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Thyroid Disorders

Thyroid Disorders

Running thyroid panels plus or minus reverse T3 and often finding tests within normal limits. Can you comment on how common it is of subclinical hypothyroidism, how the symptoms may differ from overt hypothyroidism, and common differentials for subclinical presentations?

Dr. Amy Nett: I was a little bit unclear on this one because subclinical hypothyroidism is defined by having an...

Can you figure out these thyroid test results in a patient who’s taking three-quarters of a grain of WP Thyroid and 45 micrograms of T3. TSH is zero, not surprising given how much thyroid medication she’s on, free T4 is low, also not surprising given that she’s taking free T3 and WP Thyroid, which contains T3 in it. So T3 suppresses negative feedback system and the body’s only way of- What can we do to reduce the levels of thyroid hormone?

Chris Kresser: The only thing the body can do in that situation is to reduce the output of T4 because...

I have a case study for you. Patient had a comprehensive lab panel done, and with regard to her thyroid, all functional markers were normal. However, her thyroid antibodies were very high: antithyroglobulin was 234, thyroid peroxidase, 126. What do you make of these high antibody values with normal markers, and what suggestions would you have for treatment of exposome measures? She eats a gluten-free, dairy-free diet, exercises regularly, does yoga twice a week, several walks outside, not a daily meditator but working on it. Sleeps approximately seven to eight hours a night.

Chris Kresser: Yeah, so I think in the thyroid unit we covered this, but a large percentage, well, let’s see...

Patient that cannot tolerate associated thyroid meds because of lactose intolerance may also be insulin resistant. Currently taking T3 80 micrograms twice a day. She’s monitoring basal body temperature is between 97.1 and 97.5. It feels like she’s still hypothyroid. What would you suggest? Bump up the T3, give it multiple times a day? Is there a desiccated thyroid medication you’re aware of that does not contain lactose?

Chris Kresser: Yeah, so good questions. I think so, just kind of stepping back before we get into the specifics...

I noticed that Quest has recently significantly narrowed the thyroid antibody reference range to less than nine, while the LabCorp reference range is still less than 34. Any thoughts on still following the lab range or is a functional range needed?

Dr. Amy Nett: Yeah, I noticed that too, recently, and I don’t know if, I haven’t had a chance to...