Some Simple Q & A’s

What tests are you using for thyroid assessment?

Consider as a minimum using TSH, free T4, free T3 perhaps with total T3, reverse T3, and antithyroid antibodies.

What are the objective indications (per lab) for the use of thyroid hormone supplementation/replacement?

Elevated TSH, low T4 or T3, antithyroid antibodies

Can a patient have a normal TSH, free T4 and total T3 yet still have laboratory indication for the use of thyroid hormone?

Yes, they might have elevated reverse T3, and/or a compelling clinical picture.

What are the differential indications for T4 versus T4+T3 versus T3 alone?

Patient/doctor preference; fragile patients tolerate T4 better and the half-life is about 7 days in contrast to T3’s half life of about 1 day.  T3 is the only treatment that works for functional hypothyroidism defined in this instance as elevated rT3.

What nutrients have been shown to promote proper thyroid function?

Iodine/Iodide, tyrosine, zinc and selenium.

What supplemental nutrients have been shown to impair thyroid hormone metabolism?

L-carnitine

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