGIST WOULD HAVE TOLD ME
https://thyroidpharmacist.com/articles/10-things-i-wish-my-endocrinologist-would-have-told-me
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
I have been experiencing extreme fatigue, muscular and joint pains for the past 6-7 years. (When I moved to Canada from a warmer country).
In the past couple of years my symptoms have been getting worse. Chronic pains, (Being outside in the cold makes it worse) fatigue, sleepy, mind fog, memory problems, feeling sad and overwhelmed. I have had low TSH in the past and have a strong family history of thyroid issues. I begged the doctors here in Canada to examine my thyroid properly but all they do is a TSH and then brush it off saying if TSH is normal, they won’t do any further tests.
I had a miscarriage in october 2016 as well. Have PCOS as well. All the doctors here keep telling me I have fibromyalgia which has no cure just eat healthy and exercise which I have been doing recently with my symptoms getting worse day by day. I strongly feel that I have some underlying thyroid issue as well but I am so frustrated that the doctors don’t listen.
Can you please guide me how to convince the doctors to do further tests for a thorough diagnosis.
Seelobi – thank you for following this page. I’m sorry to hear you are struggling and my heart goes out to you. <3
I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
WHAT TYPE OF DOCTOR SHOULD YOU SEE IF YOU HAVE HASHIMOTO’S
https://thyroidpharmacist.com/articles/what-type-of-doctor-should-you-see-if-you-have-hashimotos
10 THINGS I WISH MY ENDOCRINOLOGIST WOULD HAVE TOLD ME
https://thyroidpharmacist.com/articles/10-things-i-wish-my-endocrinologist-would-have-told-me
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
Dear Dr. Izabella,
Thank you for creating this website as it has so much useful information and very helpful for people like me to research on the disease. I am a 32 years old lady and confirmed having Hashimoto 1 year ago. From time to time I experienced fatigue, brain fog and constipation. In my latest blood report, doctor said my T3 and T4 numbers are alright but my TSH is 3.05, which he asked me if I would like to start taking medication now. My hesitation is that if I start taking medication, will it actually signal my body to produce even less hormone (speed up the hypo process), as it may think I don’t actually need so much? Appreciate your advice. Many thanks!
Verrine – thank you for following this page.
Hashimoto’s is a complicated condition with many layers that need to be unraveled. While conventional medicine only looks at each body system as a separate category and is only concerned with the thyroid’s ability to produce thyroid hormone, Hashimoto’s is more than just hypothyroidism. I wanted to pass along these articles that I wrote. I hope they help 🙂
WHERE DO I START WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/
OVERCOMING HASHIMOTO’S
https://thyroidpharmacist.com/articles/overcoming-hashimotos-in-the-new-year
I was diagnosed with Hashimotos 4 months back after years of unexplained symptoms. I have been on levothyroxine but changed to armour due to it being natural. (My suggestion not the doctors). I still have inflammation, some days worse than others. I have been on a paleo diet, but now seeing I should cut out more stuff to be more AIP. Opinion on that? My doctor will not do anything else with me due to my levels being normal right now. Also I have a root canal tooth. Is there any way to detox out what it could be doing besides pulling the tooth?
Angie – thank you for following this page. I’m sorry to hear that you are struggling. 🙁 Please, understand that due to liability issues, I am unable to answer specific medical questions.
I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
WHAT TYPE OF DOCTOR SHOULD YOU SEE IF YOU HAVE HASHIMOTO’S
https://thyroidpharmacist.com/articles/what-type-of-doctor-should-you-see-if-you-have-hashimotos
10 THINGS I WISH MY ENDOCRINOLOGIST WOULD HAVE TOLD ME
https://thyroidpharmacist.com/articles/10-things-i-wish-my-endocrinologist-would-have-told-me
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
My 4 year old son’s labs came back with his TSH at 3.7. Is that too high? His doctor wasn’t concerned.
We have been gluten free for 3 months and minimal dairy for 2 months. He is gluten sensitive, possibly celiac.
Amanda – thank you for following this page.
Please, understand that due to liability issues, I am unable to answer specific medical questions.
I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
WHAT TYPE OF DOCTOR SHOULD YOU SEE IF YOU HAVE HASHIMOTO’S
https://thyroidpharmacist.com/articles/what-type-of-doctor-should-you-see-if-you-have-hashimotos
10 THINGS I WISH MY ENDOCRINOLOGIST WOULD HAVE TOLD ME
https://thyroidpharmacist.com/articles/10-things-i-wish-my-endocrinologist-would-have-told-me
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
Dr. Wentz,
My wife has normal T3, T4, and Low TSH… but very high thyroglobulin (1.60), high homocysteine (8.40) and high lymphocytes (53). We have gotten the run around for weeks from doctors. Her symptoms get worse daily and the last doctor said that “lots of people have your symptoms.” We are a vegan family and exercise daily (well, used to).
Where should we look next?
Richard – thank you for following this page. I’m sorry to hear that your wife is not doing well. 🙁
I highly recommend that you work with a functional medicine clinician. It’s an entire medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
I have all the symptoms of Hypo. My recent TSH is 4.36 Free T4 .70
I finally got in to see the endo Dr and she blew it off and said my symptoms have nothing to do with my thyroid. So frustrating. Weak aching thigh muscles, carpal tunnel, gained 20 lbs in 6 months, SOB, What would you recommend? Could a person have Hypothyroidism with lab values just outside the norm / Dr said they would be WAY out of range ?
Thanks
Gary – thank you so much for following this page. I’m sorry to hear that your doctor is not being helpful. 🙁
Did you know that if you live in the United States, Australia, Europe and most developed countries that add iodine to the salt supply and take thyroid medications, there’s a higher probability that you do have Hashimoto’s?
Depending on the source, estimates are that between 90-95% of those with hypothyroidism have Hashimoto’s.
But most doctors will never tell people that they have Hashimoto’s, or that their own immune system is attacking their thyroid. People are told that their “thyroid is sluggish”, and that these things happen with age and “Just take this pill, you’ll be fine.” I hope you check out these articles that I wrote.
ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/
DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
I feel like I am spinning my wheels and getting nowhere. I got my doctor to prescribe armour, grain free, b12 and working on healing my gut. Every time I go back there is a new issue. SHB 150, ANA TITER 1:40, FT3 4.8, FT4 1.2 and TSH .01. They said my thyroid is dead, low testosterone among other things. A 6 year battle with no end in site it feels like. Help!
Megan – thank you for following this page. I’m sorry to hear that you are struggling. 🙁
When I was first diagnosed with Hashimoto’s, I felt so alone. My doctor didn’t think it was a big deal, and none of my friends or co-workers had it. It wasn’t until I started to research online that I found others who were going through the same thing.
A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous.
https://www.facebook.com/groups/hashimotos411/
Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.
After 10+ years of being fatigued and sleeping 10-12 hours a night, and watching my TSH slowly rise on yearly blood tests, my TSH finally tested out of the range at 4.6 and just like you said, my doctor wants to simply put me on a thyroid prescription. Before I start the medication I am trying the protocols in your new book. Right off the bat, the B1 supplement made a noticable difference in my fatigue. My doctor did the two antibody tests and they were well within normal range. I also had a thyroid ultrasound and was told my thyroid was normal. Will the protocols help someone like me? Or should I just take the prescription and call it a day….
Christine – thank you for following this page and for your support.
Please, understand that due to liability issues, I am unable to answer specific medical questions.
There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
HOW THE DOSE OF YOUR THYROID MEDICATION CAN UNCOVER YOUR ROOT CAUSE
https://thyroidpharmacist.com/articles/the-dose-of-your-thyroid-medication-can-uncover-your-root-cause/
HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications/
Hi. Thanks for taking the time to review this question. I have benefited greatly from your recent series of videos and feel far more empowered to fight for my own health. I have hashimotos and are reducing my TSH and antibodies through a paleo diet among other things! My question relates to my 8 yr old daughter. 15 months ago she was tested for ongoing fatigue and everything was ‘normal’ – TSH 2.08. (t3, t4 ok). There have since been a few other flags but I don’t want to over-react even though she does have the predisposition. My general question I guess it; would you expect a child to have a lower TSH than that or is that still considered absolutely fine, or would you see if as warranting further investigation?
Charis – thank you for following this page, and my heart goes out to your and your daughter. 🙁
Please, understand that due to liability issues, I am unable to answer specific medical questions.
I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
WHAT TYPE OF DOCTOR SHOULD YOU SEE IF YOU HAVE HASHIMOTO’S
https://thyroidpharmacist.com/articles/what-type-of-doctor-should-you-see-if-you-have-hashimotos
10 THINGS I WISH MY ENDOCRINOLOGIST WOULD HAVE TOLD ME
https://thyroidpharmacist.com/articles/10-things-i-wish-my-endocrinologist-would-have-told-me
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
Dr. Wentz,
I have struggled with fatigue for YEARS but was never diagnosed with a Thyroid issue. I do have psoriasis on my scalp, and methylation glitches in my genes (MTHFR & COMPT). I’ve been on the Paleo diet for several years (I was VERY strict for the first two years – & did AIP as well, but have added grains and some dairy this past year & a half). I have many food sensitivities – in addition to gluten, sugar etc. corn is one of the worst for me. My hair was falling out & I had a natural practitioner (does computerized biofeedback) give me Glandular Balance Thyroid (contains raw thyroid from New Zealand Bovine). I took this for about a year, and it helped, but I still struggled a bit with my energy. The past year my once strong nails have turned very flimsy and thin (ripping off with ease), and my skin has thinned, but my hair stopped falling out. About two months ago, I went off of the New Zealand raw thyroid (wasn’t sure it was helping) and began taking a Red Seaweed formulation. I felt better at first, but am really struggling with fatigue and not exactly sure what to contribute it to – my diet additions? going off the New Zealand raw thyroid? not enough sleep?. Just had my annual physical with GYN and received blood results today: TSH 4.68 (it was 2.04 in 2015), T3 2.4, free T4 0.9, ATPO-0.4 (I wonder if the nurse meant to say 4 – results were read to me over the phone). Dr. wants to put me on Thyroid meds, and while I know I need help, I’m concerned about doing so. Do you think going back on a strict AIP Paleo would be sufficient, or do you think I need to be on a Thyroid med d/t my labs? Thank you so much for your guidance!!
