Ep. 97: How To Properly Test For Thyroid Function (Hypothyroidism Part 3) — Key Takeaways
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Ep. 97: How To Properly Test For Thyroid Function (Hypothyroidism Part 3)
Jay Feldman Wellness1h 25mAug 1, 2023
Watch the originalA TSH above 2.0 indicates likely hypothyroidism — not the conventional cutoff of 4.0 — and TSH alone is unreliable without also measuring free T3, free T4, and reverse T3, plus tracking waking body temperature (target ≥98.0°F) and resting pulse (target 70–85 bpm).
Key takeaways
TSH above 1.4 linearly increases coronary death risk — 41-69% higher vs TSH 0.5-1.4
TSH above 1.4 linearly increases coronary death risk — 41-69% higher vs TSH 0.5-1.4
- HUNT study: women with TSH 1.5-2.4 had 41% higher coronary death risk; TSH 2.5-3.5 had 69% higher risk vs TSH 0.5-1.4
- All values still within conventional 'normal' range (under 4.0), making standard lab interpretation dangerously misleading
Suppressed TSH indicates hyperthyroidism only 16% of the time — it's wrong 84% of the time
Suppressed TSH indicates hyperthyroidism only 16% of the time — it's wrong 84% of the time
- Holtorf paper: positive predictive value of suppressed TSH for over-replacement or hyperthyroidism is only 16%
- Doctors routinely dose T4 therapy to TSH suppression, but this marker is an inaccurate guide 84% of the time
T4-only therapy (Synthroid) cannot fix hypothyroidism if T4-to-T3 conversion is impaired
T4-only therapy (Synthroid) cannot fix hypothyroidism if T4-to-T3 conversion is impaired
- Patients on levothyroxine with poor D1 enzyme activity convert T4 to reverse T3 instead of active T3 — TSH suppresses but symptoms persist
- Cholesterol remaining elevated and full hypothyroid symptom burden continuing on T4 therapy are signs conversion is the real problem
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In this video
- 1mintro
- 1mwhat causes Hashimoto’s hypothyroidism and autoimmunity in general
- 14mhow to interpret thyroid blood tests (TSH, T3, T4, rT3)
- 32mwhat reverse T3 means on a blood test and how to interpret rT3 values
- 35mlooking at all thyroid markers together to determine thyroid status
- 37mthe anti-thyroid effects of reverse T3
- 41mcholesterol levels as a marker of thyroid status, and the problems with cholesterol levels that are too high or too low
- 53mthe relationship between cholesterol, heart disease, and thyroid status
- 56mother blood markers that can be indicative of thyroid status (SHBG, ferritin)
- 57mhow we can use symptoms like metabolic rate, body temperature, and pulse rate to determine thyroid status
- 1h 12mother symptoms that can be used as indicators of thyroid status (low energy, fatigue, low immune function, dry or cracking skin, hair loss brittle nails, slow motility, weight gain, low mood)
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