Complete List of Hypothyroidism Symptoms with Checklist

Complete List of Hypothyroidism Symptoms with Checklist and Lab Guide

Do you have all of the symptoms of hypothyroidism and yet you are told that your lab tests are “normal”?

If so then this blog post should help you understand why this can happen and more importantly what you should do about it. 

Due to various reasons (that we will discuss below) your Doctor may not be ordering the right tests or evaluating your symptoms in the right context. 

Because of this, it’s up to you to have a greater understanding than the average person so that you can be an advocate for yourself. 

This post will teach you what symptoms to look out for, what tests you need to ask your doctor for, and how to interpret those lab tests. 

Let’s jump in: 


Foods to Avoid if you Have Thyroid Problems:

I’ve found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should avoid if you have thyroid disease of any type.


The Complete List of Thyroid Lab tests:

The list includes optimal ranges, normal ranges, and the complete list of tests you need to diagnose and manage thyroid disease correctly!


Are You Hypothyroid? 

Does this scenario sound familiar?

You’ve recently been diagnosed with Hashimoto’s thyroiditis or you’ve been told you have antibodies to your thyroid gland

You’ve recently had a baby…

You recently went through menopause…

You’ve recently gone through some stressful event…

And now you’re experiencing such symptoms as hair loss, unexplained weight gain, cold hands/extremities, dry skin, and constipation. 

So you go to the Doctor and have him/her run some tests, only to be told that your lab tests are completely “normal”.

causes of hypothyroidism

How can your labs be normal when you obviously feel so bad?

You know something is wrong and you know something has changed but everything shows up as “normal”. 

Instead of a solution you are offered anti-depressants or told that this is just normal and part of “getting older”. 

So you go home defeated, exhausted, and depressed thinking you have to deal with feeling this way forever.

If this has happened to you keep reading because you aren’t crazy and you aren’t alone.

These symptoms, along with many others, may be the first sign that you have a condition known as hypothyroidism (1) or low thyroid hormone in your body. 

Your thyroid either directly controls or is at least involved in all major processes in your body. 

This control helps regulate your metabolism, your mood, your sex hormones, and your weight

Small changes to this very intricate system may result in big symptoms. 

So what’s the problem?

The problem is that most Doctors look solely at a blood test known as the TSH. 

If your TSH is “normal” then your thyroid is considered “fine”. 

But TSH is NOT the most (or only) accurate way to assess thyroid function. 

This leads to a high number of patients who are either misdiagnosed or mismanaged. 

Newer studies have come out that increase our understanding of the TSH which suggests that tighter reference ranges may be in order (2) and even that the TSH may not be the best marker for assessing thyroid function (3).

More on that later though…

For now, let’s discuss the symptoms of hypothyroidism and how to know if you need further testing and how to determine if your thyroid is the root cause of your symptoms. 

List of Hypothyroidism Symptoms with Checklist

How to use this list:

  • If you have 5 or more symptoms you are likely to have hypothyroidism
  • If you have 6-10 symptoms you are very likely to have hypothyroidism
  • If you have > 10 symptoms you have Hypothyroidism it just hasn’t been diagnosed yet

Regardless of how many symptoms you have from the list, you should be evaluated with a complete thyroid blood test (more information below). 

Your symptoms may indicate you have a thyroid problem but you should always confirm with blood and serum analysis. 

Top 10 Most Common Symptoms of Hypothyroidism

This list of 10 symptoms includes the most common symptoms among hypothyroid patients. 

It’s important to realize that these symptoms may be associated with other disease states or may be non-specific by themselves. 

For this reason, you will need to confirm the presence of subclinical hypothyroidism or hypothyroidism with lab testing. 

1. Fatigue after sleeping 8-10 hours at night or needing to take a nap daily

2. Weight gain or the inability to lose weight

3. Mood issues such as mood swings, anxiety, or depression

4. Hormone imbalances such as PMS, irregular periods, infertility, and low sex drive

5. Muscle pain, joint pain, carpal tunnel syndrome, or tendonitis

6. Cold hands and feet, feeling cold when others are not, or having a body temperature consistently below 98.5 degrees

7. Dry or cracking skin, brittle nails, and excessive hair loss (up to 54% of patients with hypothyroidism report dry skin as a presenting symptom)

8. Constipation

9. Mind issues such as brain fog, poor concentration, or poor memory

10. Neck swelling, snoring, or hoarse voice

percentage of patients with hypothyroid symptoms

Signs and Symptoms of Hypothyroidism

You may have noticed that the range of symptoms related to your thyroid is quite large.

The reason hypothyroid symptoms can be so diverse is that every cell in your body has a thyroid receptor (4).