Ann – thank you for following this page. I’m sorry to hear that you are struggling. 🙁
Did you know that if you live in the United States, Australia, Europe and most developed countries that add iodine to the salt supply and take thyroid medications, there’s a higher probability that you do have Hashimoto’s?
Depending on the source, estimates are that between 90-95% of those with hypothyroidism have Hashimoto’s.
But most doctors will never tell people that they have Hashimoto’s, or that their own immune system is attacking their thyroid. People are told that their “thyroid is sluggish,” and that these things happen with age and “Just take this pill, you’ll be fine.” I hope you check out these articles that I wrote.
ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/
DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all, so you will have to request them. Make sure to request a copy of your labs as well.
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Thyroid removed 3 yrs ago. Had Hashsimoto and Graves. Been on 88 Synthroid and felt fine until month ago. Am 76. Blood work seems normal except TSHR is 3.72.
Eyes being affected. Put me on prednisone. Helps a little bit. Scared because f eyesight.
MB – thank you for following this page.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead,’ or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.
Hashimoto’s Root Cause
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol
thyroidpharmacist.com/protocol
IS HASHIMOTO’S A SURGICAL DISEASE
https://thyroidpharmacist.com/articles/is-hashimotos-a-surgical-disease
i want help about my Hyperthyroidism 2 year ago me was hyperthyroidism patient then after 6 month my reports will b normal and my doctor stopped my tablets carbimazole and inderal then after my same condition again my all tests report tsh negative nd then my doctor will take same tablet’s but now 2 Month ago my all lab reports normal but my doctor says to continue tablets then I will stopped same hyperthyroidism but now I’m feeling better nd happy then I take tablets or stopped for month? any negative affect about carbimazole tablet? please tell me
I was only 21 year hyperthyroidism in my reports some Month ago my weight 38 now 47 nd I will be feel better but I’m confused then stopped tablets and same condition now my last reports of March ft4 0.91 free t3 2.80 anti thyroid peroxidase 27.9 nd serum anti thyroglobulin 20.0 . and was take carbimazole 2 tablets in morning and 2 evening and also inderal. I was patient of hyperthyroidism 2015 and now my all reports was normal then tell what I should?…
Flavia – thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions.
Graves and Hashimoto’s are both autoimmune conditions that affect the thyroid. They are thought to be closely related. Sometimes one turns into the other. The difference is the site of the antibody attack. In Hashimoto’s, the antibodies are found to thyroglobulin (in 80%) and thyroid peroxidase (TPO) enzyme (in 95% of people)-Hashimoto’s results in hypothyroidism and is usually treated with Synthroid and replacement hormone.
The same antibodies may be present in a smaller percentage of people who have Graves, but the main antibody is to the TSH Receptor (TSHR-Ab). Usually, people with Graves have hyperthyroidism, and they are treated conventionally with thyroid suppressing drugs (methimazole) or radioactive iodine to destroy the thyroid. At that point, the thyroid will no longer produce hormones on its own, and these people end up on Synthroid as well.
Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this (sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.
Hashimoto’s Root Cause
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol
thyroidpharmacist.com/protocol
Out of the blue my doctor called me to come in. I have been on levothyroxine for 25 years and suddenly my TSH is 13.55. She adjusted my dose from 1 to 1.5. How could my number jump so high i.e. 13.55?
Paula – thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions.
I highly recommend that you work with a functional medicine clinician. It’s a whole medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
WHAT TYPE OF DOCTOR SHOULD YOU SEE IF YOU HAVE HASHIMOTO’S
https://thyroidpharmacist.com/articles/what-type-of-doctor-should-you-see-if-you-have-hashimotos
10 THINGS I WISH MY ENDOCRINOLOGIST WOULD HAVE TOLD ME
https://thyroidpharmacist.com/articles/10-things-i-wish-my-endocrinologist-would-have-told-me
CLINICIAN DATABASE
http://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
If my T3 and T4 and reverse T3 are sin the normal range my TSH is always low. Usually less than 0.1. If my TSH is even close to 0.3 my T3 and T4 are below the normal range. In case of the T3 quite a bit below normal. I took synthroid for about 18 years and everything was okay. A couple of years ago my T3’s dropped like a rock. i am now taking NP thyroid. T3’s have improved but TSH still very low and doctors always going crazy. Any advice
George – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. Every six weeks is usually a good schedule for testing your thyroid hormones.
These are the recommended labs from my book, page 32.
RECOMMENDED THYROID FUNCTION TESTS
* TSH
* TPO Antibodies
* Thyroglobulin Antibodies
* Free T4
* Free T3
* Reverse T3 (Optional)
Have you read my book, Hashimoto’s The Root Cause? Here’s the link in case you’re interested:
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol:
thyroidpharmacist.com/protocol
Do you have a link to these updated normal ranges, preferably pdf’s from their respective web pages, I could show a physician? Particularly a pediatrician for a 10 year old girl presenting other symptoms of Hashimoto’s? “The National Academy of Clinical Biochemists indicated that 95% of individuals without thyroid disease have TSH concentrations below 2.5 mIU/mL, and a new normal reference range was defined by the American College of Clinical Endocrinologists to be between 0.3-3.0 mIU/mL (1)”
Thanks,
Michael
P.S. Enjoyed your books.
Michael – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. Every six weeks is usually a good schedule for testing your thyroid hormones.
These are the recommended labs from my book, page 32.
RECOMMENDED THYROID FUNCTION TESTS
* TSH
* TPO Antibodies
* Thyroglobulin Antibodies
* Free T4
* Free T3
* Reverse T3 (Optional)
Have you read my book, Hashimoto’s The Root Cause? Here’s the link in case you’re interested:
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol:
thyroidpharmacist.com/protocol
I had thyroid cancer in 2009 took both thyroids out plus the parithyroids. I had blood work this week and my TSH is 26.55 what could be causing it to be this high I’m on two kinds of thyroid meds. my energy is down to nothing having headaches short of breath.
Janice – thank you for reaching out! Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically, is ‘dead,’ or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to re-balance the immune system to prevent this (sometimes the autoimmunity can be reversed as well). The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.
Hashimoto’s Root Cause
http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20
Hashimoto’s Protocol
thyroidpharmacist.com/protocol
Hi! Good day!
I am 22 yrl old guy and experiencing the symptoms of hyperthyroidism and thinking of having a test back then. Until having a chek up on a clinic because of chest pain and panic attack, the doctor found out that im high blood and issued a request for some blood test including TSH, T3 and T4. Also my ecg result comes out with a 156 heartbeats/minute. After a day the blood test has revealed then the thyroid function test is normal. TSH 1.66 , T3 160.2 , T4 12.9. Is it possible to have hyperthyroidism with a normal thyroid test. (btw i did fasting on that test)
Francis – thank you for reaching out. Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, where the person affected may fluctuate between highs and lows.
Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.
WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
https://thyroidpharmacist.com/articles/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Dr. Izabella, i love your website and thank you for helping people with thyroid issues!
I habe been diagnosed with colloid cyst ( very small ones, the biggest one is 3mm, but there are more than 10) and the ultrasound also showed a little bit of tyroiditis, the tyroid a little bit inflammed, (that’s what my doctor said) 6 months ago my TSH was 1.8 and now my TSH is 4.5, ( i am taking Bcomplex wich has biotin, i dont know if it could be related with the change in my TSH levels) muy T3 – T4 are normal..my T3 is 101.9 ng/dL and my FT4 is 1.28
And antiTPO is negative, my doctor prescribed me levothyroxine, i wasn’t sure if it was the right thing to do so i went to another doctor for a second opinion and he said that hormones are not necesary, so now i don’t know what is the right thing to do, i am 24 yo, my nails are trrible, i have acid reflux, whater retention, i am a little bit tired (not too much), mood swings, i think that i also have leaky gut, i started following Dr Axe program a few moths ago for leaky gut , i dont eat gluten, diary, grains, in general i eat very clean.. i will really apreciate if you could help me with this desition..
Thank you very much
Maria – Thank you for following this page. Please, understand that due to liability issues, I am unable to answer specific medical questions, but I highly recommend that you work with a functional medicine clinician. It’s an entire medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms. Here are some links which might help:
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://www.thyroidpharmacistconsulting.com/clinician-database.html
MY RECENT CHALLENGES AND FINDING DR. RIGHT
https://thyroidpharmacist.com/articles/my-challenges-and-finding-dr-right/
What do you recommend for lab results that show normal TSH (1.4), T4, and Free T4, but low-end T3 and Free T3? All I hear is that these are normal results but I am very underweight and am losing hair like crazy!
