If you’ve ever been told “your thyroid labs are normal” but you still feel exhausted, foggy, cold, bloated, or just… off—this one’s for you.
Welcome to the great thyroid debate.
In one corner, you’ve got conventional doctors swearing by TSH blood tests and prescribing T4 (Levothyroxine) as the holy grail of treatment.
In the other corner, functional medicine practitioners like me are over here saying, “That’s not enough.”
So who’s right?
Let’s clear it up in plain English—based on current science (not 1970s dogma).
We (Functional Medicine Practitioners) have FINALLY got it in writing.
Of course we knew the truth all along, but this new scientific paper confirms “we are right.“
💡 First, Know This: T4 Isn’t the Active Hormone
T4 is a prohormone—it must be converted into T3, the active hormone that actually powers your cells, brain, mood, energy, metabolism, and more.
Relying on T4-only therapy is like filling your car with gas, but never turning on the ignition.
Some people can convert T4 to T3 just fine. Many can’t—especially if you’re dealing with:
Chronic stress
Inflammation
Genetic conversion issues
Nutrient deficiencies
Gut imbalances
Menopause or aging
🔬 Why the Conventional TSH-Based Approach Falls Short
Here’s the dirty little secret in endocrinology: TSH isn’t a reliable measure of thyroid function in your body.
TSH (thyroid stimulating hormone) comes from your brain—not your cells. It’s a thermostat reading from the hallway, not your cold bedroom.
Even worse:
TSH can look “normal” even when your cells are starving for T3.
Lab reference ranges are based on broad populations, many of whom are not healthy.
“Normal” doesn’t mean “optimal.”
Symptoms get dismissed because “your labs are fine.”
Translation? People suffer. Silently. Unnecessarily.
🔁 Functional Medicine: Treating the Whole Thyroid Puzzle
We don’t just look at TSH. We also assess:
Free T3 and Free T4
Reverse T3 (the metabolic brake)
Signs, symptoms, energy, sleep, mood, digestion, and more
Your clinical picture, not just your lab results
If your body is struggling to convert T4 into T3, we treat that head-on—with a T4/T3 combination therapy that mimics your body’s natural hormone production.
Some people even do better with T3-only therapy for a time.
📊 The Science Supports What You’re Feeling
Recent reviews show that people on T4-only therapy often have:
Lower active T3 levels
Ongoing symptoms (fatigue, depression, brain fog, low metabolism)
Higher cholesterol, more weight gain, and lower quality of life
Meanwhile, people on T4/T3 therapy report:
✅ Better energy
✅ Improved mood
✅ Easier weight control
✅ Sharper thinking
✅ Better digestion
✅ And actual relief from hypothyroid symptoms
Sound familiar?
🚨 If You’re Still Symptomatic, You’re Not Crazy. You’re Under-Treated.
Functional medicine doesn’t claim traditional doctors are “wrong”—we’re saying they’re outdated. The TSH-T4 model was built on old assumptions and flawed data.
We now understand:
TSH is easily misled and overly influenced by medication peaks
Many people have genetic differences that impair their T4-to-T3 conversion
Tissues like your liver, brain, and muscles don’t all receive T3 the same way
Symptoms—not just labs—should guide treatment
🎯 Bottom Line: It’s Time to Rethink Thyroid Care
If you’ve been told your thyroid labs are fine but you still feel like a zombie, you’re not imagining it. You need a practitioner who listens to your symptoms, understands the physiology, and uses modern, evidence-based thyroid optimization.
That means:
Looking beyond TSH
Checking Free T3 and Free T4 (together!)
Treating YOU—not just your labs
Considering T4/T3 therapy when appropriate
Ready to Reclaim Your Energy, Metabolism, and Sanity?
If you suspect your thyroid isn’t being managed optimally, you’re probably right. You deserve a personalized, informed approach—because you are not a lab value.
