April 3, 2025 • 18 mins
In this episode, Dr. Emily Kiberd explains why testing just TSH (thyroid stimulating hormone) is insufficient for understanding thyroid health. She shares her personal experience with Hashimoto's diagnosis and highlights the limitations of conventional TSH tests.
Dr. Kiberd outlines the importance of testing additional markers including Free T3, Free T4, TPO antibodies, TGAB, and reverse T3 to get a comprehensive view.
She also discusses the difference between conventional and functional ranges, as well as the impact of factors like stress, nutrient deficiencies, and gut health on thyroid function.
Dr. Kiberd advocates for a holistic approach, combining direct hormone testing with root cause analysis, to effectively manage thyroid health.
00:00 My Hashimoto's Personal Story
01:54 Understanding TSH and Its Limitations
02:21 The Importance of Comprehensive Thyroid Testing
06:44 Breaking Down Thyroid Markers
10:01 The Role of Free T3 and Free T4
11:45 Addressing Root Causes Beyond Hormones
13:09 Reverse T3 and Thyroid Antibodies
16:08 Empowering Your Thyroid Health Journey
18:15 How Root Cause Functional Medicine can help you
The only doctor designed workout that is thyroid friendly: https://www.dremilykiberd.com/thyroid-strong/
Root Cause Functional Medicine for a personalized approach to uncover the triggers of your Hashimoto's to get you feeling like yourself, just better. https://www.dremilykiberd.com/functional-health-coaching/
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Emily (00:00):
What's up beautiful ladies, Dr.
(00:01):
Emily Kiberd here.
Today we are going to talk abouta very hot topic, which is why is
testing TSH, TSH alone not enoughwhen it comes to looking at the full
picture of what your thyroid is doing.
Let me share a quick personal story.
When I was diagnosed with Hashimoto's backin 2017, after the birth of my firstborn,
(00:24):
baby Elvis, he's almost nine and a halfnow, I went through five doctors and
the first four doctors only tested TSH.
The things I was struggling withwere waking, brain fog, Feeling
like I was crashing at 2 p.
m.
every day.
And when I say waking, I mean 25 pounds.
Not coming off, no matter what I did,despite doing double SoulCycle classes
(00:50):
five days a week, or a SoulCycle class,walking across the street and going to
Barry's Boot Camp, and eating very little.
I would eat a coffee and croissantfor breakfast, I would skip lunch,
and then I would eat a skirtsteak, um, And broccoli for dinner.
So massively under eating.
And the first four doctorsI went to only tested TSH.
(01:12):
And they're like, well, it looks fine.
And when I went back and lookedat my ranges, they were normal.
They were in a conventional normal range.
But they were outside afunctional normal range.
And if you're like conventional versusfunctional, M, give me the deets.
How do I know the different ranges?
I literally just did a masterclass called Know Your Labs.
(01:35):
I'll drop the link in the shownotes if you want to jump in.
And I give you What I test in the clientsI work with one on one in my functional
medicine health coaching practice andWhat are the ranges that I look at that
are conventional compared to functionaloptimal thriving normal ranges?
So the big question I get everyday is If my TSH is normal,
(02:00):
why do I feel like poop emoji?
Why do I feel awful?
Why do I feel like I'm dragging ass?
I get this in my email, I get thisin my Facebook group, Thyroid Strong.
I'll drop the link in the show notes.
It's a free, packed full ofinformation Facebook group.
It's amazing.
there's about 5, 000 women in there.
So the question I get is my TSH is normal.
Why do I feel awful?
(02:21):
And the thing is we need tobe testing more than just TSH.
TSH, also known as thyroidstimulating hormone, is a hormone
from the brain to the thyroid gland.
It is a pituitary hormone.
The pituitary is a small pea sizedgland at the base of the brain.
It's right behind our nose.
(02:43):
It is not a direct measureof thyroid hormone.
It does not show the full picture.
TSH can fluctuate due to the time ofday, due to stress, due to inflammation.