Rebekah – Thank you for following this page. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. Here are the tests you need for diagnosis. Make sure to request a copy of your labs as well.
Top 10 Thyroid Tests and how to Interpret them.
https://thyroidpharmacist.com/articles/top-6-thyroid-tests
Here is another article you might find helpful as well.
SUBCLINICAL HYPOTHYROIDISM DESERVES CARE AND TREATMENT
https://thyroidpharmacist.com/articles/patients-subclinical-hypothyroidism-deserve-care-treatment/#
Hello Dr. Wentz,
Just this week I was diagnosed with Hashimoto’s (TPO = 134), and also Hypothyroidism. My TSH was 39.6, then a week later came back at 100. My doctor said he’d never seen levels that high. Starting Synthroid, been treating a separate autoimmune disorder for 3 years so diet (paleo+) and supplements pretty good. Any other advice? How does a TSH come back at 100!?!
Thanks so much! Your information is all very helpful 🙂
Emmy
Emmy – thank you for following this page. Please understand that I can’t give you a diagnosis over the internet. However, I can give you resources for you to understand Hashimoto’s and hypothyroidism/hyperthyroidism. Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, where the person affected may fluctuate between highs and lows.
Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.
WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
https://thyroidpharmacist.com/…/what-to-do-if-your-tsh…/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 6 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Good morning Doc,
Having symptoms of thyroid issues.
1100 a.m.
First TSH test: 2.62
Retested a week later.
3 p.m
TSH was 3.23
FT4 was 1.19
T3 Free was 3.24.
Could I be Hypo.. or Subclinical.? Should my TSH levels increase during the day?
I’m just looking for the possibility or do I need to look elsewhere to get relief from my symptoms. I’m sure my Doc will tell me everything is normal based on the (0.27-4.20) lab limits for TSH.
Ray – thank you for following this page. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
Here is a research article which you might find helpful also:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
I am struggling with finding a doctor that will listen to my thyroid concerns. For years I have been saying my thyroid is not working optimally, then my thyroid swelled up with four nodules. But my doctor said it was benign and my Tsh is 2.65 so they don’t want to see me for a year. I really struggle with fatigue, brittle nails weight gain, all the symptoms. T4 free is 2.15 t3 uptake is 31.5. I started taking iodine supplements and my goiter shrank but I don’t feel it’s fixing the problem.
Carly – thank you for following this page. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
Hi Izabella,
I love your story and it inspires me to make sure I will find the reason of my condition and proper diagnosis. I find very hard to get proper diagnosis from the doctors, it seems like it’s a vicious circle. I have done myself all tests that are required to see how my thyroid functions as doctors don’t want to even send me for those tests therefore I had to go to private lab and paid fortune to have them done. I have completed tests because I’m medicine freak and I was feeling tired lately and after reading some articles I came up with an idea that it’s good to check thyroid just in case and this is what I did in Poland.
My TSH is 5,220; FT3=3,06 pg/ml (Lab norm 2-4,40pg/ml); FT4=1,17 ng/dl (Lab norm 0,93-1,70 ng/dl); anty-TG=13,70 IU/ml (Lab norm 0-115 IU/ml), anty TPO <9 IU/ml (Lab norm 0-34_; Trab <0.8IU/l ( Lab norm 0,00-1,22). I ran also cortisol level ACHC test between 8-10 am and my result is 14,1 ug/dl (Lab norm 4,82-19,5 ug/dl). Sodium level: 140 mmol/l (Lab norm 136-145); Potassium: 4,49 mmol/l ( Lab norm 3.50-5.10); Calcium : 2,36 mmol/l (Lab norm 2,09-2,54); Iron: 71,0 ug/dl ( Lab norm 37-145); Glucose tolerance test with 75g of glucose drink (3 points); glucose on empty stomach in the morning :94,5 mg/dl (Lab norm 70-99); after 1 hour :110,1 mg/dl; after 2 hrs: 101,0 mg/dl. Insulin tolerance test 2 points with 75 g of glucose drink; insulin on empty stomach in the morning: 13,5 IU/ml (Lab norm 2,6-24,9); after 1 hr (43,7); after 2 hrs (32,0). Other than that my MCHC came up slightly low 32,1 g/dl ( Lab norm 32,2- 35,5). Cholesterol CHOL :139 mg/dl ( Lab norm 115-190); HDL: 67 mg/dl; non HDL : 72 mg/dl; LDL: 62 mg/dl; triglycerides: 48 mg/dl. From my results I can clearly see hashimoto and insulin resistance. My question here would be which of those came up first and which one is causing which. I’m not taking any medications yet and I’m in search for good endocrinologist as I live in Ireland, however I would like to get your opinion on it. I’m on AIP since last 3 weeks and I’m doing well. I think that Gluten, Lactose and Soya are upsetting my stomach and they were always doing it but I didn’t see the link between the fatigue I was feeling. Moreover I used to eat a lots of sweets and always felt that I need to have something sweet after meal since I was teenager. I’m 35 now and I have been always active person no alcohol no smoking always on the air. 2 years ago I had a cellulitis from nowhere and since that time it was always in my head why I had that, they ran blood test at that time and no concerns were observed except the fact that my vitamin D was low at that time. Since I’m on AIP diet I take supplements selenium, zinc, b12, d3 and drink cod liver oil. Also I drink no teas, coffees. What would be the best synthetic for my thyroid that would be gluten and lactose free. I just want to be sure that I will not end up with prescription from another doctor for levo which as I heard upsets adrenals and has gluten. Thank you for sharing your story with us
I also did ultrasound and all is ok with exception of the thyroid gland size which is 10ml and should be from 13-16ml for my age. Emilia
Emilia – – thank you so much for following this page. There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication which you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
HOW THE DOSE OF YOUR THYROID MEDICATION CAN UNCOVER YOUR ROOT CAUSE
https://thyroidpharmacist.com/articles/the-dose-of-your-thyroid-medication-can-uncover-your-root-cause/
HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications/
Thank You Izabella- is it possible to interpret my results? Is this hashimoto and graves or ”just” hashimoto?
Thank you so much for this piece, you mentioned Southern California, I was wondering if you knew of any doctors or facilities (in SoCal) who treat subclinical hypothyroidism. I’m having a hard time finding someone to help. My TSH levels when last checked were 3.18 but I’ve gained 20 pounds in the last six months, I’m tired all the time at my skin is dry I’m freezing cold have horrible brain fog, three classes of hashimotos in my family and so on and so forth. Hope you can help, thank you!
MC – thank you for reaching out. I highly recommend that you work with a functional medicine clinician. It’s an entire medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic diseases, rather than disease symptoms.
If you cannot find a Functional Medicine practitioner in your area, it is possible to work with an practitioner remotely via Skype or some other online video platform. Here are some links which might help:
CLINICIAN DATABASE
https://www.thyroidpharmacistconsulting.com/clinician-database.html
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
Hello! My TSH is 2.47, Free T3 is 2.9, and Free T4 1.30. My doctor prescribed on 30 mg of Armour. My main complaints are fatigue and brain fog. Ideally I would like to tone up but I am at a healthy weight. Does it seem reasonable to take Armour being that my numbers are in a normal range? Thank you!
Denise – thank you for sharing your journey. Brain fog is a very common symptom of Hashimoto’s. Often we are told that being confused and forgetful is part of normal aging or that we need less stress. Really, much of our symptoms including brain fog can be attributed to low thyroid hormones and food sensitivities. Going gluten and dairy free seem to be some of the most helpful interventions to help decrease or often get rid of brain fog. Fatigue was the most debilitating symptom I experienced with Hashimoto’s. It actually started 8 years before I was finally diagnosed in 2009, after I got Mono (Epstein-Barr Virus) in college. I needed to sleep for 12 hours each night to be able to function, and by “function” I mean after hitting the snooze button on my alarm clock for two hours (ask my poor husband), I would drag myself out of bed and then had to drink 46 cups of caffeine everyday to keep myself awake. I often had Red Bull and Pepsi for breakfast, and was the epitome of “wired but tired”. I hope my articles help you get started 🙂
OVERCOMING THYROID FATIGUE
https://thyroidpharmacist.com/articles/top-10-tips-for-overcoming-hashimotos-fatigue
THIAMINE AND THYROID FATIGUE
https://thyroidpharmacist.com/articles/thiamine-and-thyroid-fatigue
FOOD SENSITIVITIES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos
I stopped taking levothyroxine 25 mcg 6 months ago because of a skipped heart beat which is now normal. In sept. 2017 I was 4.59, March 2018 7.03, June 2018 13.08, all other blood test normal. I am a 78 year old male in good health except for subclinical thyroid. Would going back on levothyroxine at a lower mcg be ok to lower my TSH or something else? I have no clue what will work for me.
Thank you,
Phil – – thank you for reaching out and sharing your journey. 🙂 There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication which you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
HOW THE DOSE OF YOUR THYROID MEDICATION CAN UNCOVER YOUR ROOT CAUSE
https://thyroidpharmacist.com/articles/the-dose-of-your-thyroid-medication-can-uncover-your-root-cause/
HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications/
I was recently diagnosed with Hashimoto’s and was put on levothyroxine. After being on the medication for a month I still feel absolutely awful but my TSH went from a 10 to a .46
I feel like if I tell my doctor I still feel terrible she’ll think I’m crazy. Is it not a to still feel this bad with such a dramatic drop in TSH? Thank you!
