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5 Thyroid Patterns That Won’t Show up on Standard Lab Tests

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Reviewed by Christina Graham, MSN, APRN, AGPCNP-BC

In medicine, the key to choosing the best treatment is an accurate diagnosis. If the diagnosis isn’t correct, the treatment will be ineffective—or even cause harm.

Unfortunately a misdiagnosis can happen in the management of hypothyroidism and other thyroid disorders. If you go to a doctor with hypothyroid symptoms, you may be given replacement hormones without first determining what’s causing your thyroid issues.

Or, if you have hypothyroid symptoms but your lab tests are normal, your doctor may not realize you’re experiencing thyroid issues in the first place. You may even receive treatment or medication to deal with the symptoms you’re experiencing—like an antidepressant to address depressive symptoms—but you won’t receive anything that will help your thyroid disorder.

The problem with this approach is that thyroid physiology is complex.

The production, conversion, and uptake of thyroid hormone in the body involves several steps. A malfunction in any of these steps can cause hypothyroid symptoms, but may not show up on standard lab tests.

All cases of hypothyroidism do not share the same cause—and, as you might guess, they require different treatments.

In this article, I’ll present five patterns of thyroid dysfunction that may not show up on standard lab tests. If you have one of these patterns, your thyroid isn’t functioning properly and you will have symptoms. But depending on the tests your doctor runs, you may not get a diagnosis of hypothyroidism; and, if that’s the case, you won’t receive the treatment you need.

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A standard thyroid panel usually includes TSH and T4 only (while some panels will also look at free T3, free T4, and check for thyroid antibodies). The ranges for these markers vary from lab to lab, which is one of two main problems with standard lab ranges. The other problem is that lab ranges are not based on research that tells us what a healthy range might be, but on a bell curve of values obtained from people who come to the labs for testing.

Now, follow me on this. Who goes to labs to get tested? Sick people. If a lab creates its “normal” range based on test results from sick people, is that really a normal range? Does that tell us anything about what the range should be for health? (For more on the problems with standard lab ranges, watch this great presentation by Dr. Bryan Walsh)

Are you experiencing hypothyroidism symptoms even though your lab work is normal? You may still have hypothyroidism, though it may not show up on standard labs. Check out this article for more. #functionalmedicine #chriskresser

The Five Thyroid Patterns

1. Hypothyroidism Caused by Pituitary Dysfunction

This pattern is caused by elevated cortisol, which is in turn caused by active infection, blood sugar imbalances, chronic stress, pregnancy, hypoglycemia, or insulin resistance. (1) These stressors fatigue the pituitary gland at the base of the brain so that it can no longer signal the thyroid to release enough thyroid hormone. There may be nothing wrong with the thyroid gland itself. The pituitary isn’t sending it the right messages.

With this pattern, you’ll have hypothyroid symptoms and a TSH below the functional range (1.8 – 3.0) but within the standard range (0.5 – 5.0). The T4 will be low in the functional range (and possibly the lab range too).

2. Under-Conversion of T4 to T3

T4 is the inactive form of thyroid hormone. It must be converted to T3 before the body can use it. More than 90 percent of thyroid hormone produced is T4.

This common pattern is caused by inflammation and elevated cortisol levels. T4 to T3 conversion happens in cell membranes. Inflammatory cytokines damage cell membranes and impair the body’s ability to convert T4 to T3. (2) High cortisol also suppresses the conversion of T4 to T3. (3)

With this pattern you’ll have hypothyroid symptoms, but your TSH and T4 will be normal. If you have your T3 tested, which it rarely is in conventional settings, it will be low.

3. Hypothyroidism Caused by Elevated TBG

Thyroid binding globulin (TBG) is the protein that transports thyroid hormone through the blood. When thyroid hormone is bound to TBG, it is inactive and unavailable to the tissues. When TBG levels are high, levels of unbound (free) thyroid hormone will be low, leading to hypothyroid symptoms. (4)

With this pattern, TSH and T4 will be normal. If tested, T3 will be low, and T3 uptake and TBG will be high.

