The first thing I want to say here is that you always need to LISTEN TO YOUR BODY. If you feel OFF or “not right”, that is far more important than any lab test or what any doctor will try to tell you. YOU know YOUR body and if it doesn’t feel right, there is a reason for that!

Here is a typical scenario: you start gaining weight, or just can’t lose extra weight; you might notice your hair is thinning; energy levels are low; perhaps you notice your eyebrows thinning; you might have some pretty good brain fog…. So you increase your exercise and lower your calories but it only makes the whole thing worse. You then go to the doctor because you know enough about thyroid to think it might be what is at play here. You go into your doctor and are sent home discouraged. Your doctor says you are “fine”. So, what happened?  

It starts with what lab numbers are actually tested. When you go into your mainstream medical practitioner and have your labs run for thyroid, they will always order TSH and *sometimes* they will throw T4 in there. TSH is the Thyroid Stimulating Hormone that is sent out by the pituitary gland in your brain when it detects you need more thyroid hormone for energy and overall metabolism. What happens then? The pituitary releases TSH and all is well, right? Nope.

Your TSH travels to the thyroid gland and binds to receptors there that signal the T4 to be released. Now you are feeling good and energy levels are where they should be! ….actually….NO. ONE MORE STEP has to occur. Your T4 has to be converted to T3 by an enzymatic process before you will actually feel any benefit as T4 is really only like a messenger (it is INACTIVE). T3 is the active thyroid hormone that gives you what you need (this is the gas that gives you energy)!

Ok let’s pause here and think about this. If T3 is the active hormone, why aren’t doctors concerned about your T3 level?

Without going into any theories as to why this is the case (and it IS the case for most mainstream practitioners), just understand this: you NEED to know what your free T3 level is at (free T3 because that is the “unbound” form of T3 that is actually in action in your body). If your doctor tells you they will NOT order a full thyroid panel that includes free T3 (which is very likely to happen and they might give you any number of reasons why that are NOT VALID) you need to A) be assertive and insist that you have the full panel run, B) find a new doctor or C) order your test yourself. You can order your own test here. (It is very easy [I have done it] and relatively inexpensive. You go to the lab near you that you will be connected with via this website once you order your test and your results are emailed to you.)

Another important part of the full thyroid panel is Reverse T3. Reverse T3 (RT3) is inactive like T4; but it will bind to receptor sites meant for T3 and therefore hijack the system, therefore not allowing you to receive the benefits of the active thyroid hormone, T3.

***PLEASE NOTE: chronic calorie restriction and reducing carbs TOO low will raise RT3 (I love the ketogenic protocol, but you can absolutely be very low carb without causing this problem. You need to listen to your body’s signals and if there is resistance, restricting carbs further is NOT the answer!). Chronic stress will also raise RT3 levels!***

Lastly, it is also imperative that you check your thyroid antibody levels checked. I would argue these might be the MOST important to test. Why?

Thyroid antibodies There are two main types of thyroid antibodies. Here is some great information from Amy Meyers, MD, “Thyroid peroxidase antibodies (TPOAb) attack an enzyme used to synthesize thyroid hormones and are commonly elevated in both Hashimoto’s and Graves’ Disease patients. Thyroglobulin Antibodies (TgAb), attack thyroglobulin, which your thyroid uses to produce its hormones. These are typically elevated in Hashimoto’s patients.”

A little known fact is that over 90% of hypothyroidism is caused by Hashimoto’s. Hashimoto’s is simply inflammation in your body leading to an attack on the thyroid. It is clearly VERY common and yet people do not realize this. The importance of knowing this is that you can then take steps to reduce systemic inflammation in your body and bring your antibody numbers down, therefore protecting the thyroid.

Full thyroid panel to request:
TSH
Free T4
Free T3
Reverse T3
Thyroid Peroxidase Antibodies (TPOAb)
Thyroglobulin Antibodies (TgAb)

Once you have your thyroid panel run, your doctor could look at it (even this full panel) and tell you that you are “within range” and therefore, “fine” and send you home; but you might still feel like there’s a problem. Here’s why:

The thyroid ranges mainstream medicine uses come from an average of actual patient labs run. What does this mean? It means the ranges you are given are based on those with thyroid problems. They are very broad ranges because they consider these numbers “normal”. However, I do not want to be compared to “normal” ranges that represent people with thyroid disorders. I want to know where my labs should be if I am at a healthy, “optimal” level. Here is a general guide from Amy Myers MD:

TSH 1-2 UIU/ML or lower (Armour or compounded T3 can artificially suppress TSH)
FT4 >1.1 NG/DL
FT3 > 3.2 PG/ML
RT3 less than a 10:1 ratio RT3:FT3
TPO – TgAb – < 4 IU/ML or negative

Knowing ALL of your thyroid numbers and comparing them to OPTIMAL ranges versus “standard ranges” will change how you approach your thyroid condition and can lead you to the ROOT CAUSE of the issue so that you can treat the actual problem and potentially reverse the issue!

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