The thyroid system: how it works, common problems, hypothyroidism, T3, T4, TSH, & more | Peter Attia
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- Опубліковано 25 сер 2024
- Peter provides a comprehensive overview of the thyroid system. This video is a segment from The Drive podcast Episode 256 - The endocrine system: exploring thyroid, adrenal, and sex hormones. The full video can be found here: • 256 ‒ The endocrine sy...
Watch the full episode and view show notes here: bit.ly/432u3eB
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
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It took my doctor 4 years to figure out my thyroid was not working correctly and another 6 to figure out I had Hashimotos. Dr. Attia just did a better job in 15 minutes than my doctor did in a decade.
It's sad that you will find a bettter solution WITH REASONING to you're issue on the internet than in a doctor's office 🤦♂️
I have been taking a Cytomel & Synthroid cocktail for 20+ years with excellent results. Thank you Dr Attia for a clear and concise video explanation.
Loved this video. Things to talk with my endocrinologist about! I fortunately have a dr that says: "I don't just treat a number on a page, I treat the symptoms and the patient". This is invaluable. I'm having breakthrough symptoms so perhaps time to have the rT3 tested too. Thanks for the content Dr. Attia, much appreciated.
Excellent teaching! Years ago, after still having hypothyroid symptoms despite high T4 numbers & being told by one doc I should be ok, a different doctor checked T3 & explained it was like having food on a plate, but I couldn't eat it. He prescribed the desiccated medication, & I finally improved. Now I understand it all & will be more careful with interpretations of my lab testing. Thanks! ! !
Interesting but he didn't mention the importance of the LIVER and STRESS (Cortisol). A lot of people have toxic livers without any symptoms. The liver converts T4 into T3; if it is toxic it will not do this efficiently and send it to where it should be used in the body. No one seems to know this. ALSO - Cortisol disrupts the functioning of the Hypothalamus so that it can send erroneous TSH instructions to the Pituitary! One would think that the medical profession with all of its research would have figured this out by now?
Absolutely love this video, we are extremely lucky to get this knowledge shared with us. Thank you Dr. Attia! 🙏🏼
Awesome explanation. Thank you! I have Hashimoto disease and I was hoping to learn more about it too. Maybe you will discuss how it affects the numbers at a later date?
I would like to hear more about D1 and D2 for conversion.
Also about iodine deficiency and why it’s helpful. When it should be avoided. And the role of selenium.
Thank you for explaining this in a way I could understand. I was given anti anxiety and anti depressants when my thyroid was out of whack. I ended up in a naturopathic doc office because my heart palpitations would not stop. I knew it was something more than anxiety/ depression.
Best video on this topic
Thank you for all these shorter very helpful videos. How u don't have over 1 mil subscribers given the public exposure you've had is crazy. Anyone that reads this go get his book. I feel like I've been to an abbreviated medical school after reading it lol
Awesome conversation again. Thank you so much. Wonderful stuff.
Thank you so much for sharing this valuable information Dr Attia. 🙏
Wonderful video! Thank you for keeping it simple. I wonder if you would be willing to comment on the idea that there might be an optimal range for a healthy adult depending on age, sex, symptoms, etc. Most doctors will see that you fall “in range” and move on much like how they treat sex hormone dysfunction.
Great Intro Dr. Attia! Thank you for making this.
You are the best Peter thank you! Love this style of explaining. Simple and short for non medical peeps🤗🤗🐕🧘♀🐕🍋
Great info, thanks as usual.
Watching this wjile in medical school very good for introduction to thyroid pituitary hypothalamus axis
Wow! You teach so clear and concise. Thank you!
Thank you for bringing the science of our body to the rest of us. I look forward to more videos- I’m especially curious about the heart and liver.
Thanks for mentioning compounded thyroid. We can compound specific ratios of T4:T3, as well as sustained release T3.
Thank you for a very helpful explanation. I’ve been on Armour or NDT for decades with the last several years of feeling super crummy and low numbers Time to explore some changes in meds.
Grateful for your channel Dr A ❤
2 Questions: 1. Does Total T4 and Total T3 matter? For example, what if both are low, very low. Are your totals your "tank"?, and, 2. Does hypothyroidism cause high cortisol to compensate?
TSH3 1.65 0.45-5.33 (uIU/mL)
F Total T4 14.2 H 6.09-12.23 (ug/dl)
F T-Uptake 51.1 H 32-48.4 (%)
F T7 18.1 H 5.93-13.13 (ug/dl)
Help. Isn’t this an issue?
Thank you for this. My current in-network doctor only checks TSH, and I’m not doing well. I’m not sure how he’ll respond y to o this information, but it’s worth a try!
It would be helpful to see a video about HYPERthyroidism too. Thank you.