So you can have a normal TSH and stillhave hypothyroid symptoms, weight gain,
(03:05):
brain fog, hairs falling out, feelingcold all the time, massive fatigue.
And there are conventionalranges versus optimal thriving
ranges that come into play.
So in theory, if TSH levels are high,it means the thyroid is not making
enough hormones, hypothyroidism.
If TSH is low, it means the thyroidis making too much thyroid hormone,
(03:31):
hyperthyroidism, and that can includesymptoms of heart palpitations, anxiety.
Losing weight rapidly, and since thepituitary is constantly monitoring
thyroid hormone levels, doctors assumedthat measuring TSH would give an
accurate reflection of thyroid function.
(03:51):
Back in the 70s, thyroid disease wasdiagnosed based on symptoms alone.
It was not diagnosed on testing.
When the TSH test, blood testwas introduced, it was considered
like, whoa, this huge breakthrough.
It was cheap.
It's easy to administer.
It was seen as an accurate reflection ofyour thyroid health, and it became the
(04:12):
default screen for thyroid disorders.
This is back in the seventies.
Hello.
This is like over 50 years ago and majorhealth organizations like the American
Thyroid Association, the AmericanAcademy of Family Physicians, just
began recommending TSH as the primarythyroid test in the 80s and the 90s.
And these guidelines were based onthe assumption that if TSH is normal,
(04:36):
the thyroid is functioning properly.
Health insurancecompanies were like, whoo.
This is awesome.
We only cover TSH because it'scheaper than a full thyroid panel.
And I will say that most conventionaldoctors follow what insurance covers.
And insurance covers whatmedical guidelines recommend.
(04:56):
But the medical guidelineshave been a little outdated.
And so now this creates a systemwhere doctors rarely order additional
tests unless TSH is abnormaloutside of conventional range.
Well, I will tell you, when I was firstdiagnosed with Hashimoto's, my TSH was 3.
2 and I felt like death.
(05:17):
I felt like I had to takea nap every day at 2 p.
m.
I felt like the end of a Mondaywas totally drained to the point of
Oh, I felt like today was Friday.
I'm so exhausted, but it's only Monday.
How am I going to get through the week?
When I started to look, it was like,Oh, my TSH is within conventional
(05:38):
normal range, but it's actually outsideof optimal functional thriving range.
And so here's the problemwith this approach.
TSH alone does not measure the actualthyroid hormone levels in the body.
That would be free T3, free T4.
(05:58):
It does not account for, am Iconverting my thyroid hormones properly?
Do I have the autoimmunedisease Hashimoto's?
About 90 percent of women who arehypothyroid have thyroid antibodies, have
the autoimmune form of hypothyroidism.
(06:19):
Is there an element of adrenaldysfunction or underlying infection
that could be driving our TSH?
up, pushing us into hypothyroidism,just looking at TSH is not going
to give us that other information.
So many women come to me and theyhave normal TSH, quote unquote, normal
TSH, but they are still experiencingdebilitating hypothyroid symptoms.
(06:44):
So what are the other markersyou need outside of just TSH.
You would want.
Free T3, free T4, TPO antibodies,thyroid peroxidase antibodies, TGAB,
thyroglobulin antibodies, and reverse T3.
(07:04):
We'll talk about reverse T3.
We'll break all of these down.
So free T3, think of this, as the gas.
It's the active thyroid hormone.
It is unbound, and it is responsiblefor Speeding up our metabolism, for
our mood, for having more energy.
It's easier to lose weight whenour free T3 is in optimal range.
(07:26):
And then there's free T4.
This is a precursor hormone.
When you don't have enough T4, it meansyou probably won't have enough T3.
So when it comes to thyroid health, T4 isthe inactive form of the thyroid hormone.
And when a lot of women ask, well, what'sthe difference between total and free T4?
(07:49):
Total is the bound form.
It's bound to proteins, likealbumin, and it is not the active
form that our body can use.
