Hypothyroidism: Facts, Interactions and Resources

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Nelson Vergel

Founder, ExcelMale.com

Hypothyroidism and Hyperthyroidism​

Hypothyroidism and hyperthyroidism are two common thyroid disorders that can be detected through thyroid function tests.

  • Hypothyroidism: Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormone, resulting in low hormone levels in the blood. Common symptoms of hypothyroidism include fatigue, weight gain, depression, and cold intolerance. Thyroid function tests, such as TSH and free thyroxine levels, help diagnose hypothyroidism. High levels of TSH, along with low levels of free thyroxine, are indicative of primary hypothyroidism, while subclinical hypothyroidism may present with normal TSH levels but low free thyroxine levels.
  • Hyperthyroidism: Hyperthyroidism, on the other hand, is characterized by an overactive thyroid gland, leading to high levels of thyroid hormone in the blood. Symptoms of hyperthyroidism include weight loss, increased heart rate, anxiety, and tremors. Thyroid function tests, such as TSH and free thyroxine levels, help diagnose hyperthyroidism. Low levels of TSH and high levels of free thyroxine are indicators of primary hyperthyroidism. Subclinical hyperthyroidism, on the other hand, may show up with normal TSH levels but high free thyroxine levels.
Diagnosing hypothyroidism or hyperthyroidism based on thyroid function test results is only the first step. Treatment options for thyroid disorders range from thyroid hormone replacement therapy for hypothyroidism to medications, radioactive iodine therapy, or thyroid surgery for hyperthyroidism. Regular monitoring of thyroid function tests is crucial for adjusting treatment as needed and ensuring optimal thyroid hormone levels.

Symptoms of Hypothyroidism​

Hypothyroidism is a condition in which the thyroid gland does not produce enough hormones. Symptoms of hypothyroidism can vary but often include fatigue, weight gain, constipation, dry skin, hair loss, and cold intolerance. Other symptoms may include depression, memory problems, and muscle weakness. If you suspect you may have hypothyroidism, it is important to consult with a healthcare professional for proper diagnosis and treatment.

Symptoms of Hyperthyroidism​

Thyroid function tests are crucial in diagnosing and monitoring thyroid disorders. One common scenario is having a low T4 level but a normal TSH level. This could indicate hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone. Symptoms of hyperthyroidism include weight loss, increased appetite, heat intolerance, sweating, tremors, a rapid heartbeat, and anxiety. If you are experiencing any of these symptoms, it is important to consult with your healthcare provider to determine the best course of action for your thyroid health. Remember, early detection and treatment can help prevent further complications.

Treatment Options for Thyroid Disorders​

The treatment of thyroid disorders depends on the underlying cause, severity of symptoms, and individual patient factors. Here are some treatment options for thyroid disorders:

  • Hypothyroidism treatment: The primary treatment for hypothyroidism is thyroid hormone replacement therapy. This involves taking a synthetic thyroid hormone, levothyroxine, orally, which restores normal hormone levels in the body. With appropriate treatment, symptoms of hypothyroidism typically improve, and thyroid function tests return to normal.
  • Hyperthyroidism treatment: The treatment of hyperthyroidism depends on various factors, including age, symptoms, and the underlying cause of thyroid dysfunction. There are many ways to treat this condition, including taking medicine like beta blockers and antithyroid drugs, getting radioactive iodine therapy, which kills only thyroid cells, or having surgery to remove part or all of the thyroid gland. Each treatment option has its own advantages, risks, and considerations, and the choice of treatment should be made in consultation with a healthcare provider.
It is important to note that treatment plans may need to be adjusted based on thyroid function test results, clinical symptoms, and the individual response to treatment. Regular monitoring of thyroid function tests, under medical supervision, is crucial for evaluating treatment effectiveness and ensuring optimal hormone levels.

Medications and Hormone Replacement Therapy​

Medications such as levothyroxine and liothyronine are commonly prescribed for the treatment of hypothyroidism. In women with thyroid disorders, hormone replacement therapy may include estrogen and progesterone. It is significant to note that a healthcare professional should always prescribe and oversee these medications and hormone therapy. Treatment for thyroid disorders may need to be adjusted based on thyroid function test results and symptoms. Proper treatment can improve thyroid function and reduce the symptoms associated with thyroid disorders. Additionally, it is worth exploring natural treatments for hypothyroidism to complement traditional medication and hormone replacement therapy.

Lifestyle Changes​

Making certain lifestyle changes can have a positive impact on symptoms associated with thyroid disorders, such as hypothyroidism and hyperthyroidism. By modifying your diet, engaging in regular exercise, and practicing effective stress management techniques, you can support better thyroid health. It is beneficial to avoid certain foods, like soy products, and incorporate more iodine-rich foods into your diet if you have a thyroid disorder. Maintaining a healthy weight is also important, as it can improve thyroid function and reduce overall health risks. However, it is essential to consult with a healthcare professional to determine the most appropriate lifestyle changes for your specific thyroid condition.