Elevated TBG is caused by high estrogen levels, which are often often associated with birth control pills or estrogen replacement (i.e. Premarin or estrogen creams). To treat this pattern, excess estrogen must be cleared from the body.

4. Hypothyroidism Caused by Decreased TBG

This is the mirror image of the pattern above. When TBG levels are low, levels of free thyroid hormone will be high. You might think this would cause hyperthyroid symptoms. But too much free thyroid hormone in the bloodstream causes the cells to develop resistance to it. So, even though there’s more than enough thyroid hormone, the cells can’t use it and you’ll have hypothyroid—not hyperthyroid—symptoms.

With this pattern, TSH and T4 will be normal. If tested, T3 will be high, and T3 uptake and TBG will be low.

Decreased TBG is caused by high testosterone levels. (5) In women, it is commonly associated with PCOS and insulin resistance. Reversing insulin resistance and restoring blood sugar balance is the key to treating this pattern.

5. Thyroid Resistance

In this pattern, both the thyroid and pituitary glands are functioning normally, but the hormones aren’t getting into the cells where they’re needed. This causes hypothyroid symptoms.

Note that all lab test markers will be normal in this pattern, because we don’t have a way to test the function of cellular receptors directly.

Thyroid resistance is usually caused by chronic stress and high cortisol levels. It can also be caused by high homocysteine and genetic factors. (6)

Thyroid Treatment Depends on the Right Diagnosis

The five patterns above are only a partial list. Several others also cause hypothyroid symptoms and don’t show up on standard lab tests. If you have hypothyroid symptoms, but your lab tests are normal, it’s likely you have one of them.

Not only do these patterns fail to show up on standard lab work, they don’t respond well to conventional thyroid hormone replacement. If your body can’t convert T4 to T3, or you have too much thyroid binding protein, or your cells are resistant, it doesn’t matter how much T4 you take; you won’t be able to use it.

Unfortunately, if you have one of these patterns and tell your doctor your medication isn’t working, all too often the doctor’s response is to simply increase the dose. When that doesn’t work, the doctor increases it yet again.

As I said at the beginning of this article, the key to a successful treatment is an accurate diagnosis. Without understanding precisely what’s causing the problem, you may end up with a treatment that isn’t well-suited to your specific situation.

The good news is that, once the correct diagnosis is made, patients respond very well to treatment.

841 Comments

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  1. Chris,
    In 2010 i went for my phy due to being tired (excessively) and weight fluctuation. I was had maintained 120 lbs w/ no weight fluctation. I was and am highly active workout daily and was eating semi healthy. My prim dr discovered a nodule on my right side of my thyroid. Long story short the TSH came back saying i was hyper. But none of that made sense as i was exhaused and gaining weight. I tried for almost 2 years to manage my healthy w/o pills but in Feb of 2012 after putting myself on a high protein diet, prenatal pills and using every nail growth nail polish when my nails split putting on a necklas (and w/ my weight then and now at 130-133 desiptie my working out and caloire watching and prioir they were long and strong!!) i went and was tested and put on 50 mg of lthyrxine 6 weeks later up to 100 then 3 months later back to 75). It seemed to help some of my symptoms (better sleeping no excessive sweating on my armpits) but now 8 months later my nails are not growing (i have never bitten my nails and they look like i chew on them) I am training for NPC competition and eating the same clean diet no soda no junk and my body isn’t responding ( i am 135 lbs @ 28%fat). I was tested for the anit bodies and that was positive and yet my TSH levels reflect i am hyper but my T4 and T3 are normal. I am at the point of going crazy. I am at a loss what to do!! i am at the point of having the nodule removed as since it came to be is when all this has changed and impacted me. I am looking for direction on what i should ask my dr and i feel like my body isn’t converting things correclty in my body based of my nails (hair dry skin …low engery) and weight etc. ? can you recomend anything to me?