It needs to become unbound.
And so a lot of endocrinologistswill order the total T4 marker,
but they don't order the free T4.
And we really want thefree T4 because this is.
(08:12):
The hormone is producedby the thyroid gland.
It is unbound, and then it turns into theactive free T three, which is the gas.
Think of T four as like theraw ingredient, and it needs
to be converted to free.
T three to actually boost our metabolism,give us energy, get rid of our brain fog.
Why is free T four so important tomeasure when free T four is low?
(08:39):
You're going to struggle with low energy,constant fatigue, weight gain, brain fog,
slow thinking, cold intolerance, dry hair,dry skin, losing your hair, brittle nails.
No one wants that.
So just check your free T4.
It will give you so much information.
What are some possible causes whensomeone comes up with a low free
(09:05):
T3 ? Hypothyroidism, Hashimoto's, yourbody isn't converting properly due
to stress, gut infections, nutrientdeficiencies, or you're not making
enough of the raw material free T4.
Maybe it's a nutrient deficiency likea deficiency in selenium, zinc, iodine
can sometimes play a role, or iron.
(09:27):
when we are getting a full thyroidpanel, and I just want to clarify
this, when you ask your physician fora full thyroid panel, sometimes they
will order TSH, total T4, and TPO.
That is not complete.
I like to go into my doctor'sappointment being like, I need these
exact markers and I give them a list.
(09:50):
TSH, free T4.
free T3, TPO, TGAB,thyroglobulin antibodies.
So let's talk about free T3.
Free T3 is a gas.
It is unbound, it isnot bound to a protein.
(10:10):
The thyroid gland makes about 80percent T4, 20 percent T3, but T3 is
about five times more active than T4.
It gives us energy.
So when we see that free T3 is low, butmaybe TSH isn't within normal range,
we know we have a conversion issue.
Thyroid hormones areconverted in the liver.
(10:33):
And the gut and also no one talksabout this in the muscle tissue.
So when you contract a muscle, youare converting the inactive T4.
To the active form T3, just throughcontraction of your muscles.
Pretty cool, right?
That is one of the reasons why I am sucha big proponent of lifting weights as a
(10:54):
non negotiable for women with Hashimoto's.
You have to lift the weights.
You have to feed the muscletissue through how we eat and
how we move our bodies swimming.
Walking, yoga, Pilates, not enough ladies.
So if you don't lift weights,go check out Thyroid Strong.
It's my six week signature workout programfor the women with Hashimoto's to learn
(11:14):
how to work out without the burnout.
I'll drop the link in the notes.
Okay, back to free T3.
So free T3 is like the gas.
If there's not enough, but yourTSH is within normal range,
there's a conversion issue.
I see this all the time.
And now we're starting tolook at nutrient deficiencies.
gut infections, moldexposure, environmental load.
(11:37):
And when we start to address theroot cause, thyroid hormones can
come back into optimal range.
So oftentimes I see women who arechasing the hormones because they're
doctors chasing the hormones.
Hormones are reactive.
So let's say Your TSH is normal,but your free T3, the gas is low.
(12:01):
I'm like, okay, let's justbump up your medication.
Let's give you more home runs.
Well, it's a little bit of a bandaidapproach and I am not against medication.
I am all for medication if you needit, if it makes you feel better, but if
you're taking it and it doesn't make youfeel better, what's the missing piece?
Let's not just chase.
Okay.
Let's just bump up the hormones.
Let's chase what is causinga dip in your hormones.
(12:23):
A lot of times I see nutrientdeficiencies, like selenium.
I see gut issues, underlying gut issues.
Sometimes I've seen women's thyroidhormones come back into optimization
after they've addressed an H pylorigut infection, stomach infection.
I've even seen it with mold exposurewhere women are swinging hyper.
(12:45):
Their medications are getting adjustedall over the place and they're like,
this just doesn't feel right, Em.
And then we discovered thatthey have a mold exposure.
Maybe they have mold in their home.