Important Considerations while Interpreting Test Results​

Interpreting thyroid function test results requires considering not only reference ranges but also clinical symptoms, medical history, and physical exam findings. Here are some important considerations:

  • Normal reference range variations: Reference ranges for thyroid function tests are based on clinical practice, but they may vary slightly between laboratories. It is important to interpret test results in the context of reference range variations specific to the laboratory where the tests were performed.
  • Trend analysis: Thyroid function tests should not be interpreted in isolation; trend analysis of test results over time can provide valuable insights into thyroid function. Monitoring test results over several tests, along with clinical symptoms, helps identify patterns of thyroid dysfunction and guides treatment decisions.
  • Testing for thyroid antibodies: To find out if someone has an autoimmune thyroid disease like Hashimoto's or Graves', they may need to test for thyroid antibodies like thyroid peroxidase antibodies, thyroid stimulating hormone antibodies, and thyroglobulin antibodies. Elevated levels of thyroid antibodies can indicate an autoimmune thyroid disease, which requires specific treatment approaches.
  • Consultation with an endocrinologist or thyroid specialist: In complex cases, consultation with an endocrinologist or thyroid specialist may be necessary for accurate interpretation of thyroid function test results, especially when results are inconclusive or additional testing is required.
Interpreting thyroid function tests is a collaborative process between the patient, primary care physician, and thyroid specialist, ensuring that thyroid disorders are accurately diagnosed and treatment plans are optimized for each individual.

Source: Guidelines | American Association of Clinical Endocrinologists

Thanks to Orrin Israel for gathering these thyroid information resources:

Basic sources to research Thyroid issues and testing:
Spend time here and get the 2 books, “STTM: The Revised Book” and “STTMII:Authored by Doctors”.

Great simple to understand articles.
Get her book.... “Tired Thyroid: From Hyper to Hypo to Healing—Breaking the TSHRule”,
A lot of clear researched information that is easy toread and understand.

Good info here. Look around.

A LOT of good articles and a youtube page.
Spend time here looking around and reading after getting labs back.
Need informationon on testing....
Read here:

And here:
and here:
and here:
and here:
And here:

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Last edited:
Defy Medical TRT clinic doctor


New Member
I have been feeling like crap for a long time no matter what testosterone level I have been on.
I recently have had my thyroid panel done and I have low free T4.
Started on a low dose of Levothyroxine and within 2 days I started feeling better. A PA from Defy medical today tells me we only look at TSH and that my thyroid is fine.
I have had all the symptoms barely been able to get out of bed, any options????? I think hypothyroidism has been the cause on my low Testosterone of 116

Increased sensitivity to cold

Dry skin
Weight gain
Puffy face
Muscle weakness
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints mjor
Heavier than normal or irregular menstrual periods
Thinning hair

Impaired memory

TSH 3.97 uiu/ml range .450-4.5
Free T4 by Dialysis/Mass Spec 0.71 Low range 0.8 - 1.7
T3, Free, Dialysis, LC/MS-MS 3.89 pg/mL



Yep you definitely have a Thyroid problem. You also need to check your Reverse T3 which many doctor's do not test for. Here is some excellent information on each Thyroid test and what levels are optimal:

And yes low testosterone and hypothyroidism are very similar in symptoms. Here is good explanation:

I hope Defy changes its pre testosterone treatment blood test to include a full thyroid panel as well before beginning any program to rule out low thyroid levels. I've been on T therapy for 3 years and just found out my Reverse T3 was very high which was causing all my symptoms. I've probably had a high RT3 all these years and it was never diagnosed. I'm now on a T3 med Cytomel 5mcg 3xday and feeling somewhat better.

I had to request the full thyroid panel since like you say they normally look at just TSH or T3 and T4 levels not the RT3 and antibodies.

Vettester Chris

Super Moderator
Something is amiss ... Dr. Saya is quite versed with the needed steps to access and diagnose thyroid disorders. Something is off if a PA at Defy is banging the "TSH Only" drum. Hopefully Dr. Saya (or other Defy Management) will chime in. When I talk with Defy, everything is on the table .. TSH, RT3, FT3, FT4, and other variables that impact thyroid productivity.


Active Member
I just had an appt with a Defy NP, and she immediately pin-pointed that my TSH was high and rising and that I needed to get the full Thyroid panel. My TSH has been gradually rising from <2 some 4 years ago, just prior to starting TRT; to 3.61 on the last test earlier this year.

I cannot pinpoint whether I am really feeling any of the symptoms as identified by Kirk; at least not on a consistent basis.

I've got the blood test prescription and will take the test next week. Does fasting matter, or the time of day/week for the best results?


New Member
I just recently started with defy. Got the thyroid panel as well due to TSH being high. Glad I did. Now on T3 and testosterone cyp. First week out my blood pressure has significantly lowered and consistent. Not sure if it's the testosterone or T3 or both but it's good either way.
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