So the symptoms that you present with will depend on which cells in your body are NOT getting enough thyroid hormone. 

Thyroid hormone receptor

Not enough thyroid hormone in your brain tissue? You may present with brain fog or depression. 

Not enough thyroid hormone in your skeletal muscles? You may present with chronic pain or tender points (or the symptoms of fibromyalgia). 

Not enough thyroid hormone in your mitochondria? You may present with weight gain and low energy. 

Not enough thyroid hormone in your gastrointestinal tract? You may present with constipation and GI-related issues. 

The important thing to understand here is that each person may present with slightly different symptoms. 


Because it depends on which tissues in your body aren’t getting enough thyroid hormone and this can vary from person to person. 

Some of this variation may be due to the different demands that certain tissues have for thyroid hormone and your individual ability to convert (or not) T4 to T3. 

It has been shown in studies (5) that age, gender, existing diseases, and certain medications can all impact thyroid hormone conversion in the body. 

With this in mind, you can find a more complete list of hypothyroid symptoms below: 

  • Fatigue
  • Lethargy
  • Low endurance
  • Slow speech
  • Slow thinking
  • Poor memory
  • Poor concentration
  • Depression
  • Nervousness
  • Anxiety
  • Worrying
  • Easy emotional upset
  • Obsessive thinking
  • Low motivation
  • Dizziness
  • Sensation of cold
  • Cold skin
  • Decreased sweating
  • Heat intolerance
  • Non-restful sleep
  • Insomnia
  • Thick tongue
  • Swelling of face
  • Sparse eyebrows
  • Low basal activity level
  • Low basal temperature
  • Slow resting pulse rate
  • Long-normal intervals on ECG
  • Swelling of eyelids
  • Dry Skin
  • Dry mucous membranes
  • Constipation
  • Weight gain unexplainably
  • Paleness of lips
  • Shortness of breath
  • Swelling
  • Hoarseness
  • Loss of appetite
  • Prolonged menstrual bleeding
  • Heavy menstrual bleeding
  • Painful menstruation
  • Low sex drive
  • Impotence
  • Hearing loss
  • Rapid heart rate
  • Pounding heartbeat
  • Slow pulse rate
  • Pain in the front of the chest
  • Poor vision
  • Weight loss
  • Wasting of tongue
  • Indistinct or faint heart tones
  • Low QRS voltage on ECG
  • Emotional instability
  • Choking sensation
  • Fineness of hair
  • Hair loss
  • Blueness of skin
  • Dry, thick, scaling skin
  • Dry, coarse, brittle hair
  • Paleness of skin
  • Puffy skin
  • Puffy face or eyelids
  • Swelling of ankles
  • Coarse skin
  • Brittle or thin nails
  • Dry ridges down nails
  • Difficulty in swallowing
  • Weakness
  • Vague body aches and pains
  • Muscle pain
  • Joint pain
  • Numbness or tingling
  • Protrusion of one or both eyeballs
  • Brain fog
  • Cardiac enlargement on x-ray
  • Fluid around heart

Believe it or not, there are even more symptoms, but at this point, it’s usually not worth going over them because if you have hypothyroidism the chance of you having 10+ symptoms on that list is VERY high. 

The presence of all of these symptoms is not necessary for a diagnosis of hypothyroidism. 

It’s also worth noting that the majority of these symptoms should go away as long as you replace the deficiency of thyroid hormone in your body! 

So what should you do if you are experiencing these symptoms? 

The “Complete Thyroid Lab Panel” Your Next Step

Most cases of hypothyroidism get missed because of two very important reasons:

1. Lack of complete thyroid lab testing

2. Inability to interpret thyroid lab findings based on newer research

Traditionally Doctors will order only the TSH and free T4 levels in the serum. 

If either of these lab tests falls within the “normal” reference range then the patient is considered to be normal. 

Newer studies (6) have suggested that our reference range may require tighter parameters due to several factors: 

Studies that look at the African American population find that the TSH is actually closer to 1.0. 

The African American population tends to have a reduced risk of developing a thyroid condition known as Hashimoto’s thyroiditis, the presence of which may skew thyroid lab tests and may have confounded previous studies which provided us with the current reference range of TSH. 

In addition, newer laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5. 

join 80000 thyroid patients

This is further complicated by the fact that studies have shown that patients who are treated with LT4 (7) (like levothyroxine and Synthroid) to a normal TSH, still have low free T3 when compared to patients with normal thyroid function. 

This suggests that reliance upon standard thyroid lab tests such as TSH and free T4 levels may not be sufficient for adequately assessing thyroid function in every person. 