They need to remediate,bring in a mold inspector.
And then we retest their labs and theyare coming back into optimal range.
And we didn't adjust their meds.
We just looked at thyroid from a rootcause approach versus a Band Aid approach.
(13:09):
All right, let's talk about reverse T3.
This is a little bitof a controversial one.
If you think of free T3, like the gas,reverse T3 is the break on the metabolism.
And when reverse T3 goes high, this istypically due to inflammation, stress,
and that could include overtraining.
(13:30):
gut infections.
And when reverse T3 starts to gohigh, the brakes go on harder.
Our metabolism slows down.
We have more fatigue,brain fog, weight gain.
Reverse T3 only gives a four hoursnapshot into that lab marker.
Insurance often does not cover itand so doctors often don't order it.
(13:53):
I would say that if there was onemarker that if the doctor was like,
Hmm, I don't think we need this.
Reverse T3 would be it.
Sometimes it takes a couple weeks forthat marker to come back from the lab.
And so you can get so muchinformation even without reverse T3.
I usually like to use reverse T3to see if there's an underlying
infection or illness or overtraining.
(14:15):
And those three things could come outfrom other tests, like a functional
gut test, like a GI map, or couldcome out in other blood work.
So, is it essential?
No.
Is it nice to have?
Yeah.
There are two thyroid antibody tests.
Most doctors order TPO,thyroid peroxidase antibodies.
(14:37):
It's nice to get both TPO and TGAB.
These will both identify if youhave an autoimmune component
to your thyroid disease.
You know, it's interesting becauseantibody tests are not that expensive,
like under 10, maybe around 5.
And I'm just like, man, why don'tdoctors just like throw it in?
(14:58):
Because the thought process is,well, once you have antibodies,
you always have antibodies.
And I would say that's not true.
And I am a testament to this.
When I was first diagnosed, mythyroid antibodies were sky high.
I addressed underlyingroot causes from a gut.
food, environmental load perspective.
And this is what I do with my one onone clients now and went into remission
(15:23):
a year later and stayed in remission,even through a second pregnancy.
And if you've been pregnant, youknow that growing a baby and having
a baby and nurturing the baby afterit comes out is a stress on the body.
And a lot of women canexperience an increase in thyroid
antibodies through pregnancy.
Luckily, I stayed in remissionthrough pregnancy and I've
(15:43):
been in remission ever since.
And it was really because I addressedwhat was going on, not from slapping a
Band Aid on like, Oh, here's a supplement.
I did that with two functionalmedicine doctors at first.
Here's some medication.
No, I did it from addressing what isthe driver that is throwing things off?
What is the drivermaking my hormones react?
(16:06):
Because hormones are reactive.
I want to give you power.
Because I feel like when we go intoour doctor's appointments with better
questions, we get better answers.
And so many women come to me and like,Oh, I wish I had said, I didn't know.
And so really, when you're asking yourdoctor, Hey, can we test more than TSH?
(16:27):
Just know TSH alone is not enough.
If you're asking for a full thyroidpanel, sometimes you're going
to get TSH, total T4, and TPO.
So I would like to go into my doctor,and I've done this with my OBGYN, and
be like, Hey, I want TSH, free T3,free T4, TPO, TGAB, and reverse T3.
(16:50):
And if you want, if the doctor won'torder it, there's ways to get it tested.
You can go through Function Health.
You could go throughUlta Labs and self order.
I order these for my clients whenthey work one on one with me.
And so don't feel stuck if your doctoris not going to give you the lab order
to get the full picture of your thyroid.
Because if you're tired, if you'renot losing weight, getting a full
(17:16):
thyroid panel is a non negotiable.
It is a 100 percent non negotiable.
So if your TSH is like 3.
2, you're not losing weight, you're tiredand you're told everything looks normal.
You start cutting out foods,doesn't really make a difference.
You add foods in, itdoesn't make a difference.
You're burning the candle at both ends,working your ass off, working out.