Any comments as to why hypothyroidism is so prevalent? I think, in general, we are missing a fundamental item because synthroid is an easy fix.
If they cure it, then they will lose patients.
Hypothyroidism is prevalent primarily because we get an excess of iodine in our diets.
It’s not more prevalent it’s just overdiagnosed because symptoms are so benign and common
Almost everyone is hypothyroid because of our modern nutrition and lifestyle. We need to eat to support thyroid/energy, but much of our food does just the opposite.
@@rickduker4969 maybe that’s true for the cases of actual hyper or hypothyroidism. But in california the rich soccer moms aren’t eating particularly badly and yet they are the highest group of diagnoses… it’s a medical scam as far as I can tell
I read your book, great chapter on physical fitness, but the rest of the book, I could do without. Good thing that Amazon has a great return policy. With the money saved, I went to the local farmers market.
Can you speak to the source of most hypothyroidism? is medicine always necessary or are there ways to heal the thyroid without it?
They won't make money if they figure out why people are becoming hypothyroid...they are only interested in throwing symptom relieving pills at it.
id like you to talk in a more day to day things you can do to improve quality of life clients with thyroid issues, that can go in conjunction with the medication strategy
What about if your levels of dhea are slightly high?
The long half life also posses difficult days with tachycardia and hyper-“ish” symptoms. Shaking and HTN for days!
Have you considered that you may be taking too much thyroid hormone?
I’m curious bc you said fasting caused your d3 to d2 ratio to be off, is there a way to improve the ratio when it’s off? What are the physiological reasons that your d1 and d2 would be down regulated and how can you upregulate them?
In other words, a TSH alone is wholly inadequate to fully evaluate thyroid and clinical status. That is driven by cost saving economics and not good medicine.
If the T3 and T4 ratio goes low does that imply that the liver (mostly) is struggling to perform the conversion, whether that be due to lack of nutrients or something like alcohol overuse?
What about elevated anti tpo, elevated tsh , normal t4 and elevated free t3 ? I have been on Levothyroxine alone and it did not help , I am currently on NP thyroid and it’s not working. I was just prescribed Levothyroxine and cytomel.
Does anyone know of any links to clinical trials for rt3......as Im currently getting thyroid testing done for hypothyroid symptons but I'm within normal ranges of t3,t4....also have a pituitary tumor...Unfortunately doctors in australia dont recognise rt3 as relevant...thanks in advance
I had my thyroid removed in 2011 and my blood lab results for t4 have been high ever since. Ranging from 68.-138. ml/UL.
I never feel good and for over a decade now, I’ve experienced declining health.
Please help me! I have terrible medical insurance and I have to be my own advocate, otherwise Im low priority.
What questions can I ask my doctor/endocrinologist that will guide me to a possible solution?
You need to get T3 and RT3 tested. You are probably rock bottom levels of T3.
Dr Attia, starting from scratch here. What blood tests should I take to make sure all the information is there for analysis by the doctor?
holy moly, my TSH is 250
my t3 is slightly lower than the normal range..probably cuz i have been intermittent fasting and have been on calorie deficit. I will try supplementing zinc and eating more iodine rich foods like fish, meat, eggs.
What about Lugol/Iodine?
Dr. Attia, the ratio of t3/rt3 that you explained sounds like have different units? What are ideal values for free and total t3 and reverse t3?
I've been on levothyroxine for 20 years and I'm still cold; I still have weight and constipation issues and so on. But they never test me for RT3. Having viewed this fantastic explanation - I have another question: why not provide D1 and D2 as well?
Wish I could find a doc to give me cytomel
The question is.. do you treat a persistent TSH of 5? Age 40.. normal T4, but on the low end
T4 and T3 in combo
My t4 is bit low 4.80 ug/dl but t3 and tsh in normal range what that mean?
Can you do the blood test to measure reverse T3
Yes. It’s available as an add on to a comprehensive panel but not a good indicator unless compared over time.
SO can a TSH be high due to fasting?
I have TSH over 10 in most blood tests, but free T3 is in the middle of the ref range.. I was taking synthetic T4 many years, but felt like complete bag of shit so I just stopped and feel much better. Btw you can look up for a papers where you can read about how high TSH can regrow thyroid tissue. For example if someone had autoimmune issues like hashimoto and had some thyroid damage. Stopped gluten or whatever was causing the autoimmune issues thyroid can grow back, but if you start to take hormones that will lower TSH this regeneration of the tissue will not happen. Simply once you start taking hormones thyroid gland is no longer stimulated to do anything and will die of basically.. It is exactly the same like when you take testosterone and your testicles shrink to the size of a green peas lol...