Sarah – thank you for reaching out. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. There are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication which you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles?
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
HOW THE DOSE OF YOUR THYROID MEDICATION CAN UNCOVER YOUR ROOT CAUSE
https://thyroidpharmacist.com/articles/the-dose-of-your-thyroid-medication-can-uncover-your-root-cause/
HOW TO GET ACCURATE LAB TESTING WHEN TAKING MEDICATIONS
https://thyroidpharmacist.com/articles/how-to-get-accurate-lab-tests-when-taking-thyroid-medications/
Here is another research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Hi Dr Izabella
I came across this page looking for answers to my problem. I know you wont be able to diagnose me but i have so many symptoms. I put on 15 kg in the last year and im battling to lose despite my hardest efforts. I have falling hair ,chronic constipation, cold feet, low libido amongs others. I am 41 year old female. My recent tests are as follows
TSH 1.76 Uiu/ml
Ft3 3.3 pmol/L
FT4 11.4 pmol/L.
In your knowledge would you think i have hypothyroidism. My doctor keeps telling me my tests are normal. I will appreciate any advice. Thanks Bibi
Bibi – thank you for reaching out and sharing your journey. I am sorry to hear you are struggling. I understand how frustrating this can be. <3 Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, where the person affected may fluctuate between highs and lows. Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.
WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
https://thyroidpharmacist.com/articles/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
I feel awful, dizzy, tired, diarrhea, anxiety. My TSH is above 4 and I’m exhausted. I’m taking compound Thyroid meds but I can’t seem to get the TSH lowered. I know with Hashimoto’s we are playing a different game but man this is rough. My adrenals are fatigued I know and I’m trying to get as much rest as I can. I’ve read your book and I’m digging as deep as I can, and have implemented EVERYTHING you’ve has requested. Don’t get me wrong I feel better but the final piece has to be this TSH cause the blood work shows it. What can I do?
James – thank you for reaching out and sharing your journey. I understand how frustrating this is! <3 There are 5 stages to thyroid disease. A person with only thyroid antibodies and normal TSH is considered in Stage 2 of thyroid disease; a person who has an elevated TSH with normal T4/T3 with or without thyroid antibodies is in Stage 3 of thyroid disease; a person with elevated TSH, lowered T3/T4 with or without thyroid antibodies is in Stage 4 of thyroid disease, regardless if she/he has thyroid antibodies or not; and Stage 5 is when the person progresses to other types of autoimmune disease. You may be interested in my 12 week online program called Hashimoto's Self-Management Program that covers all of the strategies that I go through with my one-on-one clients, in a self-paced format, so that participants have access to all of the things I’ve learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. In addition, any person that goes through the program will get access to a Quick search Q&A Database of 1000+ questions asked by past program participants, Root Cause Assessment based on 100’s of my clients’ root causes and triggers, 2-week Meal Plans, recipes, and shopping lists to get you started on the following diets: Paleo, Autoimmune Paleo, SIBO, Candida. Also, Discounts on lab tests, high-quality supplements, and consultations and much more to support you in your journey! Here is a link if you would like to check it out.
Hashimoto’s Self-Management Program
https://thyroidpharmacist.com/enroll-in-hashimotos-self-management/
Here is an article you might find helpful as well:
THE 5 STAGES OF HASHIMOTO’S THYROIDITIS
https://thyroidpharmacist.com/articles/5-stages-hashimotos-thyroiditis/
Hi Dr. Izabella,
I have followed you for a long time, but never really payed much attention to my thyroid levels. In the past year, however, I have had some changes and finally went to get some tests run. I am slightly confused by the measurement units. These are my results:
TSH – 3.13 mIU/L
Free T3 – 2.6 pg/mL
Free T4 – 1.0 ng/dL
Thyroglobulin <1 IU/mL
Thyroid peroxidase – 2 IU/mL
The units are different from the ones you use, so not sure how to read this.
Can you please clarify for me. BTW, still waiting on Reverse T3. Any suggestions on what to look for? I am 52 yrs. young, if that helps!!!
Thanks so much for all you do! I appreciate any feedback.
Lynn
Lynn – thank you for reaching out and sharing. <3 Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it's important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. Here is a research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Dr. Izabella,
Thank you for responding. I will definitely be in touch with a functional medical practitioner to address this.
I appreciate your feedback.
Lynn
Hi there,
I would love your opinion and thank you in advance. A couple months ago I experienced anaphylaxis from an antibiotic. I was put on large doses of prednisone post epinephrine and everything settled down just fine. Weeks later I received my flu shot and from that same day on, everything has been out of whack. All my symptoms point to hyperthyroidism including weight loss (15 lbs in the past month despite being smaller framed from the start), irregular menstrual cycles, fast heart beat, incredible anxiety and panic attacks (never have suffered from mental illness in my life), tightness/pressure in my neck and throat. My doctor ran my TSH and it was 1.25, and two months prior it was 0.91. I pushed my doctor for a thyroid ultrasound which he agreed to once he palpated and noted it felt enlarged. The ultrasound found: 0.4 cm cystic nodule along the right lateral aspect, along with a cystic, possibly
spongiform 3 mm nodule in the left thyroid lobe. My doctor says these nodules are likely nothing and notes there is no need and point to do anymore thyroid testing than TSH as that will tell us everything we need to know. I can’t help but to continue to feel something thyroid related is going on but I don’t know how much more I should be pushing. Thoughts? Thanks!
Ashley – thank you for reaching out and sharing your journey. <3 I understand how frustrating this can be. Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, where the person affected may fluctuate between highs and lows.
Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range. Here are some resources you might find helpful.
WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
https://thyroidpharmacist.com/articles/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but/
THYROID NODULES
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-nodules/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Dr Izaella,
I was diagnosed with Hypothyroidism in 2012. Since then I’ve been on .25mg of Synthroid and yearly have my numbers tested. Throughout the years I have gone through periods of the symptoms of hypothyroidism and my labs come back within “normal” range, but I still feel the symptoms of an out of whack thyroid.
This past few months have been worse, fatigue, hair loss, chilly, memory problems, aches, clumsiness, feeling down, etc.
I saw my doctor again, did labs and in the meantime got him to do a slight bump in the Synthroid, I just started taking a half of a .75mg pill, so 37.5mg. I’ve only had this one day.
My recent labs came back as:
Thyroid Stimulating Hormone [TSH] is 1.74
Thyroxine Free [Free T4] is 14 pmol/L
Triiodothyronine Free [Free T3] is 2.7 pmol/L
I’m sure my doctor will say all is within normal range. But is it normal range? Online everyone has a different idea of “normal”
Will, it hurt to try this slightly higher dose for a while and see if my hair and skin and fatigue ease up? I don’t want to take a higher dose if it could do harm in the long run.
I just know I feel awful and remember this was the feeling back in 2012 when I was first diagnosed.
Thanks for the help.
Gina
Gina – thank you for reaching out. I am so sorry to hear your are struggling with all of this. <3 It is never advisable to stop taking your medications, or alter your dosages, without the advice of your practitioner. T4 thyroid hormone medications have a half-life of about 1 week. This means that when a person stops taking them, the amount of the hormone activity in their body, from the medication, will decrease by about 1/2 each week. For T3 medications, this half-life is only about 1 day. Generally, within three weeks (or a few days for T3), most of the hormone will be out of the body. This could result in increased symptoms, an increase in the autoimmune attack on the thyroid, and extra stress on your body and the thyroid.Thyroid hormones affect every organ, tissue and cell in the body. Appropriate medication management will allow you to recover from the effects of hypothyroidism, giving you the energy, vitality and support to continue working on optimizing your health. Please do not change your medications without speaking to your doctor first.
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
Hi Izabella. Thanks for all your great work!
I’m confused by your chart above though. You show Free T4 & Free T3 reference ranges in pmol/L. My labs come back using pg/ML so your numbers make no sense to me. For example, T3 ref range is 2.0 – 4.4 and T4 is .82 – 1.77
All my numbers have been off the charts since I figured I had Hashimotos in April 2018 and demanded all the tests your recommended. I’m on my 3rd doctor trying to get my med ironed out after being on Levothyroxine for 20+ years misdiagnosed with Hypothyroid. Finally found a Japanese DO last month who is awesome and finally a doc who read your book! A patient gave it to her & she actually read it. how refreshing!
I have 3 nodules on my Thyroid and ever increasing Armour is not helping after 9 months. TPO at 253 and antibodies 103.7! With T4 at .77 and me feeling miserable, she’s adding 25-50mcg of Levo back in plus DHEA & D3+K2. My B12 was off the charts high & all else normal so go figure. I’ve cut out almost everything in my diet so we’re going to do food test & gut, etc next visit.
Anyway, if you could clear up the reference measurements for me I’d so appreciate it. And thanks again. You’re such a lovely person & a Godsend! xoxo
Kelly – thank you for reaching out and sharing your journey. I am happy to hear you have found a practitioner and are taking charge of your health. <3 Different labs will have different ranges, a good general guideline is to get your Free T4 in the top half of the range, your Free T3 in the top half to top quarter of the range and your TSH around 1.5 or below. I hope that helps! Please keep me posted on your progress.