Know there's a better way.
(17:38):
So this is the work I do oneon one with women inside of my
functional medicine practice.
I'll drop the link to jumpon a call in the show notes.
See if you're a good fit todive in, to get more data.
I'm a big test, don't guess kind of girl.
And I'm also a big, let's optimizebody composition and make sure we're
doing all the things to feel like ourbest selves that is within our control.
(18:02):
How we're eating, how we're sleeping,how we're working out, how we're
regulating our nervous system.
It's not an either or like functionalmedicine or do the foundations.
It's both.
All right, ladies, I hopeyou enjoyed this episode.
If you loved it, go, drop a reviewin Apple, iTunes, Spotify, wherever
(18:24):
you listen to this podcast,and I'll see you next time.
What's up beautiful ladies, Dr.
(00:01):
Emily Kiberd here.
Today we are going to talk abouta very hot topic, which is why is
testing TSH, TSH alone not enoughwhen it comes to looking at the full
picture of what your thyroid is doing.
Let me share a quick personal story.
When I was diagnosed with Hashimoto's backin 2017, after the birth of my firstborn,
(00:24):
baby Elvis, he's almost nine and a halfnow, I went through five doctors and
the first four doctors only tested TSH.
The things I was struggling withwere waking, brain fog, Feeling
like I was crashing at 2 p.
m.
every day.
And when I say waking, I mean 25 pounds.
Not coming off, no matter what I did,despite doing double SoulCycle classes
(00:50):
five days a week, or a SoulCycle class,walking across the street and going to
Barry's Boot Camp, and eating very little.
I would eat a coffee and croissantfor breakfast, I would skip lunch,
and then I would eat a skirtsteak, um, And broccoli for dinner.
So massively under eating.
And the first four doctorsI went to only tested TSH.
(01:12):
And they're like, well, it looks fine.
And when I went back and lookedat my ranges, they were normal.
They were in a conventional normal range.
But they were outside afunctional normal range.
And if you're like conventional versusfunctional, M, give me the deets.
How do I know the different ranges?
I literally just did a masterclass called Know Your Labs.
(01:35):
I'll drop the link in the shownotes if you want to jump in.
And I give you What I test in the clientsI work with one on one in my functional
medicine health coaching practice andWhat are the ranges that I look at that
are conventional compared to functionaloptimal thriving normal ranges?
So the big question I get everyday is If my TSH is normal,
(02:00):
why do I feel like poop emoji?
Why do I feel awful?
Why do I feel like I'm dragging ass?
I get this in my email, I get thisin my Facebook group, Thyroid Strong.
I'll drop the link in the show notes.
It's a free, packed full ofinformation Facebook group.
It's amazing.
there's about 5, 000 women in there.
So the question I get is my TSH is normal.
Why do I feel awful?
(02:21):
And the thing is we need tobe testing more than just TSH.
TSH, also known as thyroidstimulating hormone, is a hormone
from the brain to the thyroid gland.
It is a pituitary hormone.
The pituitary is a small pea sizedgland at the base of the brain.
It's right behind our nose.
(02:43):
It is not a direct measureof thyroid hormone.
It does not show the full picture.
TSH can fluctuate due to the time ofday, due to stress, due to inflammation.
So you can have a normal TSH and stillhave hypothyroid symptoms, weight gain,
(03:05):
brain fog, hairs falling out, feelingcold all the time, massive fatigue.
And there are conventionalranges versus optimal thriving
ranges that come into play.
So in theory, if TSH levels are high,it means the thyroid is not making
enough hormones, hypothyroidism.
If TSH is low, it means the thyroidis making too much thyroid hormone,
(03:31):
hyperthyroidism, and that can includesymptoms of heart palpitations, anxiety.
Losing weight rapidly, and since thepituitary is constantly monitoring
thyroid hormone levels, doctors assumedthat measuring TSH would give an
accurate reflection of thyroid function.
