Scott Habermehl says, "How would you address normal TSH but low T4?"
Well, the first thing I'd do is I'd look at your T3.
So, for those of you who aren't familiar with thyroid hormones, TSH tells your thyroid to
make thyroid hormone.
T4 is the precursor.
T3 is the active hormone.
So, your T4—so, if your TSH is normal, that means that your pituitary is receiving the
proper messages from your thyroid gland.
But if your T4 is low, I would look, first of all, is your T3 normal or high?
So, if your T3 is high, then you're probably just converting it very rapidly.
If your T3 is low, then even though your pituitary appears to be receiving the right signals,
you're not making enough thyroid hormone.
And in fact, it would become unclear whether your pituitary is actually making the right
signal because if your T4 and your T3 are low, your TSH should be high because your
pituitary should be saying, "wait a second, T4 and T3 are low, so I need to make more
of the message, TSH, to tell the thyroid gland to kick into gear."
So, if the T4 and T3 are both on the lowish side and the TSH is normal, I would reinterpret
the TSH and say, actually your TSH is not as high as it should be given your thyroid
hormones.
And so, I would then look to the pituitary.
In terms of nutritional issues, I think the big things that you're looking at are calories,
carbohydrate, and body fat, because the pituitary is overwhelmingly asking the question, do
I have enough energy in the short term and the long term to engage in the health-promoting,
long-term investments that thyroid hormone governs?
And those are many, like all the biological peacocking, like making nice hair, and making
nice skin, and making things look nice.
But they're also protecting your tissues from damage.
And then the big, big, big thing, if you're in the right age bracket, is fertility.
So, if your pituitary is not making as much TSH as it should, then that's basically saying
your brain perceives that you don't have enough energy on hand, and that means either your
body fat's too low, or your calories are too low, or your carbs are too low because those
are the big signals that your brain is going to use.
And then I would say, I mentioned in the Nutrition in Neuroscience series, I mentioned that all
of the releasing hormones, so all of the things that the brain is making to govern the endocrine
system, all of them require copper, vitamin C, zinc, and glycine to make.
So, I think the big thing to look at is body fat, calories, and carbs.
But the next layer to peel back would be those four, vitamin C and copper especially, in
the background zinc and glycine.
And I would especially look at those if the big picture incorporates all the other things
you expect from those nutrients being missing in the brain.
And that's not just low thyroid, it's low thyroid paralleled with low adrenal, low sex
hormones.
So, across the board, if that's true, yes.
And then also, if your appetite is dysregulated, you're eating too much, if your hair is graying,
if you're peeing too much, and I might be missing a couple things in there, but if that
general picture starts to look like that, that's when I start saying, maybe these nutrients
are missing in the brain.
But always first thing is carbs, calories, and body fat.