Thyroid Pearls & Tips

February 14, 2020 Dan Purser MD

Wow I see all this almost every day in my office -- same exact thyroid related medical issues/complaints. After ten years of endocrinology research and 33 years in practice, I've concluded that a lot of my fellow doctors weren't really taught the nuances of thyroid care. Those include how patients need levels optimized, or how to really listen to patient's symptoms (and treat accordingly), and which labs to get at what time. So, I always tell patients to believe their ‘lying eyes’ (their symptoms are real), and not always the lab results (which can be inaccurate or not interpreted correctly). If you have a good medical clinician, your symptoms of hypothyroidism are more important than the lab results.

It is very complicated but let me make it simpler. If your hands and feet are ice cold, you are probably NOT on enough thyroid medication. It is almost NEVER Raynaud's phenomenon, but is undiagnosed hypothyroidism and/or under-treated hypothyroidism. Download my thyroid book Out of The Deep Freeze: No More Cold Hand, Cold Feet now ($0.99 on Kindle) and start with that. Even at the most basic level what looks like hypothyroidism is not always hypothyroidism but could be a zinc, selenium, and/or B12 deficiency.

Why do doctors check the Free T4 (FT4) instead of the active part of the thyroid, the Free T3 (FT3)? It depends how these doctors are educated in medical school/residency. In the 1970s, Knoll Pharmaceutical developed Synthroid (synthetic T4) and ‘captured’ the endocrinologists in the medical schools who still believe in this concept today only using Synthroid. Heaven forbid they use ‘animal thyroid’ (as they derisively call Armour or Nature Thyroid).

Neither you nor I know what is happening with your thyroid, unless you know your FT3 lab result. Ideally, you want a normal FT4 and a FT3 that is optimized up to near the top of the normal range at 4.1 pmol/L. Being at the bottom of the range guarantees misery (cold hands. cold feet, weight gain, sluggishness, hair loss, etc.). FT3 is where it counts!

Thyroid resistance is just as real as insulin resistance and you need a lot more thyroid hormone to treat. I often see it in thyroid cancer survivors who need more thyroid than normal. If you have Grave’s disease or thyroid resistance, make sure you are taking extra CoQ10 (i.e. ubiquinol). I suggest Qunol 200-300mg a day since hyperthyroidism blows through your CoQ10 causing fatigue and brain fog.

Suffering from Hasimoto’s disease requires a higher dose of thyroid to get optimal results. If you are a fan of Thyromin from Young Living Essential Oils, the max dose you should take is five at night before bed and three in the morning upon arising. I've seen this insight work many times with my patients.