(03:51):
Back in the 70s, thyroid disease wasdiagnosed based on symptoms alone.
It was not diagnosed on testing.
When the TSH test, blood testwas introduced, it was considered
like, whoa, this huge breakthrough.
It was cheap.
It's easy to administer.
It was seen as an accurate reflection ofyour thyroid health, and it became the
(04:12):
default screen for thyroid disorders.
This is back in the seventies.
Hello.
This is like over 50 years ago and majorhealth organizations like the American
Thyroid Association, the AmericanAcademy of Family Physicians, just
began recommending TSH as the primarythyroid test in the 80s and the 90s.
And these guidelines were based onthe assumption that if TSH is normal,
(04:36):
the thyroid is functioning properly.
Health insurancecompanies were like, whoo.
This is awesome.
We only cover TSH because it'scheaper than a full thyroid panel.
And I will say that most conventionaldoctors follow what insurance covers.
And insurance covers whatmedical guidelines recommend.
(04:56):
But the medical guidelineshave been a little outdated.
And so now this creates a systemwhere doctors rarely order additional
tests unless TSH is abnormaloutside of conventional range.
Well, I will tell you, when I was firstdiagnosed with Hashimoto's, my TSH was 3.
2 and I felt like death.
(05:17):
I felt like I had to takea nap every day at 2 p.
m.
I felt like the end of a Mondaywas totally drained to the point of
Oh, I felt like today was Friday.
I'm so exhausted, but it's only Monday.
How am I going to get through the week?
When I started to look, it was like,Oh, my TSH is within conventional
(05:38):
normal range, but it's actually outsideof optimal functional thriving range.
And so here's the problemwith this approach.
TSH alone does not measure the actualthyroid hormone levels in the body.
That would be free T3, free T4.
(05:58):
It does not account for, am Iconverting my thyroid hormones properly?
Do I have the autoimmunedisease Hashimoto's?
About 90 percent of women who arehypothyroid have thyroid antibodies, have
the autoimmune form of hypothyroidism.
(06:19):
Is there an element of adrenaldysfunction or underlying infection
that could be driving our TSH?
up, pushing us into hypothyroidism,just looking at TSH is not going
to give us that other information.
So many women come to me and theyhave normal TSH, quote unquote, normal
TSH, but they are still experiencingdebilitating hypothyroid symptoms.
(06:44):
So what are the other markersyou need outside of just TSH.
You would want.
Free T3, free T4, TPO antibodies,thyroid peroxidase antibodies, TGAB,
thyroglobulin antibodies, and reverse T3.
(07:04):
We'll talk about reverse T3.
We'll break all of these down.
So free T3, think of this, as the gas.
It's the active thyroid hormone.
It is unbound, and it is responsiblefor Speeding up our metabolism, for
our mood, for having more energy.
It's easier to lose weight whenour free T3 is in optimal range.
(07:26):
And then there's free T4.
This is a precursor hormone.
When you don't have enough T4, it meansyou probably won't have enough T3.
So when it comes to thyroid health, T4 isthe inactive form of the thyroid hormone.
And when a lot of women ask, well, what'sthe difference between total and free T4?
(07:49):
Total is the bound form.
It's bound to proteins, likealbumin, and it is not the active
form that our body can use.
It needs to become unbound.
And so a lot of endocrinologistswill order the total T4 marker,
but they don't order the free T4.
And we really want thefree T4 because this is.
(08:12):
The hormone is producedby the thyroid gland.
It is unbound, and then it turns into theactive free T three, which is the gas.
Think of T four as like theraw ingredient, and it needs
to be converted to free.
T three to actually boost our metabolism,give us energy, get rid of our brain fog.
Why is free T four so important tomeasure when free T four is low?
(08:39):
You're going to struggle with low energy,constant fatigue, weight gain, brain fog,
slow thinking, cold intolerance, dry hair,dry skin, losing your hair, brittle nails.
No one wants that.
So just check your free T4.
It will give you so much information.