    • Crystal, I had many of your health issues and was dx with Graves. I told my Endo I felt like I had Hashimotos. He insisted it was Graves and quickly scheduled me for RAI, which I declined and went on 3 surgery consults instead. After my total thyroidectomy June 2011, the biopsy showed I did indeed have Hashimotos… My suggestion to you is to get ALL the antibody tests to see if you are like me and have BOTH Graves AND Hashis. The tests I had done were: TG-AB, TPO and TSIG. My antibodies were high for all of them. Have you had your ANA labs done, with the ANA Pattern? I did, and my ANA was positive, with a speckled pattern, with a positive SSA antibody, so I also have Sjogrens. My point is, if we have one autoimmune disorder diagnosed, often times, we will also have a second autoimmune (or even 3rd, like me). Over half the battle is getting an accurate dx. Good luck to you.

      • Hey thanks for the heads up! I guess my results in Feb were suppressed tsh and t3 &t4.. thus the l thyroine but w no weight loss and now my tsh ar. 01 i went off (& i am training for npc comp..so clean eating 2 a days and no fat loss). Went on hypo meds and i gained 5lbs in a week!! Now am seeing a sports metabolic dr specialist.. she thinks there is something bigger going on so testing all ny # hormones tsh etc ) hoping they can find out what i will let u know and willask about alk that

        • So after labs and all have been done .. am being treated for insulin..and leptin resistance…will see how this pans out but fingers crossed

          • Your case sounds so similar to mine regarding all the symptoms and body weight issues…the only thing different is that my dietitian was actually the one that told me to do all these tests again, eventhough I had been doing it for 3 years in a row, and all doctors (neurologist, alergologist and gynecologist would say everything is normal). I am currently waiting for TPO and TG-AB results, my TSH is low and T3 and T4 are normal. How did your experience ended?.

            • Have they checked your pituitary gland output? Also it isnt totally uncommon to have both HYPER and HYPOthyroidism simultaneously. You need a new Doc perhaps; someone who fully understand thyroid issues. How about Dr Brownstein?

  2. Hi,
    I came across this forum trying to figure out what my doctors apparently are not able to. While I do not expect you to provide a proper diagnosis simply based on what I write here, I was hoping you could possible point me in the right direction. I have been suffering from insomnia for the past (at least) 3 years. About the same time I started having difficulty sleeping, I had an abdominal surgery (2009) (I have Crohn’s disease, which currently appears to be in remission as of my last colonoscopy a month ago) and put on 30 pounds following the surgery for no apparent reason. I did not change my eating habits at all, I did not change my exercise routine at all and my stress level really did not change either.

    The following summer, we went to take our first annual bike ride (we are avid riders and would ride 15-20 miles every weekend with the kids) and by the time I got to the corner of our street, I was literally crying because my legs burned and hurt so badly, I ended up walking my bike back because I could not pedal it home. I went to my doctor, again complained of being exhausted by this point, still from lack of sleep and the burning in my legs. He ran a bunch of tests, of which I cannot recall, I was told all levels were normal except my triglycerides, which were over 500 or something crazy high like that. None of my other cholesterol levels were above normal, just my triglycerides. I did not want to start statins because my legs were already hurting, so I modified my already relatively healthy diet to exclude the small amount of occasional fried foods. Of note, prior to the surgery, my weight fluctuated between 125 and 130 and I am 5’2″ tall.

    Fast forward to a bunch of normal tests and I end up at a rheumatologists office who tells me I have fibromyalgia and prescribes Lyrica, which is in addition to the Ambien my doctor has prescribed for sleep (or lack thereof), neither of which did much of anything for either of my issues (sleep or leg burning).

    About 5 months ago or so, the insomnia was getting worse and started to affect my cognitive function….. forgetfulness……so badly, I actually forgot to go to work on two separate occasions (who does that right?), inability to follow along in simple conversations, excessive daytime sleepiness to the point that I would lie down and take a nap for 3-4 hours every afternoon or I could not get through school.

    I went back to my doctor because one afternoon last week, it took me 7 hours to answer 15 simple questions in my psychopharmacology class, which happens to be a subject I excel in…..my GPA is 3.98 on a 4 point scale and I have never in my life ever struggled with school and rarely have to study. So, for me, this is a new symptom or I should say worsening symptom. I am also working on my supervised hours for addiction counselor and “forgot” a very important court date I had to appear at for one of my clients.

