Labs are Great, Still Gaining Weight

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Hi, I'm Dr. Gibbs, and I want to share insights into a topic close to my heart: thyroid health. As both a thyroid sufferer and a physician, my journey with this condition spans four decades:  first being misunderstood and misdiagnosed, then the lightbulb moment when I realized how I felt was not actually "normal" as I had been told, then the quest for as much information as possible, so I could help patients as well as myself.

A stubborn problem in the care of hypothyroid patients, aside from the problem of the condition going unrecognized,  is the frustrating tendency to gain weight, no matter how little you eat, or what else you try. There are several reasons that can happen. I will explore 3 of them today.

1. The Importance of Complete Labs: One of the primary pitfalls in thyroid evaluation lies in the choice of lab tests. Surprisingly, the standard tests often miss crucial indicators of thyroid dysfunction, leaving many undiagnosed or improperly managed. Traditional measures like TSH (Thyroid Stimulating Hormone) and Free T4 may overlook issues such as impaired hormone activation or receptor blockages, which can stem from various factors like genetic predisposition, stress, or previous dieting habits.

To delve deeper, additional tests beyond the conventional panel are essential. Free T3, total T3 and Reverse T3 provide valuable insights into activated hormone levels and receptor blockages, respectively. Understanding the ratio between Total T3 and Reverse T3 offers a nuanced view of thyroid function, guiding tailored interventions for optimal outcomes.

2. Interpreting Labs with Precision: Even when the right tests are conducted, interpreting the results requires finesse. The widely accepted reference ranges for thyroid hormones often mask deviations from the ideal, leading to underestimation or misdiagnosis of thyroid disorders. For instance, while the standard TSH range extends from 0.45 to 4.5, optimal thyroid function is typically observed at lower levels, around 1.0. Elevated TSH levels signal thyroid inefficiency, demanding further investigation and personalized treatment approaches.

Similarly, understanding the interplay between T3 and Reverse T3 levels offers critical insights into metabolic dynamics. Achieving an optimal ratio, ideally around 12, reflects a balanced thyroid state conducive to overall well-being. By refining our interpretation of thyroid labs, we empower individuals to receive targeted interventions that address underlying imbalances effectively.

3. Embracing Comprehensive Treatment Strategies: A common oversight in thyroid management involves reliance solely on Levothyroxine (T4) supplementation, overlooking the role of Triiodothyronine (T3) in restoring metabolic equilibrium. While Levothyroxine remains a cornerstone of thyroid therapy, integrating prescription T3 can offer significant benefits, particularly in cases of receptor blockages or autoimmune thyroid disease.

Prescribing T3 requires careful titration and monitoring to mitigate potential side effects and optimize outcomes. By harnessing the synergistic effects of T4 and T3, healthcare providers can tailor treatment regimens that address individual needs comprehensively. However, access to knowledgeable physicians well-versed in advanced thyroid management remains paramount, underscoring the importance of seeking specialized care for thyroid-related concerns.

Conclusion: In the pursuit of thyroid health, navigating the complexities of diagnostic testing and treatment protocols is paramount. By advocating for comprehensive lab evaluations, precise interpretation of results, and holistic treatment strategies, we can empower individuals to reclaim their well-being and thrive despite thyroid challenges. Remember, thyroid health is not a one-size-fits-all endeavor; it requires personalized attention and informed decision-making to achieve optimal outcomes. If you resonate with the struggles outlined here, I encourage you to seek guidance from healthcare professionals versed in advanced thyroid care. Together, we can unravel the mysteries of thyroid dysfunction and pave the path to vibrant health and vitality.

Thank you for joining me on this journey towards thyroid wellness. For more resources and insights, visit my website at and stay tuned for upcoming programs and initiatives aimed at optimizing health and vitality.


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