What are some possible causes whensomeone comes up with a low free
(09:05):
T3 ? Hypothyroidism, Hashimoto's, yourbody isn't converting properly due
to stress, gut infections, nutrientdeficiencies, or you're not making
enough of the raw material free T4.
Maybe it's a nutrient deficiency likea deficiency in selenium, zinc, iodine
can sometimes play a role, or iron.
(09:27):
when we are getting a full thyroidpanel, and I just want to clarify
this, when you ask your physician fora full thyroid panel, sometimes they
will order TSH, total T4, and TPO.
That is not complete.
I like to go into my doctor'sappointment being like, I need these
exact markers and I give them a list.
(09:50):
TSH, free T4.
free T3, TPO, TGAB,thyroglobulin antibodies.
So let's talk about free T3.
Free T3 is a gas.
It is unbound, it isnot bound to a protein.
(10:10):
The thyroid gland makes about 80percent T4, 20 percent T3, but T3 is
about five times more active than T4.
It gives us energy.
So when we see that free T3 is low, butmaybe TSH isn't within normal range,
we know we have a conversion issue.
Thyroid hormones areconverted in the liver.
(10:33):
And the gut and also no one talksabout this in the muscle tissue.
So when you contract a muscle, youare converting the inactive T4.
To the active form T3, just throughcontraction of your muscles.
Pretty cool, right?
That is one of the reasons why I am sucha big proponent of lifting weights as a
(10:54):
non negotiable for women with Hashimoto's.
You have to lift the weights.
You have to feed the muscletissue through how we eat and
how we move our bodies swimming.
Walking, yoga, Pilates, not enough ladies.
So if you don't lift weights,go check out Thyroid Strong.
It's my six week signature workout programfor the women with Hashimoto's to learn
(11:14):
how to work out without the burnout.
I'll drop the link in the notes.
Okay, back to free T3.
So free T3 is like the gas.
If there's not enough, but yourTSH is within normal range,
there's a conversion issue.
I see this all the time.
And now we're starting tolook at nutrient deficiencies.
gut infections, moldexposure, environmental load.
(11:37):
And when we start to address theroot cause, thyroid hormones can
come back into optimal range.
So oftentimes I see women who arechasing the hormones because they're
doctors chasing the hormones.
Hormones are reactive.
So let's say Your TSH is normal,but your free T3, the gas is low.
(12:01):
I'm like, okay, let's justbump up your medication.
Let's give you more home runs.
Well, it's a little bit of a bandaidapproach and I am not against medication.
I am all for medication if you needit, if it makes you feel better, but if
you're taking it and it doesn't make youfeel better, what's the missing piece?
Let's not just chase.
Okay.
Let's just bump up the hormones.
Let's chase what is causinga dip in your hormones.
(12:23):
A lot of times I see nutrientdeficiencies, like selenium.
I see gut issues, underlying gut issues.
Sometimes I've seen women's thyroidhormones come back into optimization
after they've addressed an H pylorigut infection, stomach infection.
I've even seen it with mold exposurewhere women are swinging hyper.
(12:45):
Their medications are getting adjustedall over the place and they're like,
this just doesn't feel right, Em.
And then we discovered thatthey have a mold exposure.
Maybe they have mold in their home.
They need to remediate,bring in a mold inspector.
And then we retest their labs and theyare coming back into optimal range.
And we didn't adjust their meds.
We just looked at thyroid from a rootcause approach versus a Band Aid approach.
(13:09):
All right, let's talk about reverse T3.
This is a little bitof a controversial one.
If you think of free T3, like the gas,reverse T3 is the break on the metabolism.
And when reverse T3 goes high, this istypically due to inflammation, stress,
and that could include overtraining.
(13:30):
gut infections.
And when reverse T3 starts to gohigh, the brakes go on harder.
Our metabolism slows down.
We have more fatigue,brain fog, weight gain.
Reverse T3 only gives a four hoursnapshot into that lab marker.
Insurance often does not cover itand so doctors often don't order it.
