Thyroid Treatment

Thyroid dysfunction symptoms include persistent fatigue despite adequate sleep, unexplained weight gain or difficulty losing weight, cold intolerance, brain fog and mental sluggishness, dry skin and hair, hair loss, constipation, mood changes including depression, muscle weakness, and decreased exercise tolerance. However, symptoms alone don’t confirm thyroid issues. Diagnosis requires comprehensive lab testing, including TSH, free T3, free T4, and thyroid antibodies. Many people have subclinical thyroid dysfunction with symptoms but labs that are “technically normal.”

We run comprehensive thyroid panels that include TSH (thyroid-stimulating hormone), free T3 (active thyroid hormone), free T4 (thyroid prohormone), reverse T3 (inactive form that can block T3), and thyroid antibodies (anti-TPO and anti-thyroglobulin) to check for autoimmune thyroid disease. Most doctors test only TSH, which misses the full picture. Free T3 is particularly important because it’s the active form of the hormone that affects your metabolism, but it’s rarely tested in conventional medicine.

T4 (thyroxine) is the storage form of thyroid hormone produced by your thyroid gland. It has four iodine molecules and is relatively inactive. Your body converts T4 to T3 (triiodothyronine) by removing one iodine molecule. T3 is the active hormone that affects your cells’ metabolism and energy production. Some people don’t convert T4 to T3 efficiently, resulting in normal T4 and TSH levels but low T3 and persistent symptoms. This is why testing free T3 is critical.

TSH is an indirect measure of thyroid function. It measures your pituitary’s response to thyroid hormone levels, not the actual hormone levels themselves. You can have “normal” TSH but low free T3, poor T4-to-T3 conversion, or thyroid resistance at the cellular level. Additionally, “normal” ranges are very broad. A TSH of 4.5 is technically normal, but many people feel better with a TSH under 2.0. This is why comprehensive testing, including free T3 and free T4, is essential.

Thyroid treatment and optimization can support weight loss efforts if you have hypothyroidism by restoring normal metabolic function. However, thyroid treatment alone doesn’t cause weight loss. It removes the metabolic barrier that makes weight loss difficult. With optimized thyroid function, your body can respond normally to diet and exercise. Many people find they can finally lose weight with reasonable effort once their thyroid levels are optimized, whereas weight loss was nearly impossible before, regardless of diet or exercise intensity.

Synthroid (levothyroxine) is synthetic T4 only. It relies on your body converting T4 to active T3, which doesn’t work well for everyone. We prescribe natural desiccated thyroid (NDT), specifically NP Thyroid or Armour Thyroid. These are derived from pig thyroid glands and naturally contain both T4 and T3, plus trace amounts of T2, T1, and calcitonin. For people who don’t convert T4 efficiently, NDT thyroid treatment often works better because it provides the active T3 directly rather than relying on conversion.

Most people notice initial improvements in energy and mental clarity within 2-4 weeks of starting thyroid treatment and optimization. Full symptom resolution typically takes 8-12 weeks as your body adjusts to optimized levels and metabolic function improves. Some symptoms, like weight changes, may take longer, often 3-6 months, for significant body composition improvements. Thyroid medication requires consistent daily use and periodic lab monitoring to ensure optimal dosing.

Most thyroid conditions are permanent and require lifelong thyroid treatment and medication. However, some causes of hypothyroidism are temporary, such as postpartum thyroiditis, medication-induced hypothyroidism, or thyroiditis that resolves. The need for lifelong treatment depends on the underlying cause. Primary hypothyroidism (thyroid gland failure) or Hashimoto’s thyroiditis typically requires permanent treatment. We monitor your thyroid function over time and adjust treatment as needed.

Yes, chronic stress can significantly impact thyroid function through multiple pathways. Stress increases cortisol, which can inhibit the conversion of T4 to T3 and increase reverse T3 (the inactive form that blocks T3 receptors). Stress also affects the hypothalamic-pituitary-thyroid axis, potentially reducing TSH and thyroid hormone production. Additionally, stress affects gut health, which in turn affects nutrient absorption necessary for thyroid function. Managing stress through lifestyle modifications, sleep optimization, and stress reduction techniques supports thyroid health.

When properly dosed and monitored, thyroid treatment and medication should not negatively affect your heart. In fact, untreated hypothyroidism can be harmful to cardiovascular health by increasing cholesterol, blood pressure, and heart disease risk. However, excessive thyroid treatment and medication (hyperthyroid state) can cause increased heart rate, palpitations, and cardiovascular stress. This is why we start with conservative doses, monitor your response through labs and clinical assessment, and adjust carefully. Patients with existing heart conditions require especially careful monitoring.

Many men on TRT still feel suboptimal because thyroid dysfunction is masking their results. Low thyroid causes fatigue, brain fog, and weight gain that mirrors low testosterone. We often see men who’ve been on TRT for months but haven’t gotten the full benefit because their thyroid was never addressed. Optimizing both creates complete hormone optimization, not partial fixes. If you’re on TRT and still dragging, thyroid is worth investigating.

You must be at least 18 years old with clinical symptoms and lab evidence of thyroid dysfunction. This includes hypothyroidism, subclinical hypothyroidism, poor T4 to T3 conversion, or Hashimoto’s thyroiditis. Some medical conditions may affect the treatment approach. Your provider will review your full health history and comprehensive thyroid lab results during the consultation to determine appropriate therapy.