Hi Dr. Izabella. I am at my wits end. I have had symptoms for going on 10 years. I am seeing an endocrinologist tomorrow, however this whole experience has made me reluctant to trust doctors as too many are quick to label you a hypochondriac or as having the dreaded diagnosis of general anxiety disorder. I referred myself because I have Anti Tpo in the thousands, TSH is normal at 3.05 and Free T4 is 0.95. My CRP is elevated at 1.9. I also suffer from low Ferritin (IDA) Vitamin D Deficiency, carpal tunnel syndrome, and psoriasis. I have fatigue, muscle cramps, shortness of breath, palpitations, and i’m puffy. My face is especially puffy and greatly affects my self- esteem. My family doc is not concerned with thyroid function. I feel like I have Hashimoto’s and would benefit from treatment. Any advice would be greatly appreciated.
Angela – thank you so much for reaching out and sharing your journey with me. <3 I am so sorry you are struggling with all of this. Hashimoto’s is often a combination of food sensitivities, nutrient deficiencies, adrenal issues, gut issues as well as an impaired ability to get rid of toxins. Any of those things would prevent a person from getting better.
Hashimoto's is very much an individual condition. While there are root cause commonalities, each person will have their own or in some cases, more than one root cause. You will have to start with the simplest modifications, by removing triggers, followed by repairing the other broken systems to restore equilibrium, allowing the body to rebuild itself. You will need to dig down to why the immune system is imbalanced in the first place and this will tell you how you begin to finally feel better, reduce your thyroid antibodies and even take your condition into remission.
You will have to create your own health timeline. Look back at your overall history as far back as you can remember. Look for infections, periods of severe stress, the use of medications (especially antibiotics, antacids, and oral contraceptives), accidents, and exposure to toxins. These are events that may have contributed to Hashimoto's. Once you do, you will know what types of changes you need to implement to make yourself feel better.
If you need further support, please check out the list of lab tests inside the “Testing” chapter of my book, Hashimoto’s Root Cause. I also offers a 12-week program, Hashimoto's Self Management Program. I hope this helps!
BUILDING YOUR OWN HEALTH TIMELINE
https://thyroidpharmacist.com/sample-health-timeline/
Hashimoto’s Self-Management Program
https://thyroidpharmacist.com/enroll-in-hashimotos-self-management/
I just had blood work done at rheumatologists office for sjogrens syndrome..the last two years my tsh has been below 2.5 but on my new test it was 4.36…should I get more testing done for hypothyroidism ? Thanks
Janice – thank you for reaching out. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones.
These are the recommended thyroid function tests from page 32 of my book:
– TSH
¨ TPO Antibodies
¨ Thyroglobulin Antibodies
¨ Free T4
¨ Free T3
¨ Reverse T3 (optional)
¨ Thyroid Ultrasound (optional)
Here is a research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
This is a really helpful article and I wonder if you could give me some advice – I have a history of Graves treated with ATDs in 2014/2015. I fell pregnant during this time and had my daughter Sept 2015. In Jan 2016 I was put back onto the Cilest pill which I then took until Oct 2018. Yearly blood tests in that time all showed normal range results off TSH and T4 (I have never had T3 tested despite requesting it).
I have been off Cilest since Oct-18 and had 4 blood tests in that time due to feeling like my Graves was returning. The results were:
6th Dec – Serum TSH level (XaELV) 2.44 miu/L [0.27 – 4.2], Serum free T4 level (XaERr) 16.1 pmol/L [12 – 22]
26th Feb – Serum TSH level (XaELV) 1.4 miu/L [0.27 – 4.2], Serum free T4 level (XaERr) 16.2 pmol/L [12 – 22]
21st Mar – Serum TSH level (XaELV) 0.7 miu/L [0.27 – 4.2], Serum free T4 level (XaERr) 18.5 pmol/L [12 – 22]
30th Apr – Serum TSH level (XaELV) 0.7 miu/L [0.27 – 4.2], Serum free T4 level (XaERr) 16.2 pmol/L [12 – 22]
I’m confused about the Apr results as before then I can see a definite trend towards Graves, my doctor is reluctant to keep giving me blood tests and won’t refer to an endocrinologist despite my history. Estrogen and testosterone levels also fell in the “normal” ranges on all tests. Should I be pushing for another test in 5 weeks? Despite my “normal” results I have extremely light periods that last 1-3 days at most which is what alerted me back in 2014 as I was also obviously infertile at that time and the same is happening again now. At present I don’t have any tachycardia but my hair is falling out, my skin is dry, my nails are weak. Doctor just doesn’t seem to take that on board and I don’t know what to do next!
Sorry, that Apr result should be Serum TSH level (XaELV) 1.25 miu/L [0.27 – 4.2], Serum free T4 level (XaERr) 16.2 pmol/L [12 – 22]#
I should also add i am now not taking any medication at all.
Rebecca – thank you so much for reaching out and sharing your journey. I am so sorry you are struggling with this. <3 Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it's important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. Here is a research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It’s a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
Thank you for your reply. It is very frustrating as I feel I am being blocked by my GP to access to an endocrinologist; I am no longer under their care as my Graves has not been active for over 3 years. I have spent a fair amount of time looking online and speaking with others in my family who have also suffered with Graves/thyroid problems and cannot find anything to suggest why my TSH would nosedive over the course of 4/5 months then suddenly ruse back up – I did think it may be related to coming off of the Cilest contraceptive but the connections I find to that are tenuous at best. Something I did read is that people with a history of Graves should ideally not be prescribed a hormonal pill but my GP did not seem bothered by my history. I am going to wait and see what happens with my menstrual cycle this month and then if my period is still not normal, ask GP for another set of blood tests and go from there. Thankfully I do have private healthcare if needed so will use that if I have to. Thanks again for taking the time to reply to me. Rebecca
Yeah!!!! Just got my thyroid panel back. I had taken your on line course and using the gradient chart tool included for determining if you were or were not converting T4 to T3 properly. After presenting all the info to my endo, we have finally gotten the gradient chart to look optimal by adjusting my meds down. I can’t believe how much more Synthroid I was taking than I needed! My TSH is also optimal for my age and I feel so much better! Thank you so much! Still working on the antibodies, but they too have come down.
Jane – thank you so much for sharing your journey! I am so happy to hear your are feeling so much better! Please keep me posted on your progress. <3
Hi. I’m taking uthirox for more than a year- after TSH came out 15.4
Now the TSH came out 1.08 – which is supposed the be normal but I’m feeling so bad- I’m so exhausted after sleeping 10 hours at night+ 2 hours doring the day. I feel like I live in a cloud of tiredness (Normally 7 hours at night were enough)
I don’t remember basic things. I’m very confused- get mixed up about everything. I forget what I’m doing. I hold things in my hands and don’t remember that I put them down and where. I’m 27.
My hair is falling out.
and I started sweating- it’s winter in the place where I live.
I don’t know what to do. I thought the TSH is going to come out bad but it didn’t.
I’m healthy besides the TSH problem
Nechama – thank you for reaching out and sharing your journey. I’m so sorry to hear you are struggling with all of this. <3 Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, where the person affected may fluctuate between highs and lows. Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range.
WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
https://thyroidpharmacist.com/articles/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but/
Here are the tests you need for diagnosis. Most endocrinologists don’t run them all so you will have to request them. Make sure to request a copy of your labs as well.
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Hi Dr. I found your site due to my ongoing search for answers on my declining health and being told all if fine by several Dr.’s for many years. I will try to make this as short as possible. I had a hysterectomy at 43 due to fibroids about two years later I started having hot flashes off and on and memory fog. Every time my hot flashes would return they were worse and lasted longer. My tinnitus has gotten worse, anxiety, fatigue, insomnia, overall body aches, memory loss/fogginess has all progressed. I now have terrible chills, some due to hot flashes but others just come on without a flash. I always have had hormonal problems as per Dr’s and now they blame menopause. I am now 51 and feel I can’t go on like this.
I’ve had my thyroid checked and have always been told it’s not yet I feel I have all of the symptoms. I have a sister who has been in Synthroid for many years. I went to a new Dr. and she said I had subclinical hypothyroidism and put me on low dose Synthroid. My number were TSH 1.50, Free T4 1.0 Free T3 3.1. I was taken off the medication shortly after starting due to a reaction I had to another medication thinking it was the Synthroid. Now a new Dr. took over and he did a TSH W/REFLEX TO FT4 resulting in 1.30. He says all is normal. Not sure what to do. Please let me know what your thoughts are on this. I understand you are limited on what you can advise but any help would be greatly appreciated.
I have done a ton of research and have read a lot of your postings but I am confused and stressed and with my mental health declining it is just making things worse. Really trying not to give up but there are days when that’s all I feel like doing.
Ily – thank you for reaching out and sharing your journey. I’m so sorry you are struggling with all of this. I do understand how hard and frustrating this is! I do suggest that you join one of the Hashimoto’s groups that are out there. Being able to share ideas of what has worked with one another and offer support for each other can be very helpful. A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 45,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another. The comfort I received from knowing that there were others going through the same challenges as I, was enormous. Ask questions. Post your thoughts. Scan the files. It is an absolutely amazing resource. Best of all it’s kept private from spammers.
https://www.facebook.com/groups/hashimotos411/
Here are some resources you may find helpful as well:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
PATIENTS WITH SUBCLINICAL HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/patients-subclinical-hypothyroidism-deserve-care-treatment/
ESTROGEN DOMINANCE AS A HASHIMOTO’S TRIGGER
https://thyroidpharmacist.com/articles/estrogen-dominance-as-a-hashimotos-trigger/
HORMONE REPLACEMENT THERAPY
https://thyroidpharmacist.com/articles/hormone-replacement-therapy/
Hi!
