Over the last few years, there has been an increased awareness of thyroid conditions, specifically hypothyroidism. The proper thyroid evaluation has become somewhat controversial as well. For decades, a simple TSH (Thyroid Stimulating Hormone) test has been the conventional test of choice in screening most thyroid related issues.
However, an ideal thyroid evaluation is so much more than just the typical TSH blood test. The TSH reference range is 0.45 – 4.5 uIU/mL depending on the lab. This range is quite large and many people can exhibit hypothyroid related symptoms, but their TSH is within normal range.
Common Hypothyroid Symptoms:
Other tests for thyroid function include both Free T4 and Free T3. The hormone Thyroxine (T4), which is released by the thyroid gland is an inactive hormone. The body will convert T4 into T3, which mainly occurs in the liver. The free T3 is the active form of thyroid so it is very important to include this blood test for proper evaluation.
It is important to point out, that approximately 70% of all hypothyroid cases are of the Hashimoto’s Thyroiditis type, which is an autoimmune condition where the immune system is attacking the thyroid. With Hashimoto’s you want to work on the autoimmune component, which means beyond just medication.
The antibodies involved in Hashimoto’s hypothyroid are the Thyroid Peroxidase Antibody (TPO) and and the Thyroglobulin Antibody (TGab). It is important to test these antibodies in any thyroid patient to differentiate if they have Hashimoto’s or generalized hypothyroid. Often some patients have elevated antibodies but have normal values of TSH, Free T3, Free T4.
Thyroid Testing:
There are many different types of medications for hypothyroidism. Conventionally, the typical medications prescribed are Synthroid, Levothyroxine or Levoxyl. It is very common for many patients on Synthroid, Levothyroxine or Levoxyl to have a reduced TSH but also still experience hypothyroid related symptoms.
In most cases, we like to use medications with a combination of both T4 and T3. Conventionally, Cytomel is a T3 drug that is often prescribed, but it is an instant release and many patients do not tolerate this medication. A better option is Compounded Thyroid, which is usually a Sustained Release (SR) combination of T4 and T3. In addition, there is Armour and Nature-Throid, which are both porcine based medications that also included T4 and T3. There is no one-size-fits-all in hypothyroid treatment.
The thyroid and adrenal glands are connected and when one is low the other is compromised. Patients with adrenal fatigue sometimes cannot tolerate thyroid medication until you treat the adrenal dysfunction, making it important to work on the adrenals when you are being treated for hypothyroid.
Hypothyroidism also includes patients that have had their thyroid removed due to thyroid cancer. These patients do very well on compounded T3/T4 thyroid therapy.
Many doctors that practice “functional medicine” will be able to treat your thyroid condition more individually, looking more into functional blood testing for Free T3 and Free T4 as well as treating other systems of the endocrine system.
If you have questions, please feel free to leave a comment below, you can contact us directly.
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Discover the common and unfamiliar symptoms that you might be experiencing. Get access to cases of real women with hormonal conditions.
In this episode, we discuss the best way to reduce triglycerides. Sasha, a podcast listener, asked us how to lower her triglycerides. We then go into depth about triglycerides, how to lower them, and why they could be high in the first place.
How to read a lipid panel
Supplements for lowering triglycerides
Lifestyle changes for lowering triglycerides
What do high triglycerides mean?
Building blocks for triglycerides
Improving metabolic health
Can menopause increase triglycerides?
High triglycerides and thyroid hormones
Sacha’s Question:”I know this isn’t a hormone question but was hoping you could give me some direction. I was wondering what is the best way to lower triglycerides? thank you for your help!”
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns youmay have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode, we discuss a podcast listener’s question. ‘Alesha’ is concerned that she should not take estrogen replacement therapy because she has fibroids. This is a common concern. The idea that estrogen can cause or propagate fibroids has left many menopausal women without support for their symptoms. Just because women have or have had a history of fibroids does not mean they are not a candidate for estrogentherapy. In fact, women with fibroid can take estrogen hormone replacement therapy.
In this episode, we go into depth about taking estrogen with fibroids. And we break Alesha’s question into:
What are fibroids?
Fibroids and estrogen replacement therapy
Can I take estrogen if I have fibroids?
What is adenomyosis?
Estrogen’s role in fibroids
Difference between perimenopause and menopause
How menopause can affect prediabetes
Alesha’s Question:
“Is there any hope for someone with adenomyosis take estrogen? If so, when is the right time? I know adenomyosis is stimulated by estrogen. I even had 1 dr offer a hysterectomy so I could take estrogen without any issues ??!! I have a history of heavy periods have had many trans vag ultrasounds and biopsy’s over the years Uterus was enlarged, lining was wnl. Had a hysterscopy to remove some cysts they found 4 hrs ago. Last ultrasound showed probable adenomyosis.i am almost 57and I am in late perimenopause. Cycles have been erratic just went 6 months without a cycle then had a normal cycle…for years of perimenopause I had symptoms of high estrogen. Most of the time for the last year I had symptoms of low estrogen. Poor sleep waking up 4-5x night, dry skin, vaginal dryness, night sweats, brain fog, difficulty concentrating which makes my job very difficult. I have also developed mild sleep apnea(sleep lab) and after my last physical I am on the edge of pre diabetes. ( am normal weight, I walk daily and lift weights, eat high protein diet with lots of veggies and healthy fats.) I am currently taking a progesterone troche( 1/4 lozenge 50mg 2x day) and vaginal estrogen. I was taking an oral progesterone 300 mg thought it would help with sleep but didn’t. The progesterone has helped with GI issues, puffiness, bloating, cramping and anxiety.”