    My doctor has now added a low dose of Adderall (10 mg) as a “temporary fix” until they can figure out what is going on with me and it has greatly improved my energy level and clarity. I easily recall things I need to, do not have a need to take a nap, and for the first time in 3 years feel “normal”.

    I had a sleep study performed a few weeks ago (prior to the addition of Adderall)….This showed no evidence of sleep apnea. With taking 3 mg of Lunesta (changed from Ambien because of no improvement) prior to retiring for the night, I only entered REM sleep for 7% of my total sleep time and woke up or cycled back to stage I sleep 29 times. I feel asleep in 11 minutes, the study lasted for 371 minutes and it took me 271 minutes to get to REM sleep, where I spent approximately 26 minutes. Of most clinical significance, it was noted that my O2 saturation dropped to 84% and it was suggested I have an overnight O2 saturation study. I had that study performed immediately after and in a 6 hour period, my O2 saturation dropped 31 times to between 80.4% and 80.8% and staying that low for between 21 seconds to 5 minutes. Restless leg symptoms were not noted, nor was there any evidence of snoring.

    In addition, TSH was normal (using that term loosely), CRP was normal, B12 was low (I was given a B12 injection), WBC normal, CBC normal, triglycerides still elevated, but decreased to 282, all pulmonary function studies were normal and I have no evidence of asthma nor do I have any shortness of breath while awake or during exercise.

    My doctor sent me to an ENT thinking my tonsils may have something to do with my O2 sat dropping. ENT thought I was crazy and asked if I was depressed…..went to a second ENT (since I thought it was impossible for a proper diagnosis from the first one when he did not even take the time to look at my tonsils or examine me in any way) who informed me I had tonsiloliths, but not significant enough to cause O2 desaturation and this one also asked if I am depressed. By this time, I am frustrated, exhausted and don’t really care if they call it the chicken pox, I just want it to stop so I can get some quality sleep. I calmly told him that since my profession is to recognize signs of depression and provide counseling services to my clients, I am pretty sure I could recognize if I myself was experiencing depression. I went on to tell him I had a very happy childhood, was never sexually abused, have a pretty good relationship with my mother, am involved very happily in a relationship and we are planning on getting married when I graduate in the spring, I absolutely love my job and while I occasionally get a day when I feel like life is treating me like its own personal toilet bowl, for the most part, I am very happy and not very dysfunctional. I also wondered out loud, in an inquisitive tone, when depression started to cause ones O2 saturation to decrease as I have been taught that it can cause difficulties sleeping or excessive tiredness, but have never heard that oxygen desaturation can be caused by depression. I suspected, again out loud, that if my oxygen saturation issue was solved, that likely my sleep issue would also be solved.

    So, now that I have taken up a great deal of your time, my question is this……how possible is it that my issue with O2 sats dropping as low as they are is caused by either my thyroid or my adrenal gland? The ENT wants to perform yet another sleep study, which I think is a tremendous waste of my time since I have already had one done only a few weeks ago. Should I be seeking an opinion from an endocrinologist to explore a thyroid or adrenal issue? I feel like I am going out of my mind because even simple tasks like remembering to take something out for dinner is incredibly cumbersome. I struggle to do even basic activities throughout my day and my legs are still burning so bad I cannot even go grocery shopping because of the walking involved. I should also mention that I did have ABI testing performed to rule out any clots or arterial/venous issues and I have had a complete cardiac work up, also normal.

    I would appreciate any direction you might be able to lend.
    Thank you
    Kimm

    • Kimm

      People with Chron’s Disease tend to have low selenium, low zinc levels and high copper levels.

      http://www.ncbi.nlm.nih.gov/pubmed/8362213

      The high copper can affect women with Chron’s especially as most women already have higher copper levels due to such things as copper IUD’s and birth control pills. Copper also rises as estrogen levels rise. and it needs very good adrenals and liver function to eliminate excess copper. which sress will deplete.