What does this mean for you?

It means that you may need a more comprehensive approach to thyroid management which begins with a comprehensive thyroid lab panel. 

Comprehensive lab testing will allow you to assess pituitary function (by evaluating your TSH), thyroid conversion status (by assessing T3), and thyroid cellular action (by assessing sex hormone-binding globulin). 

This will obviously give you much more information than simply testing the T4 and TSH. 

You can find the list of recommended lab tests below: 

(The optimal reference ranges are listed to the right of the lab tests)

  • TSH – Studies suggest a range of greater than 2.5 may be indicative of hypothyroidism. I find that healthy individuals have a TSH closer to 1.0 and prefer this as an “optimal” range for TSH. 
  • Free T4 – Preferably the upper 1/2 of the reference range if not taking thyroid medication (though note this will number may go down if you are on T3 formulations like liothyronine, in which case you will want to look at the free T3 levels).
  • Free T3 – Preferably the upper 1/2 of the reference range if not taking thyroid medication. 
  • Reverse T3 – Should be < 15, higher levels of reverse T3 in the presence of low T3 may indicate thyroid conversion problems. 
  • Thyroglobulin antibodies – Should be as close to 0 as possible (the exact value depends on the laboratory you are using). 
  • Thyroid peroxidase antibodies – Should be as close to 0 as possible. 
  • Sex hormone-binding globulin – In women, this should be in the 70-80 range (note: the SHBG can only be used if you are not taking birth control medications or estrogen therapy), in men, it should be around 20-30. Your SHBG should increase with thyroid therapy and can be monitored as you alter your dose. 
  • Free T3/Reverse T3 ratioCalculate this number by dividing free T3 by Reverse T3, your calculation should be > 0.20 (if < 0.20 this may indicate that you have excessive reverse T3 relative to free T3 and may have a conversion problem or low T3 syndrome). If you are using pg/ml by ng/dl then your value should be > 0.20 if you are using ng/dl then the value should be > 0.02. 

When interpreting thyroid hormone lab tests (or any other hormones in your body) you want to concern yourself with “optimal ranges” not the standard “reference range” that the lab creates. 

The reference range that the lab creates is based on the average for the population. 

When you consider that up to 70% of the population is overweight and that the average person over the age of 50 is on 5 different medications, it’s easy to determine that this is NOT the population that you want to be compared to. 

You want to compare your numbers to actually HEALTHY individuals, and the numbers I’ve outlined above come close to that population. 

Your doctor will likely try to compare you against the standard reference range so you may need to bring this list of optimal ranges to them. 

When it comes to your thyroid there is a large difference between being “normal” and being “optimal” especially when we are talking about very small changes to hormone concentration in the serum. 

Lastly, and perhaps more importantly, is that you are more than just the numbers on a piece of paper. 

All Doctors know that while lab tests are helpful in diagnosis, they aren’t the end-all-be-all either. 

Lab tests should be used in conjunction with your existing symptoms to help give a clear picture of what is actually happening inside your body. 

Why your Doctor says your Lab Tests are Normal when they aren’t

There are a couple of things you have to understand about lab testing…

We (both Doctors and patients) like to think that they are 100% perfect but that is far from the truth. 

No test is 100% accurate and thyroid lab tests are no exception.

One of the ways that lab testing falls short is in our ability to only test what is in your bloodstream. 

We aren’t actually interested in the blood levels of certain hormones in the body, believe it or not. 


Because hormones (and most of the markers we measure in your blood) don’t have action in your bloodstream. 

Your bloodstream is a highway to get to other tissues like your heart, brain, skeletal muscles, etc. 

With this in mind, we are actually much more concerned about whether or not thyroid hormone is actually getting to your tissues. 

We just make the assumption that if your blood levels are “high” enough they will get to their target destination.

But this isn’t always a fair or safe assumption to make, for a variety of reasons…

What if there is a blockade at the cellular level and thyroid hormone can’t leave the bloodstream to get into the cells?

What if you lack the cellular enzymes required for thyroid hormone activation in the cells? 

This process actually happens and the condition is known as thyroid resistance or tissue level hypothyroidism (8).

Tissue level hypothyroidism

You’d never know something like this was happening unless you checked your reverse T3 levels and peripheral conversion status. 

Elevated reverse T3 in Hypothyroid patient

Other factors also influence lab tests such as the presence of autoimmune thyroiditis or Hashimoto’s thyroiditis

It is estimated that up to 90% of hypothyroidism in the US is caused by this autoimmune condition. 

The problem is that patients with this condition present with slightly suboptimal thyroid lab tests and don’t generally develop overt hypothyroidism for years. 

