Endocrine System

How do I get to GOOD?

Or, in other words, if my tests suggest something is amiss, what do I do? Let's just talk about hypothyroidism, which raises the possibility of replacing, by prescription, thyroid hormone. Hypothyroidism, whether overt or subclinical, takes a toll on normal physiology and will generally get worse if treatment is delayed. You have many options for treatment, starting with two special considerations:

Here’s the million dollar question, because most large medical clinics have switched to “efficient” thyroid testing, which I would call perhaps efficient but in the long term, absolutely insufficient. Bare bones testing checks just the TSH (the messenger from the brain’s control center, turning on thyroid hormone production) with a “reflex to T4”, the free T4 only ordered if the TSH crosses a worrisome threshold, usually set too high, in my opinion. Such testing will identify “overt” hypothyroidism, namely when there is an elevated TSH and a sub-normal T4 level.