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Discussion Thread: DIY Thyroid, Part 2: Lab Interpretation

Inner Circle Member Forum >> Iodine and Thyroid Health >> Discussion Thread: DIY Thyroid, Part 2: Lab Interpretation


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Posted: 9/30/2017 7:10:18 PM
Edited: 9/30/2017 7:14:42 PM (1)

This is a forum copy of the second of three transcripts for an Undoctored Blog video series. Only the first part is presently in the Inner Circle video library (since there is equivalent member-only content there).
DIY Thyroid {Part 1} [in UIC Video library] [on Undoctored Blog] [Forum thread]
DIY Thyroid, Part 2: Lab Interpretation (blog only)
DIY Thyroid, Part 3: Thyroid Hormone Replacement (blog only) [Forum thread]

For why this is here, see this revised Reply in an earlier transcript thread.


This is a continuation of a conversation that began in the first video on this topic: DIY thyroid. This is the second part, where I want to talk about the interpretation of the tests that you may have gotten on your own. These are the kinds of conversations, by the way, that I have in my new book Undoctored — Why Health Care Has Failed You And How You Can Become Smarter Than Your Doctor.

The doctor should have been the expert in thyroid, and helping you achieve my ideal thyroid status, because it helps you feel good and have good energy. It facilitates weight loss. It reduces cardiovascular risk. But the doctor often does not follow rules for health, because they are too involved in drugs and procedures and not just health. So now health becomes your job.

TSH (thyroid-stimulating hormone)

The first test is the TSH, the thyroid-stimulating hormone, the pituitary hormone level that controls your thyroid status. If you look at the laboratory slip, it may say things like a “normal” TSH, or the Reference Range they say, is 0.5 to 4.5. That’s a typical range quoted. Let me ask a different question: where does ideal thyroid status occur, at what level of TSH?

Well: 1.5 micro units per liter, or less. Above that range, you have an increasingly difficult time losing weight, people tend to be very cold (inappropriately cold hands and feet, even when the weather is warm), mental fog, leg edema (leg water retention), higher cholesterol values, and you can’t lose weight. So we aim for ideal TSH and that, by the way, also is where cardiovascular risk is minimized. People who have a TSH, for instance, of 3.5, have dramatic increases in cardiovascular risk, including death from heart disease. Last I checked, death is not “normal”, right? So we aim for 1.5, might be much less, for TSH.

Free T3, free T4

For the thyroid hormones free T3 and free T4, simple rule of thumb: aim for the upper half of the Reference Range. People feel better, and do better at the upper half of the Reference Range. One word of caution on the free T3: if you’re just starting out on the Undoctored program, or have been losing weight by any means, that will drop your free T3 temporarily. Do not check your thyroid panel if you’re losing weight. If you have a thyroid panel checked during ongoing weight loss, recognize the low free T3 doesn’t mean anything. You’ll have to reassess when weight has plateaued for at least 4 weeks.

Reverse T3


We call that reverse T3; it looks like T3. It’s a mirror image of the T3 thyroid hormone, but thereby blocks the action of T3. It can cause hypothyroid symptoms even when free T3 looks okay. There’s lots of rules, a lot of debate about how to interpret reverse T3. I’ll tell you what I’ve done, and it seems to work pretty well. You want reverse T3 to not be above about the halfway point in the Reference Range; certainly not above the Reference Range.

Use some judgment here. View reverse T3 on the background of all of the thyroid phenomena. Let’s say reverse T3 is in the upper half of the Reference Range, and free T3 is in a good range, and you have no hypothyroid symptoms, like there’s no low energy, there’s no inability to lose weight, and your temperature sense is good. Well then, that reverse T3 probably doesn’t mean that much, even though it’s highish.

What if reverse T3 is in that upper half of the Reference Range, and free T3 is okay, and TSH is perfect, free T4 is perfect, but you’ve got symptoms of inappropriate cold hands and feet, you can’t lose weight, you have mental fog, you have water retention. Well then, that may mean something then. In which case, you counteract the reverse T3 with taking more T3 thyroid hormone.

Thyroid antibodies

Thyroid antibodies are also an issue of a lot of debate over the years. That’s because endocrinologists are looking for Hashimoto’s or Graves disease, two autoimmune thyroid inflammatory conditions, because they’re going to talk about thyroid surgery: taking your thyroid out, or giving you radioactive iodine, which essentially kills off your thyroid. They try to use the antibody values, and they want to be confident that you actually do have the condition, so they’ll set the bar really high.

You and I are not going to talk about thyroid surgery, or radioactive iodine. We’re going to try to subdue autoimmune inflammation, if the antibody levels are high, by diet, wheat and grain elimination, consider dairy elimination (to eliminate the casein beta A1), correction of vitamin D, and other factors. This is all discussed in the Undoctored book, Undoctored websites, and some of it in this series of videos.

So we don’t have to be so worried about getting a diagnosis right. I will use any elevation of thyroid antibodies (the anti-thyroid globulin and thyroid peroxidase antibodies). If they’re above normal, either or both above normal, I would take that to suggest there is ongoing thyroid inflammation. You don’t have to go by the arbitrary cut-offs that some endocrinologists will use, where they’re very high. You don’t have to go by that. Just go by the Reference Range. If they’re elevated, you have inflammation, and it’s all the more reason to stick to the program as we do in the Undoctored lifestyle.

Those are the basic landscape of thyroid tests and how to interpret them. Even better, in the Undoctored world, we collaborate. I encourage you, if you get these numbers, and you want some feedback, come on Undoctored Blog, the Undoctored Inner Circle, Undoctored Facebook page, and share. You don’t have to tell who you are. Just use and anonymous nickname, for instance, and say “what do you think of this? my free T3 is this; my TSH is this”, and you’ll be impressed at the level of concern, interest, and sophistication of everyday people, who are just sharing interest in your thyroid. So I encourage you to post those numbers, anonymously, and see what great information you get.

DIY Thyroid: Part 1
DIY Thyroid, Part 3: Thyroid Hormone Replacement