I am looking for help!! I have hashimoto’s and hypothyroidism. diagnosed in the last year. and it has been a complete gong show. while my levels became normal relatively quickly, I still felt like crap and was sure it was something MORE than just hypothyroidism. when the doctor finally tested my antibodies they read 101. at last check in at the end of last year, they were down to 80.
while i’m still experiencing some issues, they are better. i’m curious to know if anxiety is a symptom of high antibodies? it seems to hit me out of the blue sometimes. is there a magic number for where my antibodies to be so that I will start to feel better?
I feel like my doctor just discounts me and everything I say and just that i’m an anxious person. for the record, I have NEVER struggled with anxiety (until now) and am just wanting to feel like my old self. will that ever happen?
I also have been told and researched that female contraceptive – ie. the mirena – has been reported to cause thyroid issues. I wish we could find out whether that was accurate or not.
any help or support is greatly appreciated!
Tara – thank you so much for sharing your journey. <3 I understand how hard this is. <3 Anxiety symptoms are very common in people with thyroid disorders. Here are a couple articles you may find helpful:
AUTOIMMUNE THYROID DISEASE AND ANXIETY
https://thyroidpharmacist.com/articles/autoimmune-thyroid-disease-and-anxiety
ARE YOU GOING CRAZY OR IS IT JUST YOUR THYROID
https://thyroidpharmacist.com/articles/are-you-going-crazy-or-is-it-just-your-thyroid
My tsh is 74.6 and antibodies is <600 I have been in meds for 3 months now and still no change.
Melissa – thank you for reaching out. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. Here are some articles I hope you find interesting:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
WHERE DO I START WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/
OVERCOMING HASHIMOTO’S
https://thyroidpharmacist.com/articles/overcoming-hashimotos-in-the-new-year
Thanks for this, it is really useful
Based on your outline it seems like my TPO is too high, at a marker of 12.4
kIU/L and possibly my TgAB, which is at 10 kU/L. All other results were in the optimum range.
I’m fairly new to this, but I have been improving my knowledge on thyroid via your great site. I still need a little help….Is there a specific thing I should be focusing in to lower the TPO and TgAB? Any article you can show me would be perfect. Thanks so much
Henry – thank you for reaching out. <3 About 95% of people with Hashimoto's have elevated Thyroid Peroxidase Antibodies, while 80% will have elevated Thyroglobulin Antibodies. They can both be important in monitoring the autoimmune attack on the thyroid, and can both be used to monitor the effect of interventions. Some interventions will lower TPO antibodies more, while others will have a greater effect on TG antibodies. This can depend on the individual and their body's response. Some people with Hashimoto’s test negative for thyroid antibodies because their overall immune health is so weak, they do not produce enough antibodies. I tested negative for antibodies several times. Now, I insist on a thyroid ultrasound. A thyroid ultrasound can be used to detect changes in the thyroid, associated with Hashimoto's. Given that Hashimoto’s is one of the leading causes of hypothyroidism worldwide, it's best to be certain, one way or another. I have written several articles about how to best decrease thyroid antibodies.
Here are some articles I think you might find helpful:
HASHIMOTO'S AND THYROID ANTIBODIES: PART 1
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-antibodies/
HASHIMOTO’S AND THYROID ANTIBODIES: PART 2
https://thyroidpharmacist.com/articles/part-2-mechanisms-reduce-thyroid-antibodies/
When doing thyroid panel blood work, is it best to take your thyroid medications (like synthroid) in the morning before the tests? I have always been told to take the med before testing but not sure what’s best for accurate results.
Thank you.
Lee – thank you for reaching out. <3 If you are taking a T4 only medication, you can go ahead and take your medication in the morning before the test. T4 medication has a long half-life, and your levels will be stable regardless of when you take it. If you take a T3 medication on the other hand, or a combination of T3/T4, T3 has a shorter half-life so your blood work may not be reflected accurately. It will appear that you have more thyroid hormone on board than you do. Thus it may be helpful to delay your morning dose of a T3/T4 medication until after you do the test to see (try to schedule the test in the morning). Here's a resource you might find helpful:
OPTIMIZING MEDS
https://thyroidpharmacist.com/checkout/?product_id=4702
Hello!! All the women in my family have hypothyroidism (including me). My son is having growth problems and the Doctor says his thyroid is fine (and everything else too). Im very scared to give him the growth hormone shots, but is the only solution they gave me, so I’m researching more options! Can you please advice me which are the best thyroid levels in kids?? Thank you so much!!
Hi Laura, thank you for reaching out and sharing your son’s journey. <3 My heart goes out to you both. The same labs used to diagnose thyroid disease in adults can be used for children. However, the lab values and reference ranges to look for may differ. My research is based on adults so I cannot provide information for children/babies; please consult your doctor for pediatric thyroid testing. Here are the tests you need for diagnosis. Most endocrinologists don't run them all so you will have to request them.
¨ TSH
¨ TPO Antibodies
¨ Thyroglobulin Antibodies
¨ Free T4
¨ Free T3
¨ Reverse T3 (optional)
¨ Thyroid Ultrasound (optional)
Here is a research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
I do suggest that you work with a functional medicine doctor that is familiar in working with children. I hope this helps!
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
Good Morning Dr. Wentz,
My doctor’s assistant just called to say my thyroid test came back normal except for my TSH…my level is 91. I am already aware that I have Hashimoto.
During my quarantine, I stopped taking Levothyroxine as my hair was falling out, fatigue and overall feeling bad. After the withdrawal period, I feel very good.
Since taking the Levothyroxine, I have changed my diet to plant based food, take my thyroid med (60mg Armour) 1 hr before eating or drinking water. I have omitted soy, gluten, dairy, & non-gmo from my food diet and supplements.
With all the above information, any suggestions in how to reduce my TSH?
Kenda – thank you for reaching out. <3 Unfortunately, most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. However, this test can often times be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, the person affected may fluctuate between highs and lows. Additionally, when scientists first set the “normal” ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations leading to an overly lax reference range. This resulted in people with underactive thyroid hormones being told that their thyroid tests were “normal,” based on this skewed reference range. Here are some articles which might help:
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
ARE YOU GOING CRAZY OR IS IT JUST YOUR THYROID
https://thyroidpharmacist.com/articles/are-you-going-crazy-or-is-it-just-your-thyroid/
Thank you for replying so quickly. I stopped taking Levothyroxine and feel great; however, my TSH is 91. I am still taking Armour 60mg. I was taking Armour and Levothyroxine together and when I stopped Levothyroxine, my TSH increased to 91. Is there an alternative drug to Levothyroxine? Thank you!
Hi Kenda, there are quite a few options for thyroid medications. In my experience, what works for one person may not work for another. If your doctor will not prescribe the medication which you are looking for, ask your local pharmacist for doctors in your area who prescribe the medication you are looking to try. Have you read these articles? <3
WHICH THYROID MEDICATION IS BEST?
https://thyroidpharmacist.com/articles/which-thyroid-medication-is-best/
TOP 11 THINGS YOU NEED TO KNOW ABOUT THYROID MEDICATIONS
https://thyroidpharmacist.com/articles/top-11-things-you-need-to-know-about-thyroid-medications/
HOW THE DOSE OF YOUR THYROID MEDICATION CAN UNCOVER YOUR ROOT CAUSE
https://thyroidpharmacist.com/articles/the-dose-of-your-thyroid-medication-can-uncover-your-root-cause/
Hi! I love reading your articles. Just bought 2 of your books <3
My free t4 is 11.6 pmol/l and total t4 is 66 nmol/l, reverse t3 is 0.25nmol/l. The doctor says this is all within 'normal range' but I disagree and after looking at the optimal range guide it seems to me that I have an underactive thyroid. Any suggestions? Thanks, Nadine
Nadine – thank you for reachng out. <3 Hypothyroidism is associated with a lack of thyroid hormone that can occur as a result of a variety of different factors such as iodine deficiency, surgical removal of the thyroid, or damage to the thyroid. Hashimoto’s is an autoimmune condition that results in the immune system damaging the thyroid, which leads to a lack of thyroid hormone production. Most cases of hypothyroidism in the United States and other countries that add iodine to their salt supply are caused by Hashimoto’s. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. Here are a couple articles I hope you find helpful:
ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/
DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/
I am having migraines that are painless but cause stroke like symptoms, possibly with a-typical seizures, hot flashes, the hormones of a pregnant woman, fatigue, insomnia and now muscle cramps in my legs.
I have seen an ENT who wants an MRI, but recently went to my GYNO to see if this could be hormone related. He told me that if that were the case my periods would be off. they are extremely regular (for the first time in my life) after having 3 kids and my tubes taken out. they are awesomely light and last maybe 4 days.
My T4-Free came back 1.0
My TSH came back 1.08
Although this is in the normal range I just don’t understand the results. they seem low with the “normal range”
Candice – thank you for sharing. I’m so sorry you are experiencing all of this! ❤️ Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms. Here are some resources I hope you find helpful:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
Hello
I write to you from Spain
I have the Spanish version of your book on Hashimoto’s disease and it seems to me a fantastic guide to understand and improve the health of people who suffer from this pathology
Pascual – thank you so much for sharing! ❤️ I’m so glad you are finding my research helpful and I hope you will keep me posted on your progress.
