Do you have a thyroid problem but were told you were in the "normal range?" Tune in to hear the experts explain why the thyroid can be overlooked.

Thyroid is tested in every one of our patient's blood work that comes in for wellness visits including hormones. 

"Normal" is relative because patients may have normal levels but have symptoms. This is why we go for "OPTIMAL" and symptom resolution! 

Active hormones need to be checked including T4, but T3 (the most active hormone) is overlooked a lot but is the most important. 

Dr. Durst and Farideh list several symptoms of thyroid issues while the list goes on! 

The most common medications that people are put on are synthetic and for T4. T3 and T4 medications are Dr. Durst and Farideh's favorite. Sometimes the ratio of the two can be tweaked to optimize the thyroid level which is why RMD uses a compounding pharmacy. Compounding pharmacies are so important for this reason. Every patient is different and has different levels. 

Nutrition can cause thyroid problems. Soy can decrease thyroid function. Low Zinc, iodine, fluoride poisoning, etc can also cause thyroid issues. Estrogen dominance in women can also cause issues. Stress is another thing that can play a big part in your thyroid function.

Hyperthyroidism can be diagnosed by coming into the office and having hormones drawn along with T3. A lot of times it can be treated with lifestyle changes and sometimes medication. 

T3 can have a direct effect on muscle building and heart health. 

Clinical Findings:Depression, Weight gain, Constipation, Headaches/migraine headaches, Brittle, ridged, striated, thickened nails, Rough, dry skin, Menstrual irregularities, Fluid retention, Slow speech, Nails that are easily broken, Anxiety/panic attacks, Decreased memory, Inability to concentrate, Muscle and joint pain, reduced heart rate, Slow movements, Morning stiffness, Puffy face, Swollen eyelids, Decreased sexual interest, Cold intolerance, Cold hands and feet, Swollen legs, feet, hands, abdomen, Insomnia, Fatigue, Low body temperature, Horse, husky voice, Low blood pressure, Muscle weakness, Agitation/Irritability Hypercholesterolemia, Infertility, PMS, Hyperinsulinemia,  Some studies supporting T4/T3

Bunevicius, R., et al., “Effect of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism,” NEJM 1994; 340(6):424-29. 

Adlin, V., et al., Subclinical hypothyroidism: deciding when to treat,” Amer Fam Physician 1998; 57(4):776-80. 62

Lab results were not better but patients felt better when both T3 and T4 were replaced.

Escobar-Morreale, H., et al., “Thyroid hormone replacement therapy in primary hypothyroidism: a randomized trial comparing L-thyroxine plus liothyronine with L-thyroxine alone,” Ann Int Med 2005; 142(6):412-24. 63

Woeber, K., “Levothyroxine therapy and serum free thyroxine and free triiodothyronine concentrations,” Jour Endocrinol Invest 2002; 25(2):106-09.65

Recent studies have shown that it is now time for personalized thyroid replacement to be prescribed for patients. Wartofsky, L., “Combination L-T3 and L-T4 therapy for hypothyroidism,” Curr Opin Endocrinology Diabetes Obes 2013; 20(5):460-66.

Biondi, B., et al., “Combination treatment with T4 and T3: toward personalized replacement therapy in hypothyroidism,” Jour Clin Endocrinol Metab 2012; 97(7):2256-71.66

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