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode, we talk about POI (primary/premature ovarian insufficiency) and earlymenopause. Samantha sent in a question about whether she is in menopause or hasPOI at the age of 36.We break Samantha’s question into:- What is POI (Premature/Primary ovarian insufficiency)?- Taking estradiol during perimenopause- Difference between perimenopause and menopause- What is an FSH?- Insulin resistance and perimenopauseSamantha’s Question:I am 36 and have been slowly noticing perimenopause/low estrogen symptoms for thepast year and a half. I went to an online provider and started HRT and haveexperienced so much relief! From mental symptoms to night sweats to dryness(everywhere) I have started to feel so much better being on estradiol and progesteronefor 3 months. I have been working with a functional nutritionist on my diet, walking daily,etc.i had gestational diabetes for all 3 pregnancies and also got my tubes removed lastyear. After I came off the birth control all of my symptoms started! I recently saw mynormal OBGYN so I could get my HRT through insurance and he agreed- but made itclear this isn’t menopause, could be POI, but seemed skeptical. I got bloodwork doneand my FSH has risen in the past few months from a 3.7 to an 8. But it’s still considerednormal. All of my thyroid and other bloodwork also comes back normal. Is POI apossible diagnosis? I feel crazy!!If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats,was created for informational purposes only. This video, website, and blog aim topromote consumer/public understanding and general knowledge of various healthtopics. This content is not a substitute for professional medical advice, diagnosis, ortreatment. Please consult your healthcare provider with any questions or concerns youmay have regarding your condition before undertaking a new healthcare regimen.
Never disregard professional medical advice or delay seeking it because of somethingyou have read on this website. If your healthcare provider is not interested indiscussing your health concerns regarding this topic, then it is time to find a new doctor.
Can you be in both in perimenopause and menopause? Can you be menopausal andperimenopausal at the same time? The difference between perimenopause andmenopause is not a line in the sand. It is not like crossing through the Peace Arch fromBlaine Washington to the country of Canada. And at times, there is nothing peacefulabout perimenopause or menopause.There is a gray area where you are just moving out of perimenopause and intomenopause, where you are not quite in perimenopause but are not completely inmenopause. We delve deeper into the place that is between perimenopause andmenopause:- What is the difference between perimenopause and menopause?- Can you be both in perimenopause and menopause?- The difference between perimenopause and menopause- What it feels like to go from perimenopause to menopause- Can you take estrogen or biest when you are going from perimenopause tomenopause?- Is bleeding in menopause considered perimenopause?- Top symptoms of perimenopause- Top symptoms of menopause- Are you a candidate for estrogen replacement in perimenopause?If you have a question, please visit our website and click Ask the Doctor a question.Disclaimer: All content in this blog, including text, images, audio, video, or other formats,was created for informational purposes only. This video, website, and blog aim topromote consumer/public understanding and general knowledge of various healthtopics. This content is not a substitute for professional medical advice, diagnosis, ortreatment. Please consult your healthcare provider with any questions or concerns youmay have regarding your condition before undertaking a new healthcare regimen.Never disregard professional medical advice or delay seeking it because of somethingyou have read on this website. If your healthcare provider is not interested indiscussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode, we discuss a listener’s question about how to apply estriol to your face. ‘Connie’ is confused about whether she can use her Biest cream on her face. And she wanted to know the difference between estriol and Biest when it comes to treating menopausal symptoms.
We analyze Connie’s question into:
Applying estriol to the face
What is biest?
What is estriol?
What is the difference between estriol and biest?
Applying estriol vaginally
It is not a good idea to apply biest to vaginal tissues if you have a uterus
Connie’s Question:
“HI there, I loved your article on estriol for the face. I was prescribed an 80-20 bi-est cream for HRT. My question is, how is that different from a 0.3 estriol cream for the face like the kind My Alloy makes? Could I just use more of my Biest cream on my face? Would that be stronger than the My alloy 0.3 estriol cream? Lastly, the .3 estriol cream is not supposed to affect your overall hormone levels, but the Bi-est cream is supposed to affect your hormones and relieve symptoms of menopause. Why does one estriol work differently than the other? Thank you so much for any guidance you may be able to offer. It’s so hard figuring all of this out!”
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In this episode we talk about where to apply hormone creams. Sadie, our listener wants to know if she needs to rotate the application sites of her hormone cream.
In this episode we discuss:
Where to apply biest cream
What to apply testosterone cream for females
Places you should not apply your testosterone cream
Best absorption sites for hormone creams
Sadie’s Question:”I have been using hormones for a little over a year. I swear by them!! I have not rotated sites at all. I use testosterone/DHEA cream behind both of my knees and E3/E2 on both of my inner thighs every morning. I take a progesterone capsule at bedtime. My doctor and everything I read says to rotate sites. I found an article by Dr. Collins and now I found your article about not having to rotate sites, so I am going to keep doing what I have been. I put the cream on both of the backs of my legs and thighs. My question is should I alternate one back of knee and then the other and the same with the inner thighs or does it matter?
If you have a question, please visit our website and click Ask the Doctor a question.
Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