I've taken 40mcg T3 + 160 mcg T4 for 4 Months, stopped within two weeks my TSH was 0.04, felt like crap being on it (way too hot) my rT3 was like 340 or so but i didn't notice anything negative comming off. In fact all my Thyroid labs went (noticeably) better after than before. Even after 6 months, better than before, plus i felt better.
@@usernwn7qe yeah taking thyroid hormones is not like taking testosterone.. With testosterone you can take lets say 100mg every 7 days forever and you will be ok, but metabolism is changing all the time and the body is regulating thyroid hormone production all the time. For example if you don't eat a good diet. For example you don't have all the nutrients (because by taking thyroid hormones your body is burning calories and using all the vitamins and minerals like crazy and you). So you can run into issues very fast. A lot of people ended up with damagd teeth for example or crazy hair loss etc. Because their body simply didn't have all the nutrients needed to support fast metabolism like that from taking thyroid hormones... Also making thyroid hormones is making a lot of oxidative stress so if your body can't handle this oxidative stress for some reason the body will again lower thyroid hormone production, but if you take just whatever and you keep taking that dose forever it can do a lot of damage in the body.. That's why I don't know what is doing more harm if having elevated TSH, but "normal" T3 or taking hormones, lowering TSH and hoping that it will not damage my body even more..
I believe you have good insight here, that taking exogenous thyroid hormone can suppress your thyroid from making its own hormone. My TSH got as high as 12, yet I de-prescribed my (natural desiccated) thyroid hormone with the help of my doctor, and my TSH is now normal and I feel good. I have Hashimoto’s, but I’ve recovered by keeping a healthy diet and restricting iodine intake. The key is iodine. You can still improve. When your TSH is high, it’s your body yelling at your thyroid to produce more hormone. If your thyroid makes the hormones, that is much better than taking hormone.
@@lexitejeda6209 interesting. But why you think iodine is the problem here? Iodine is needed in the breasts, prostate and other tissues of the body. It is the key component for estrogen metabolism. With iodine deficiency you can end up with estrogen dominant cancers and they are very aggressive.. What is your diet? I keep avoiding gluten, dairy(expet whey protein) and eggs. I know that I had hashimoto from gluten as well.. I take iodine from lugol as well.. But just like 1mg a day.. Also selenium, molybdenum etc.. I did some hair tests so I know what minerals I had low. Also low thyroid makes people toxic in copper and vit A. So I am on low vit A diet for like 5 years now + I try to limit copper, take some zinc.. It wuld be great If my TSH would go down to some normal numbers.. But maybe in my case it is also about physical stress. I always have physical jobs + I like riding bike etc.. I should go on vocation, just rest on the beach for couple of weeks and after that retest my thyroid labs. I am sure the TSH would be much lower than testing when I am stressed like crazy.. Also low carb is bad for thyroid. Many people lowered TSH and increased T4/T3 with high carb diets.. But I feel the best on mixed diet like 40% carbs, 30% fats, and 30% protein..
could a nutrient deficiency potentially be the root cause of TSH/T4 / T3 imbalance ?
not just micronutrient deficiency, but also life style, bad diet, too much stress etc.. Unfortunately doctors don't care about the cause of your thyroid problems..
@@jirihutecka9020 with the exception of Dr Attia (just finished reading his book) I agree with you and thanks for your reply
iodine deficiency could be.. especially if youre supplementing boron (for its testosterone boosting effect for example) your iodine from food might not be enough
Vegans may have iodine deficiency. Will iodine supplementation improve the TSH?
nope, the root cause of your imbalance is called menstrual cycle, they just relabeled it into "thyroid" disease.The beta fraction of hCG is 85% homologous with TSH. These so called bio markers are utterly and completely useless exept when elevated for a prolonged period. You can litterally have pneumonia or sepsis with a normal bloodwork. That's the reason people drop dead after being diagnosed completely fine.
My son TSH HIGH and normal t3 normal t4 he is SUPER healthy!!! Does keto or carnivore diets and no processed foods no seed oils exercises and why would he have a high TSH is it because he intermittent fasts?
subclinical hypothyroidism. Don't worry unless he becomes symptomatic
ARMOUR WORKS BEST FOR ME !
What about a normal t3 and t4 but still a high TSH about 6 or 7?
Hashimoto
What does it mean to have high tsh 4.93 and normal t3 and t4? Do u still have thyroid problems even if u have no symptoms (athletic can runs 60min a day)
Probably nothing to worry about but keep an eye and get checked again if you have symptoms
Why there haven't been invented D3 inhibitors?
can Hypo ever be healed?
I would recommend Kate Deering's book "How to heal your metabolism." She explains how to correct low thyroid/energy with nutrition and lifestyle.
Armour & cytomel
For god sake someone talk about hyperthyroidism and not hypo
This!!! 😢
Don't believe the man a word your TSH is fine, it's all in your head !