HI. I think my comment may have been deleted. Anyway. I have Hashimoto’s. Long story short is I also have very high cholesterol. Last year my TSH was 2.0 and cholesterol was high at 240. However, my recent TSH was 3.6 and cholesterol shot up to 330. I asked my dr about the correlation and said I prefer to get my TSH down to 1-1.5. He said my thyroid is “normal” and wants to put my on statins which raise my blood sugar. Common sense tells me to lower TSH first then do statins if need be. Am I wrong here? thank you..
John – thank you for reaching out. Elevated levels of cholesterol can be a symptom of Adrenal fatigue and can be due to the body compensating for the increased need for this hormone-building material. Most people with Hashimoto’s are likely to have numerous signs of adrenal dysfunction as a result of chronic stress and anxiety. I highly recommend that you work with a functional medicine clinician. It’s an entire medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic disease rather than disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
http://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://www.functionalmedicine.org/practitioner_search.aspx?id=117
Hi, I have been dealing with Hashimoto’s since the birth of my first child nearly 5 years ago with a wide range of symptoms however it was only finally diagnosed 3 years ago. Last year they took half of my thyroid out as I had a tumour on it that kept growing and the biopsies kept coming back as one to watch after the 5 the biopsy they decided it was time to remove half of my thyroid as it could turn cancerous and I’m only 31 at the time. Ever since then my symptoms have been worse I’m on T4 medication and my last blood work my Doctor done was TSH of 0.15 and T4 of 14.3, they never tested my T3. I’ve tried everything from the antidepressants to the anxiety medication as I was told to keep an open mind about my symptoms and not just blame my thyroid. So I took the medication and took allergic reactions to it so came off them. I’ve now fought with my endocrinologist to take me more seriously as I’ve been suffering very badly from anxiety, mood swings, joint pain, weight loss, weight gain as it can fluctuate. Even hair loss, brain fog and insomnia to name a few. He even went as far as to tell that having kids can causes anxiety and nothing to do with my thyroid condition! Even though this all went hand in hand I went from being a very fit active person to becoming very ill and dizzy after playing with my children after 30 mins. So he has agreed to try me in a mix of T4 and T3 medication to see if it makes a difference. I have been gluten free for 3 years now and have recently cut out dairy which has helped with my gastritis immensely. So my question is, the levels of TSH 0.15 and T4 of 14.3 normal? As I keep getting told they are. I have high antibodies and my thyroid inflamed as angry looking as it was put to me when I was diagnosed with Hashimoto’s 3 years ago.
I am reading your books currently and intend to take your course as well as paying £200 to sit and listen to a condescending ‘specialist’ is not worth my time and money that I wasted last week seeing the endocrinologist when I can learn from someone who has been through it like yourself.
Laura – thank you for sharing your journey. ❤️ I’m so sorry you are struggling with all of this. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Please feel free to email my team at info@thyroidpharmacist.com if you have any questions about my protocols and they will be happy to help. Here are some articles you might find helpful as well: T
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
HASHIMOTO’S AND THYROID ANTIBODIES: PART 1
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-antibodies/
HASHIMOTO’S AND THYROID ANTIBODIES: PART 2
https://thyroidpharmacist.com/articles/part-2-mechanisms-reduce-thyroid-antibodies/
Hello I am 66 year old female and in May my T4 free was 0.9 and TSH 3.73 and T3 free was 2.8. I just had a test done 7-29-21 and T4 free was 1.2 and TSH was 2.37 and T3 free was 3.0. Am I doing better or worse?
Thank you.
Jane – thank you for reaching out. ❤️ Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. Here is an article you might find helpful:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Hi I have got hypothyroidism on 200mcg my doctor say my levels still arnt right after 9 1/2 years but last few week I am in pain with my spine and knees, my muscles are weak, tingling in my hands, tired all the time swelling in my neck struggling to breathe cause of it my voice has gone croaky can anyone give me any advice please
Sarah – thank you so much for following. ❤️ I’m so sorry you are struggling with all of this. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms. Check out this article:
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
Your books, website and emails have been a lifesaver – both for me and my daughter. I am 6 years post thyroid cancer and thyroidectomy, and started treatment for tick infections a year ago. My thyroid labs are unprecedented: negative antibodies but a TSH level of 94 with a t4/t3 ratio of 41.25. I’m being told that it’s normal, and that I shouldn’t consider the TSH level at all, just the ratio, which should be higher than 20. Still, I’m concerned and would love to have your opinion. Thank you!
Susan – thank you for reaching out. ❤️ Removing the thyroid with a thyroidectomy eliminates thyroid antibodies, as there is nothing left to attack. However, life is not always roses with a thyroidectomy, as it does not remove the autoimmunity. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. Here are some articles you might find interesting:
IMPORTANCE OF GUT HEALTH
https://thyroidpharmacist.com/articles/importance-gut-health/
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
WHERE DO I START WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/
Hi Dr. Wentz,
My peroxidase levels went from 122 to 71, but my TSH stayed the same at 3.7.
I have a few other things going on as well – maybe related. My ferritin levels are 24 (taking 130 mg of iron a day), my b-12 is over 900 and my platelet count is slightly low at 128.
Any idea of why my TSH may not have lowered if my antibody count went down?
Thanks in advance!
Dee – thank you for reaching out. ❤️ When the TSH is between 2.5 and 10 μIU/mL and T3 and T4 is within normal limits, this is known as subclinical hypothyroidism (at this point, people may or may not have thyroid antibodies). Here is an artice I hope you find helpful:
https://thyroidpharmacist.com/articles/patients-subclinical-hypothyroidism-deserve-care-treatment/
Hello Dr. Wentz. I am a 51 year old female who had been “sickly” my whole life and has not been treated properly by people in the medical field. I have a laundry list of issues, but I believe my thyroid being off is one of the main issues I have yet my test come back ok, my THS is 1.6 -2.2 my t3 is 144 my t4 1.2 . My doctor says its normal, but I have every issue of Hypothyroidism. I have been looking into adding selenium, Magnesium and iodine supplements to my diet but I keep second guessing myself. How do I find the right amounts o each to take? can I take these along with a multi vitamin? How do I find a doctor who doesn’t dismiss my symptoms? I am worried my daughter also has it, but she sees me get dismissed by doctors and doesn’t want to bother going to do test so I need to find someone who will hear us both.
Thank you
Sandra – thank you for reaching out. I understand how hard and frustrating it is to find the right practitioner for you and your daughter.❤️ I believe that everyone needs to find a practitioner that will let them be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It’s a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
Hi there, I just had bloodwork done and the doctor called and said I was in normal range. When I looked at the TSH, it says .04 and that appears to be out of range (I’m wondering if they misread it?). Free T4 is 1.3 and I’m on 137mcg of levothyroxin, which I think may be too much. All my other labs are pretty much okay with just a few being ever so slightly out of range (we’re talking within 3-5 points – so nothing alarming).
My issue is that I am hungry ALL THE TIME! I eat a health meal and an hour or two later I am starving again. I’m not losing weight (even though I am trying to!), so I don’t understand why I am so hungry.
Charlene – thank you for following. You may want to consider what you are eating at your meal to be sure you are balancing your proteins, carbs and fats. Here are some articles that I hope are helpful as well:
BEST DIET FOR HASHIMOTO’S HYPOTHYROIDISM
https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism/
MTHFR, HASHIMOTO’S, AND NUTRIENTS
https://thyroidpharmacist.com/articles/mthfr-hashimotos-and-nutrients/
Hello. I am a 50 yo male. For the last 6-7 years my TSH has been between 2 and 4, with Free T4 between 1.5-1.8. Levothyroxin at 137 mcg the entire time. I have always felt fairly well physically other than having general anxiety. A year ago I was at 2.11 TSH, 1.8 Free T4. However, starting around 5-6 months ago, I have started to notice palpitations (maybe I’ve always had them, but recent ECG confirmed PVCs) and I routinely feel my heart pounding. Blood pressure and pulse are normal. I am a little agitated and tire somewhat easily during exertion. I just had another blood test and my TSH is at 1.01, which is very low compared to my past results. Free T4 is still at 1.8. Even though my TSH and T4 are in “normal” range, could the palpitations and other symptoms be due to the TSH being too low for “my normal”? My doctor is now lowering my prescription to 112 mcg. Thank you in advance.
Jeff – thank you for reaching out. Most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones.
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-10-thyroid-tests/
WHAT TO DO IF YOUR TSH IS NORMAL AND YOU ARE ANYTHING BUT
https://thyroidpharmacist.com/articles/what-to-do-if-your-tsh-is-normal-and-you-are-anything-but/
I am 78 years old and continue on bHRT-biest [E3/E2 (40/60)/gm cream/.25gm topical); bloodwork estriol .03ng/ml, estradiol 36.8pg/L] and thyroid (sublingual) compounded meds. Stopped testosterone and dhea because of ovarian cyst growth, being monitored. I have done well through the years with a few ups and downs.
