My Thyroid Treatment Philosophy

I listen to and believe in my patients' complaints and symptoms. I don't label their problems as chronic complainers or malingerers. It is my experience that most patients have genuine complaints. For example, if they are gaining weight or have difficulty losing weight, I don't blame them for not watching their diet or not exercising. They may have 'suboptimal metabolism' or 'low Body Temperature Syndrome', which makes it difficult for the body to lose weight.

I adjust my patients' thyroid medicine dosage based on their thyroid-related symptoms, and not just lab test reports. Your body's response and how you feel are just as important as the numbers on paper. This personalized approach ensures optimal treatment outcomes.

A person can have an underactive or hypothyroid condition which is oftenmissed on routine blood tests alone. Standard testing doesn't always reveal the complete picture of your thyroid health. Comprehensive evaluation is essential for accurate diagnosis.

Normal blood tests (according to lab range) may not mean they are optimum for you. If you have symptoms which can be attributed to 'low thyroid', and even if your lab tests are in'normal range', I sometimes put my patients on thyroid medications to see if it can alleviate their symptoms. I call it a'therapeutic trial'.

Most doctors order only a TSH test and rely on it to diagnose hypothyroidism and monitor treatment progress. A TSH test is a fraction of the overall thyroid picture. TSH is NOT a thyroid hormone. It is a pituitary hormone from which doctors have to guess the quality of your thyroid hormones. In addition, it can only diagnose "primary" hypothyroidism, NOT other types of hypothyroidism.

Just because your TSH level is 'normal' does not mean that you don't have underactive or hypothyroidism. A good doctor will not rule out a thyroid condition solely on the basis of a TSH, but will order a complete thyroid panel. A full thyroid panel includes TSH, Free T3(FT3), Free T4 (FT4), Reverse T3 (rT3), Thyroglobulin level and thyroid antibody tests.

Proper interpretation of any lab result is very important and thyroid results are no exception. A "normal" blood test does not mean "optimum". Many mainstream physicians think that, "You don't have hypothyroidism because your blood tests are in normal range", even if you have all the symptoms of hypothyroidism. I think differently. If you have 'low or mid range normal' blood levels, and still experience symptoms of low thyroid function, then that level is not optimum for you.

Normal range for Free T3 is 2.30to 4.20 (again, it varies with each lab). In my experience most patients with Free T3 level of3 or less, will have symptoms of hypothyroidism. I have some patients who don't feel normal till their Free T3 level is 5or even higher. Even with this high FT3 level, they do not have palpitation or tachycardia (when their adrenals are also balanced).

Very few doctors order Reverse or inactive T3 (RT3) and thyroid antibodies levels. RT3, Free T3 (FT3) and Free T4 (FT4) should be checked at the same time. The body produces the benign RT3 naturally to rid itself of excess of T4, but in some cases, especially during stress or after delivery, and high or low cortisol levels, it's made in excess. When RT3 is in excess it occupies the same cell receptors where active T3 (FT3) stimulates cellular activities and functions.

Our body needs optimal iron and ferritin (storage iron) levels in order to tolerate thyroid medications. Both too high or too low can cause or aggravate hypothyroid condition and symptoms. Other than preventing anemia, iron is also an important facilitator of thyroid hormone at cellular level.

Most doctors rely only on lab results. They exclude your symptoms and how you actually feel. They think that if your test results are "normal" you are not suffering from hypothyroidism. Many of these patients have been wrongly diagnosed as depressed or suffering from fibromyalgia, chronic fatigue syndrome, anxiety, stress, insomnia, etc. Some are even thought as chronic complainer or even malingerer.

Thyroid antibodies diagnose autoimmune conditions (Hashimoto's Thyroiditis and Grave's disease) that can only be diagnosed by a full Thyroid Panel long before other blood values become abnormal. Treatment for people with autoimmune thyroid conditions is different from those with non-autoimmune hypothyroidism. Early detection through comprehensive testing allows for more targeted and effective treatment approaches.

A low body temperature plays a large role in diagnosing thyroid problems. Many doctorsdo not check or ignore your Body Temperature to correlate with your symptoms. Ideal body temperature is 98.6° F. Most doctors are concerned if your temperature goes above 99° F, but they are not concerned if it is below 98° or97° F.

In our body, there are thousands of chemical reactions occurring every minute. Like cooking where correct temperature will cook food properly, these metabolic reactions also will perform efficiently at ideal temperature of98.6° F. Our body maintains this ideal temperature because of internal metabolism and these chemical reactions. If our metabolism is slow it will be reflected in low temperature and most common reason for slow metabolism is underactive or hypothyroid condition.

The adrenal glands and thyroid work together in a delicate balance. Adrenal dysfunction can mimic or worsen thyroid symptoms. Many patients with thyroid issues also have compromised adrenal function, which must be addressed for optimal thyroid treatment success. Stress, poor sleep, and nutritional deficiencies can all impact both glands simultaneously.

Certain nutrients are essential for proper thyroid function. Deficiencies in iodine, selenium, zinc, vitamin D, and B vitamins can significantly impact thyroid health. I evaluate and address these nutritional gaps as part of comprehensive thyroid care. Simply taking thyroid medication without correcting underlying deficiencies may not provide optimal results.

Not all thyroid medications are created equal. While most doctors prescribe only synthetic T4 (levothyroxine), some patients benefit more from natural desiccated thyroid, T3-only medications, or combination therapies. I work with each patient to find the medication type and dosage that provides the best symptom relief and quality of life improvement.

Thyroid treatment is not a "set it and forget it" approach. Regular monitoring of symptoms, lab values, and quality of life is essential. Life changes, stress, aging, and other health conditions can affect thyroid needs over time. I provide ongoing support and adjustments to ensure my patients continue to feel their best throughout their thyroid journey.