(13:53):
I would say that if there was onemarker that if the doctor was like,
Hmm, I don't think we need this.
Reverse T3 would be it.
Sometimes it takes a couple weeks forthat marker to come back from the lab.
And so you can get so muchinformation even without reverse T3.
I usually like to use reverse T3to see if there's an underlying
infection or illness or overtraining.
(14:15):
And those three things could come outfrom other tests, like a functional
gut test, like a GI map, or couldcome out in other blood work.
So, is it essential?
No.
Is it nice to have?
Yeah.
There are two thyroid antibody tests.
Most doctors order TPO,thyroid peroxidase antibodies.
(14:37):
It's nice to get both TPO and TGAB.
These will both identify if youhave an autoimmune component
to your thyroid disease.
You know, it's interesting becauseantibody tests are not that expensive,
like under 10, maybe around 5.
And I'm just like, man, why don'tdoctors just like throw it in?
(14:58):
Because the thought process is,well, once you have antibodies,
you always have antibodies.
And I would say that's not true.
And I am a testament to this.
When I was first diagnosed, mythyroid antibodies were sky high.
I addressed underlyingroot causes from a gut.
food, environmental load perspective.
And this is what I do with my one onone clients now and went into remission
(15:23):
a year later and stayed in remission,even through a second pregnancy.
And if you've been pregnant, youknow that growing a baby and having
a baby and nurturing the baby afterit comes out is a stress on the body.
And a lot of women canexperience an increase in thyroid
antibodies through pregnancy.
Luckily, I stayed in remissionthrough pregnancy and I've
(15:43):
been in remission ever since.
And it was really because I addressedwhat was going on, not from slapping a
Band Aid on like, Oh, here's a supplement.
I did that with two functionalmedicine doctors at first.
Here's some medication.
No, I did it from addressing what isthe driver that is throwing things off?
What is the drivermaking my hormones react?
(16:06):
Because hormones are reactive.
I want to give you power.
Because I feel like when we go intoour doctor's appointments with better
questions, we get better answers.
And so many women come to me and like,Oh, I wish I had said, I didn't know.
And so really, when you're asking yourdoctor, Hey, can we test more than TSH?
(16:27):
Just know TSH alone is not enough.
If you're asking for a full thyroidpanel, sometimes you're going
to get TSH, total T4, and TPO.
So I would like to go into my doctor,and I've done this with my OBGYN, and
be like, Hey, I want TSH, free T3,free T4, TPO, TGAB, and reverse T3.
(16:50):
And if you want, if the doctor won'torder it, there's ways to get it tested.
You can go through Function Health.
You could go throughUlta Labs and self order.
I order these for my clients whenthey work one on one with me.
And so don't feel stuck if your doctoris not going to give you the lab order
to get the full picture of your thyroid.
Because if you're tired, if you'renot losing weight, getting a full
(17:16):
thyroid panel is a non negotiable.
It is a 100 percent non negotiable.
So if your TSH is like 3.
2, you're not losing weight, you're tiredand you're told everything looks normal.
You start cutting out foods,doesn't really make a difference.
You add foods in, itdoesn't make a difference.
You're burning the candle at both ends,working your ass off, working out.
Know there's a better way.
(17:38):
So this is the work I do oneon one with women inside of my
functional medicine practice.
I'll drop the link to jumpon a call in the show notes.
See if you're a good fit todive in, to get more data.
I'm a big test, don't guess kind of girl.
And I'm also a big, let's optimizebody composition and make sure we're
doing all the things to feel like ourbest selves that is within our control.
(18:02):
How we're eating, how we're sleeping,how we're working out, how we're
regulating our nervous system.
It's not an either or like functionalmedicine or do the foundations.
It's both.
All right, ladies, I hopeyou enjoyed this episode.
If you loved it, go, drop a reviewin Apple, iTunes, Spotify, wherever
(18:24):
you listen to this podcast,and I'll see you next time.
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