Recently, been having a return of CFS and Fibromyalgia/muscle aches/cramps symptoms that meds usually helped. I continue with my very disciplined whole foods eating routines doctors put me on years ago, plus exercise. My recent bloodwork is T3 3.8pg/ml, T4 1.02ng/dl (TSH 1.9UIU/ML, FSH 76.7IU/L, LH 50.7IU/L, TPO <1, TGO<1). Converting to pmol/L via http://www.endmemo.com/medical/unitconvert/ results show T3 .0585pmol/L, T4 13.1274pmol/L. Are these converted correctly and relevant to make some changes with my thyroid meds based on your optimum T3/T4 ranges? Doctor raised my T4 last time saying I seem to have some T3 resistance. Will be talking with my doctor next week. Your input appreciated.
Sharon – thank you for reaching out! I’m so proud of you for taking charge of your health and doing your research. Different labs will have different ranges, a good general guideline is to get your Free T4 in the top half of the range, your Free T3 in the top half to top quarter of the range and your TSH around 1.5 or below. Here is an article I hope you find helpful
TOP 10 THYROID TESTS AND HOW TO INTERPRET THEM
https://thyroidpharmacist.com/articles/top-10-thyroid-tests/
Hi Dr. Wentz
I’m a 24 yr old female and I’ve gained 50 pounds in the last 2-3 years (30 lbs of which occurred in the last 6 months). My hair is brittle and falling out, I’m exhausted all the time. I’m having digestive issues. I already keep a mostly Gluten Free diet. Last february, my TSH was 1.49. On friday, it tested as 4.77. It should be noted my doctor would not order a full panel because according to her, insurance will not cover it. My aunt (mother’s older sister) has Hashimoto’s. The doctor once again said my levels are normal (though she said my thyroid appeared enlarged and ordered an ultrasound, which I will be getting in 2 days). She was pretty dismissive of all my symptoms, chalking it up to depression (I have a diagnosed clinical history of depression and anxiety) which feels inaccurate. I’m in grad school (which is stressful, but I am passionate about what I’m studying and doing), I just moved in with my boyfriend of almost 4 years, I’ve got friends and a supportive family. I know what depression feels like; that doesn’t seem the best explanation. My feelings of depression are directly related to how uncomfortable I feel in my body right now. I’m so frustrated with being brushed off by my doctor. I know that I don’t feel right and I’m 90% sure it is related to poor thyroid function. Very eager to read your articles and hear more on these things.
Brooke – thank you so much for sharing your story. I’m so sorry you are going through all of this. Here are some articles that I hope help you to get started on your healing journey:
HAIR LOSS AND YOUR THYROID
https://thyroidpharmacist.com/articles/hair-loss-and-thyroid/
IS GLUTEN THE ROOT CAUSE OF YOUR THYROID CONDITION?
https://thyroidpharmacist.com/articles/gluten-root-cause-thyroid-condition/
HOW TO LOSE WEIGHT WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos/
Thank you for this article. The guidelines to print for my doctor is no longer available. Has it been updated since 2012?
I’ve had hypo since 2010 and it’s been a journey!! Just recently I got my most updated bloodwork done and had to specifically ask for these labs. I ask for them yearly. My Free T3 is low at 3.2, but my Free T4 just made it to 15. TSH is good at 0.98. My TG Antibodies are finally <1.0 (whoo hoo!) but my TPO lingers in the low 200s every year. I take 200 mg selenium daily as you recommended for the past year and I think that helped a lot! So now I will search your site to see how to improve my free T3. Thank you for all you do!!!
Christina – thank you so much for letting me know that the link was not working, my team is working to fix that now. In the mean time here is the link: https://www.google.com/url?q=https://pro.aace.com/clinical-guidance/2012-clinical-practice-guideline-hypothyroidism-adults-cosponsored-aace-and&sa=D&source=docs&ust=1696962812693510&usg=AOvVaw3i174vEKK-wNgU41aebEa8
I have rheumatoid arthritis my parathyroid was removed as I Had a tumor on it and I had been taking levothyroxine for several years for hypothyroidism. My mother and grandmother had it and I did too. The TSH test is a curse to people who have had rheumatic fever and who develop other autoimmune disorders- especially after having a hysterectomy or menopause when our hormones are not so normal. I have had wieght gain, I have osteoporosis and have lost 6 inches of height so I have to lose weight, but I’m losing hair, sleep, and I’m so constipated I only go every 9 days – if I take milk of magnesia! All because my doctor says my TSH is normal. My skin is so pale I look like a ghost and it’s dry and flaky, it’s never beenike this. I have headaches and I am so tired I don’t seem to want to do anything- but I’m getting ready to. Move an hour away from my daughter and grandchildren, I should be on top of the world and full of energy. I am cold all of the time- even in Virginia when it’s hot. I sleep under an elder down folded in four and I still shiver, actually I huddle under it and watch TV because I have trouble sleeping but I’m always tired. Then, I fall asleep at odd times for a few minutes at a time. I have terrible stomach pains at times and I think it is because my new endocrinologist has lowered my levoththyroxine dose to a level that I have never been lowered to before. I tried to tell her that TSH doesn’t mean anything if the patient is miserable. She said, “We’ll see in 6 months.”, I might not even be here in 6 months! What should I do?
Khaetidawne – thank you for sharing your journey. I’m so sorry you are struggling with all of these symptoms! I know how hard it can be! I often talk about how people with Hashimoto’s struggle with a combination of issues: hair falling out, brain fog, sleep issues, weight gain, fatigue, pain, hot/cold sensitivity, thyroid nodules, swelling lymph nodes, eye and teeth issues, food sensitivities, nutrient deficiencies, nausea, adrenal issues, gut issues, additional autoimmune diseases as well as an impaired ability to get rid of toxins. It’s also frustrating that many of us have reached out to doctors for years and receive very little help. We are sometimes told it just comes with aging and to take this pill. Doctors don’t ever seem to get to the root cause. It’s important to know that Hashimoto’s is more than a thyroid disorder, it’s an autoimmune disease. We need to balance our immune systems to reverse Hashimoto’s and get our life back! I have been there, and I understand. The first step is healing your gut! You will have to start with the simplest modifications, by removing all environmental and food triggers, followed by repairing the other broken systems to restore equilibrium, allowing the body to rebuild itself. You will dig down to why the immune system is imbalanced in the first place, and this will tell you how you begin to finally feel better, reduce your thyroid antibodies and even take your condition into remission.
You will have to create your own health timeline; looking back at your overall history as far back as you can remember. Look for infections, periods of severe stress, the use of medications (especially antibiotics, antacids, and oral contraceptives), accidents, and exposure to toxins. These are events that may have contributed to Hashimoto’s. Once you do, you will know what types of changes you need to implement to make yourself feel better.
This approach is detailed in my book, Hashimoto’s Protocol, which is a more step by step in-depth plan that streamlines the most effective interventions. If you need further support, please check out the list of lab tests inside the “Testing” chapter of my book, Hashimoto’s Root Cause. I also offer a 12-week program, Hashimoto’s Self Management Program. I hope this helps! Here are some resources that I hope are helpful as well:
BUILDING YOUR OWN HEALTH TIMELINE
https://thyroidpharmacist.com/sample-health-timeline/
WHERE DO I START WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/
OVERCOMING HASHIMOTO’S
https://thyroidpharmacist.com/articles/overcoming-hashimotos-in-the-new-year
Hashimoto’s Self-Management Program
https://thyroidpharmacist.com/enroll-in-hashimotos-self-management/
My TSH is around 1.5, but my free T3 is 2.3, my free T4 0.9, total T4 is 5.9, and total T3 is 69. Still waiting on results for reverse T3. Could I still have hashimotos even with a normal TSH? My liver enzymes are also very elevated so that is why we are looking into this. What are your thoughts on these lab numbers?
Presley, Thanks for sharing. While a TSH around 1.5 is often considered optimal, low Free T3, Free T4, and Total T3 levels can suggest that cells may not be getting enough thyroid hormone, even if TSH is in range. This is something I recommend discussing with your practitioner. Hashimoto’s can still be present with a normal TSH. I typically recommend checking thyroid antibodies, including TPO and TG antibodies, to assess for Hashimoto’s. Elevated liver enzymes may also affect thyroid hormone conversion and clearance. Supporting liver health through nutrient-dense foods and reducing toxin exposures can be helpful. Once you have your Reverse T3 results, that may offer more insight into how well your body is converting T4 to the active T3 hormone. Please be sure to work closely with your practitioner to interpret these results. Here is an article that you might find helpful as well: https://thyroidpharmacist.com/articles/top-10-thyroid-tests/
What would optimal ranges be for someone after radioactive iodine treatment, leaving them with hypothyroidism, that experiences debilitatingly high amounts of exhaustion/fatigue/brain fog?
I have heard that different levels might be optimal for someone with low energy problems
Tyler, Thank you for your question. After radioactive iodine treatment, many people develop hypothyroidism and may experience symptoms like fatigue and brain fog even when labs are “normal.” Optimal thyroid lab ranges can vary individually, but generally: TSH: 0.5–2.0 mIU/L, Free T4: Mid to upper part of the reference range, Free T3: Mid to upper reference range. Because symptoms can persist despite “normal” labs, working with a knowledgeable practitioner to evaluate your full thyroid panel, including reverse T3 and thyroid antibodies and clinical symptoms is key. A personalized approach to thyroid hormone replacement and supportive therapies often helps improve energy and brain fog. Please discuss your symptoms and labs with your healthcare provider to find the best plan for you. Here is an article that you might find helpful as well: https://thyroidpharmacist.com/articles/top-10-thyroid-tests/