Thyroid Lab Ranges: Normal vs. Optimal

Calling astroman and other thyroid-savvy folks...

Almost two months ago, I ran across some comments that RainyCloud made in a thread back in February 2022. In them, he shared some thyroid-related information taken from the website of Westin Childs, DO.

Dr. Westin Childs: Thyroid Support, Supplements, and Resources
https://www.restartmed.com

Of particular interest to me was Dr. Childs' download about "Thyroid Lab Ranges" where he lists (what he believes are) Normal vs. Optimal lab ranges.

Downloads from Dr. Childs' Website
https://www.dropbox.com/scl/fo/07oaf42ogs37rsctewd4w/h?dl=0&rlkey=ukj2ouivxr4c8crkgnyzvhtdv

For those knowledgeable in thyroid matters, what do you think about the "Thyroid Lab Ranges" document in the above Dropbox link?

Have you (or, a family member or friend) had any personal experience that seems to support his theory? That is, suffering thyroid symptoms while labs were in the "Normal" range and then improving or recovering after moving thyroid labs into the "Optimal" range shown in the document.

So many symptoms are somewhat nebulous (fatigue, brain fog, etc.) and can be caused by any number of things. I'm trying to figure out how to address my fatigue, in hopes that improving that might improve other issues. As I suspect may be the case for many people here, I have several symptoms that are often considered to be thyroid-related. But, my thyroid labs are always "Normal."

I also have low Free Testosterone and high Sex Hormone Binding Globulin, but my doctor was informed by Endocrinology that "fatigue is non-specific" and that hormone therapy isn't indicated. I recently switched primary care doctors, but it's going to be another four weeks before I meet with him and try addressing this yet again.

Thanks to anyone who reads and/or chooses to comment.

Dude

Thanks so much, Astro. I know we had a previous discussion about thyroid and I kept that information, too. I appreciate you adding to my knowledge base here, too. We're lucky to have your knowledge and wisdom about thyroid and so many other topics. I need to find a knowledgeable thyroid doctor to help me explore this matter further. Right now, I'm not having much luck with most things through the VA. They're the wrong tool for the job.

Hey Dude - hope you are doing well and you are managing to get on top of your sleep pattern a little

i have travelled down this path quite a bit and have hashimotos myself
so i just wanted to add to the good input from astro above.

i think Westin Childs is a good source ( i may have been me that suggested it to Rainy some time ago)

and i think his ranges are a decent guide / target

and as astro says - so for some people achieving a small change from perhaps low normal range for Free T3 to upper 1/3 of normal range for Free T3 ( as westin childs suggests) can make a considerable difference to how they feel - this does not follow for everyone - but there are other reasons to optimise thyroid status - i will get into in a bit

what i think is happening is if your fatigue is actually caused by low thyroid levels - then raising them can significantly help
whereas if your fatigue is caused by something else - say an infectious disease or auto-immune condition - then it may have little or no impact

for instance - in my own case - after obtaining my medical records - i found that i had tested with high TSH ( not super high but outside GP / NHS normal range ) several years before becoming properly ill with lyme. the GP had failed to mention this and had failed to retest or follow up as they are supposed to so i carried on unaware
At this point i may have had occasional bouts of unexplained mild fatigue - but i was working crazy hours - so this was not entirely unexpected.
however, what i found was interesting was that i could still go mountain biking in the hills for 4hrs - with vertical climbs of 1000m - and a 4hrs drive there and 4hrs back - so while i may not have been at my absolute peak of fitness - i was obviously still able to do 10x more stuff than i could later after lyme took hold.

this tells me that in my case at least - with my only mildly elevated TSH numbers and relatively low levels of antibodies - my symptoms are probably not driven primarily by thyroid issues

i think its more a case that the thyroid tissue is in fact more of a "canary in the coalmine" and the body seems to very readily develop auto-antibodies to it when other stressors are at work in the body - eg chronic intracellular infection.
note - normal ( non thyroid disease) patients who have even short hospital stays for other health reasons are known to have sudden excursions of v low thyroid hormones and high TSH ( possibly antibodies too) for unknown reasons - perhaps driven by immune disturbance from whatever was putting them in the hospital.

there are now more recent studies showing that the kind of mild autoimmune hypothyroidism that many people with chronic illnesses get - that manifest in mildly elevated TSH and thyroid antibodies - are not quite the same as same as some other overt auto-immune diseases.
in that they may be more symptom of something other / deeper - rather than root cause.

inline with this - some of these newer studies seem to show that quality of life is not returned to many of these people by treatment with thyroid hormones - even natural ones
so this lends weight to the idea that the thyroid is not the true root of their issues - but something else as yet undiagnosed is ( at least for a proportion of them) -

nevertheless, if it progresses enough then permanent thyroid damage results and it can indeed become more of an issue over time.

so all that said - i do believe thyroid hormones should be corrected to recommended levels in the case of mysterious ongoing chronic illness, and am doing this myself for several reasons

1, so many processes in the body depend on the proper level of thyroid hormones - including the function of the immune system - so for that reason alone if infection or autoimmune conditions are known or even suspected - it makes sense to correct the thyroid hormones to remove this as a potential cause - give oneself the best chance of fighting / correcting that condition.

2, there are long term health risk of low thyroid function - including increased risk of cancer - presumably di to the above mentioned reduced immune function

3, as mentioned - if increased antibody levels are present - ongoing tissue damage could lead to permanent damage to the thyroid - and worse health outcomes in the future, and a harder condition to manage in the future - even if it is not the root cause of most of ones health issues right now.

as you can see - thyroid disease is in itself a complex topic - and thyroid disease in the context of other chronic diseases ( eg possible infections ) is even more complex and nuanced vs thyroid disease on its own in an otherwise health person (which is how most information on the subject is framed - but which i think is probably actually a rare instance) -

so i wanted to write something to try an put it in some kind of hopefully more useful context.

My husband takes synthroid.
When he tests - he is “in range”

BUT he does feel better if he takes a “tad” more.
But because he is “ in range” with his current dose, the dr isn’t on board giving him a tad more.
He can’t just go ahead and take the tad more because he will run out of his pills.
If he were to take a tad more - he could still be “in range” but feeling better.
Very frustrating. This is his GP.

Years ago he went to an endo a few hours away but he wasn’t willing to give him a script for a slightly higher dose either.

I understand that taking too much and going into hyper range is not good - but jeez - at least let him have a tiny more and test him after awhile to see the numbers.

Garzie said...
yep - frustrating

over here in the UK - they will not prescribe T3 medications at all .....

Wow Garzie, that’s insane.

Because of that alone, they probably have thousands of people in the UK who cannot function properly enough to work full time.

Garzie: I'm a bit delayed in responding, as I wanted to read your detailed reply when my brain felt a bit less foggy. (Often, my head feels like it's full of guacamole.) Thank you so much for the information and context you provided. I really appreciate your help!