      High copper can cause a lot of your stated symptoms including insomnia and muscle problems. The low selenium and zinc could also cause
      thyroid problems. To reduce your triglycerides google” fish oil reduces triglcerides”

      I have found this site to be helpful for those with excess copper problems and she will answer any questions.

      http://www.tvernonlac.com/copper-toxicity.html

    • I am sorry you are having a tough time. It might be helpful to have a hair analysis; this will tell you what is happening in your tissues – often different to what is happening in your blood – and the hair analysis I use here in Europe will also give advise on diet and supplements but more importantly will diagnose low adrenal output and low thyroid hormone too. The feedback is specific to you and you would inform them of Chron’s.
      Certainly insomnia is a symptom of low adrenal output and low thyroid hormone since I suffered with it for around 28years. Insomnia where you wake around 2-3am is due to hypoglycaemia and that in turn is due to low adrenal output, low thyroid hormone and resulting low liver funcion. Sometimes I couldnt even get to sleep let alone wake up.
      Hair analysis gave me information and a determination to get the right diagnosis; this came after 33years. Since treating my adrenals with vitamins, minerals, trace elements and herbs plus DHEA and also getting the right thyroid meds, I USUALLY now sleep like a baby. Best of luck.

      • Sally – where can you get the hair analysis? I am in Germany and having a horrendous time finding a doctor that will listen to my *symptoms* despite normal results.

        General question here…I am getting a bit confused as my “normal” levels use the German names:

        Free “trijodthyronin” (FT3?): 4.2
        Free “thyroxin” (FT4?): 14.2
        “Thyreoidea-stimulierendes Hormon” (TSH): 1.69
        “Thyreoidea-Peroxidase” Antibodies (???): 312
        “TSH Rezeptor”, Antibodies (???): negative

        But, despite my “normal” levels, I feel like hell. I have a long history of PMDD that no doctor will do anything to help so I was already running with about 50% of a ‘normal’ existence (pmdd for me always sucked all the life and energy I had out of me plus made my moods and emotions uncontrollable, my appetite rage out of control, my concentration disappear completely – for two full weeks every.single.month.) But then I returned to normal. Happy, with energy, focus, PATIENCE, normal appetite.

        Within the last 3 months, my energy level has vanished completely. My hair has been breaking for a long time, I am fully exhausted, if I do anything (do the shopping on Saturday afternoon) it takes hours to recover. My appetite has gone crazy, I crave sugar and salt, I am short of breath, I get really cold (i freeze), I have serious brain fog, I am irritable and NOW I am depressed. This is a major change to “just” the PMDD. This is horrible for me and my little boy. I have no energy to do things with him. I feel hopeless of ever getting to the bottom of this.

        My iron levels were a bit low. I have been taking iron pills for the last 4 weeks, but there is no major change there. I do have a lot of stress though, but in general, have a lot of positive things happening. I was feeling pretty darn good on my non-PMDD days) It’s just a lot in for a long time. My cortisone level is 127.

        My mother, father and sister all are hypothyroid. My gynecologist (from an Endocrinology practice) thinks I am just depressed and prescribed Zoely which is a birth control pill with “natural hormone replacement”. The pill was a nightmare for the PMDD when I tried it before. I have not started this.

        But I have several other Hypo symptoms. These are just the ones that are truly making my life miserable right now.

        Does anyone have any ideas? Sorry, I started with just general questions and just kept going. 😉

        Thanks for any thoughts. I wish us all the help we’re looking for.

        Tina

    • Kimm, I know yours was an older post, but parathyroid adenoma comes to mind. Did anyone run a serum calcium on you? Better yet, an ionized calcium.

      If you are over about 30-33 years old ,your calcium should be in the nines, anything over 10, on a regular basis or climbing, coupled with insomnia and fatigue points to primary hyperparathyroidism.

      • Forgot to add, check out parathyroid.com for a complete list if symptoms. This condition is grossly under diagnosed , and many providers do not have an accurate picture of clinical HPT. Most have outdated information.

  3. I’ve got another one for you. A friend of mine was recently diagnosed hypothyroid do to a medication side effect (carbamezapine). This manifests as normal TSH, low T4, and low T3 – but in the early stages, T4 (and possibly T3) are depressed but not out of range. This develops over time. It’s unclear if this is acting through the pituitary or something else entirely. Troublesome for anyone on continuous treatment with these sorts of drugs, as the TSH remains normal, and many doctors test only that. In our case, we discovered the change due to a sudden and rapid increase in cholesterol.

  4. Once again, no high cholesterol, but I am hypothyroid. I’m getting far too much thyroid medication according to my primary doctor, but my endocrinologist lets me stay on the present dose because I don’t have high cholesterol, or heart probems, and bone density is fine. And no diarrhea.

  5. What about when labs indicate Hashimoto’s but I felt healthy with no hypo symptoms to report (I had a TSH of 10, FT4 of 1.0, and FT3 of 297, TPO >1000, ATA 1268)? I went off gluten for 5 months and now my TSH is 2.08 and all of a sudden I feel terrible — brain fog, fatigue, mild depression (FT4 of 1.2, TPO 447, and ATA 260). I started a dose of Armour Thryroid a week ago and am hoping this will help alleviate these unpleasant symptoms!

  6. I forgot to add that at the moment (as of yesturday) I have started to supplement Betaine HCL, as I also have some symptoms of low stomach acid. Not sure if I will get any results from that.

    I have scheduled a phone consultation. Thank you Chris.

  7. Nope, he isn’t, but the point of thyroid replacement is to mimic normal phsyiology. So, if thyroid patients do best at the top of the FT3 range; I would venture that healthy people should be there too.

    I also FIRMLY believe in fixing underlying causes low thyroid such as low adrenals, low iron/ferritin, low B12, gluten intolerance etc.

  8. Well some labs use the range 2.0 – 4.4 for FT3 and other labs use the range 4.0-6.8 for example. People who are doing well (absence of thyroid symptoms) on their thyroid meds tend to have their FT3 at the very top or slightly over the range. This observation comes from years of interaction at patient groups. Apparently the ranges used to be higher, which explains this.

  9. Ranges don’t differ that greatly, in my experience, for FT3 & FT4. He’s at the high end for FT3, though he is towards the low end for FT4. It’s more likely he has thyroid receptor site resistance secondary to dysregulated cortisol rhythms. It’s perfectly possible for people to have normal thyroid labs and still have symptoms.

    • my tsh is 1.27 normal
      i have all the hypo symptoms
      i checked my estrogen /progesterone ratio and it is normal

  10. I should have phrased that more clearly. I meant that that the FT4 and FT3 are more important than the TSH, and that just because his TSH is low does not mean he is euthyroid.

    Without ranges, it is hard to tell where Bill’s numbers are though. Ranges differ from lab to lab and they don’t all use the same units.

  11. Lynn: I disagree that TSH isn’t useful. I think it’s very useful. It tells us what hormone levels are feeding back on the pituitary, and whether the pituitary is functioning properly.

    Bill’s FT3 and FT4 levels are within both the functional and lab ranges.

  12. Bill,

    I wish there was an easy answer I could offer you. As you have no doubt gathered, thyroid physiology is complex and multi-factorial. From reading your story, I suspect (as you do) that it’s your HPA axis that’s driving your symptoms. This isn’t uncommon – I have several patients with normal thyroid labs, but still have weak thyroid function secondary to pituitary or adrenal dysfunction.

    There’s really no way to know more without doing a full work-up. If you’re interested in that, please visit my professional site to learn more about how I work with people and schedule a free, 15-minute phone consultation.

  13. Hey Chris

    I am hoping you can help me. I have many of the thyroid symptoms, but all my levels check out:

    TSH 1.27, FT4 1.1 and FT3 3.7

    Negative or “normal” for antibodies. TSH was tested separately and I was on “the raw milk diet”for both the tests.

    Testosterone was 306 on the first test, on the second it was 438. I was not fasting during any of these tests which I now have read could screw up results.

    I have been gluten-free, Primal type diet, no cheats with any grains whatsoever, since December. Unless there was gluten in something I ate at a restaraunt, although I was very persistant about being “gluten intolerant.

    I have had folliculitis caused by gram negative organisms, usually Enterobacter Aerogenes for 3 years, it waxes and wanes. It’s not “horrible”, but it definitely has ruined my face.

    I have been on Tetracycline in 2003 for Acne. Then nothing till 2007, where since I have been Doxycycline twice, Amoxicillion, Erythromiycin, and Clarithyromycn. Never for more than a month at a time.

    Obviously my gut flora is screwed. I did the raw milk diet and am now taking Theralac and Ohhiras. The condition has improved and definitely improved when I let go of topical therapy (a huge waste).

    But now my thyroid symptoms are really showing up, and I can’t tell if my folliculitis is flaring from the very dry skin from thyroid, or if the Enterobacter is still going strong. I wanna say it’s both.

    I was VERY underweight for about a whole year (all of 2007, some of 2008)due to being an overzealous cross country athelete who could not recognize when my overly competitive attitude was doing me wrong. I restored my weight with a junk food-binge type diet quickly by 2008.

    Found Primal in 2009. Many health problems left. But now things are much much worse. Did Zero carb for a bit, Very low carb for a few months.

    Never had thyroid symptoms till now, but clearly I had them coming.

    I am guessing my pituatary, adrenals, and thyroid are just fed up with me.

    I have been overfeeding, at least 2500-3500 calories a day for about two months now. There have been days when I feel and look great. But then days where I feel horrible, my eyes get puffy and baggy, skin flaring.

    Really don’t know where to go. I really just want that fecal therapy done to correct my gut flora, and then address the rest of the issues. I am afraid to go on antibiotics again unless I can get fecal therapy right after. Folliculitis get’s worse after each antibiotic and I really don;t need any other immune issues.

    I am ruling out Hashimoto’s for now. Just because for years I ate gluten and never had any thyroid symptoms. I gained and lost weight like a normal person, slept alright, didn’t really display any food intolerance symptoms besides acne and ADD, some anxiety sometimes about sleep.

    Too long of a comment, I am sorry. Hopefully I can get some advice. I have a doctor at Whitaker Wellness.. but so far that is going no where.

    • You have several other people commenting on your post but one thing to think about due to high amounts of antibiotic therapy is fungal infection. It is highly likely you have fungal infections which are causing some of your symptoms.
      I have used Lufenurone to good effect and without side effects which has to be a bonus with everything else you have. You will need to take Lufenurone for around 6 months and then repeat it again next year and so on until those symptoms resolve. It will then enable you to work on your gut dysbiosis and then the other things including thyroid. It is a long and windy road but its possible to get there; be patient; though I understand that is frustrating when you feel so Sh*t. Best of luck

  14. Lynn,
    Yes, I meant raising the dose until optimised.

    Chris,
    I´m with you. I was just pondering the accuracy of such trials. I guess I should have directed my question to Angus who was the one mentioning it in his comment.

  15. Hi Carina

    It is normal to raise the dose quite often when you first add thyroid hormone. You do this until you reach your sweet spot. Then, some need to increase slightly in winter and decrease a bit in summer. Otherwise, if you need to constantly tweak your dosage there is something wrong. Check out all the things Chris mentioned in his series as well as ferritin, B12, electrolyte and adrenals.

    Also, T3 or natural thyroid works better for most.

    • If you need to increase your thyroid medication in winter, you probably want to think of getting some D-vitamin instead….. My underlying issue with hypothyroidism was gluten and dairy intolerances and vitamin and mineral defciencies as well as a gut infection.
      2 months after I went paleo I had to get off all thyroid medication (I have been taking Levaxin for more than 15 years!). The thyroid medication never worked for me, all the low thyroid symptoms were there all these years despite the medication. My doctor said “everything is OK” year after year – he trusted the results from the blood work…..
      Thank you Chris for all your hard work informing and educating us all!

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