This leads to symptomatic patients that go undiagnosed for years. 

You can find a list of other conditions that alter the effectiveness of standard thyroid lab tests in this post

What to do if you are on Medication but still have Hypothyroid Symptoms

Let’s say you’re reading this and you’ve already been diagnosed with hypothyroidism and you’re currently on thyroid medication with “normal” labs but still exhibiting symptoms. 

What then?

Are you just destined to feel this way forever? 

No way. 

It’s actually not that uncommon for patients to still have symptoms of hypothyroidism on thyroid medication for a variety of reasons: 

1. They are being treated with Levothyroxine (AKA T4 medication only)

2. They are being treated based on their TSH.

3. They have nutrient deficiencies that haven’t been addressed.

4. They haven’t focused on T4 to T3 conversion or Reverse T3 levels.

We can address each of these problems 1 by 1…

#1. Treatment with T4 only thyroid medication and/or treatment based on your TSH

The truth is that MOST patients do much better when they have some T3 thyroid hormone added to their thyroid hormone replacement. 

Medications that include T3 thyroid hormone: 

What is the “best” dose for each of these? 

Unfortunately, it’s impossible to say without trial and error. Each patient will need an individualized dose and may require a different amount of T4 and/or T3 to “feel optimal”.

Having said that you can look at some of these average doses to help you: 

  • Liothyronine – As little as 5-10mcg per day can make a large difference but up to 20mcg per day or more may be necessary for some individuals. 
  • Natural desiccated thyroid – 1-3 grains per day and everything in between. 
  • A combination of NDT + Liothyronine – 1-2 grains + 5-10mcg of Liothyronine tends to work well for most patients. 

It’s also worth pointing out that MANY of you have more than just thyroid problems going on in your body. 

If these problems are NOT addressed, it doesn’t really matter how much thyroid hormone you get – you will NOT feel optimal.

That includes other hormones, nutrients, and the basic 4 foundational pillars of health:

Paleo food pyramid

1. Stress coping techniques – These would include things like yoga, meditation, or spiritual prayer. You may also consider adrenal adaptogens or adrenal glandulars to help your body tolerate stress and boost energy levels. 

2. Proper Whole Food Diet – See a list of diets that work for Hypothyroidism and Hashimoto’s here and here. If used correctly these diets can help you increase energy levels and help with weight loss. 

3. Exercise and movement routine – This includes a combination of low-intensity exercise (like walking) daily in addition to high-intensity exercise once your thyroid function has improved. 

4. High-quality restful sleep – You need to be getting 8 hours of sleep per night at least in order for your hormones to function optimally

#2. Addressing Nutrient Deficiencies

Another way to improve thyroid function is by addressing existing nutrient deficiencies in your body. 

Certain nutrients (including minerals) are required and involved in enzymatic processes in your body. 

Iron, for instance, is involved in cellular thyroid function

B12 is another nutrient that up to 50% of thyroid patients are deficient in (9).

Low B12 will lead to low energy production and fatigue. 

Deficiencies in several basic nutrients may, therefore, reduce thyroid function. 

The good news is that you can replace existing nutrients quite easily by taking certain supplements. 

You can learn about all of the nutrients involved in thyroid function and how to replace them appropriately in this post

#3. Focusing on T4 to T3 Conversion

Lastly, another way that you can improve thyroid function is by taking steps to increase your T4 to T3 conversion. 

Increasing T4 to T3 conversion will necessarily reduce reverse T3 levels and make more effective your current dose of thyroid hormone. 

This is a great thing considering that most patients take T4-only medications like Synthroid or levothyroxine and the conversion of T4 to T3 is required before these medications work in your body. 

Increasing T4 to T3 conversion can be accomplished through a few easy steps (for more elaboration please see this post):

What if your Doctor Just Doesn’t get it


Life is too short to waste your precious time and energy on a Doctor who isn’t willing to work with you. 

If you’re meeting resistance from your doctor it may be time to seek out a second opinion. 

Your chances of “educating” your doctor on proper thyroid function is VERY slim.

Your best bet is to look for a doctor who specializes in thyroid care with an integrative or personalized approach

Alternatively, you can also call local pharmacies and ask for a list of doctors that doctor prescribes liothyronine and natural desiccated thyroid hormone, again if the answer is “Yes” you are onto something. 

You can also look for reviews online or from other patients. 

Whatever you do make sure you find a doctor who can prescribe medication.

Many doctors that practice functional medicine may be more willing to prescribe the medications I listed above, but you still need to do your research.

Helpful Tips and Tricks for treating your thyroid:

Trouble losing weight? Check out this link.

Want to increase your thyroid hormone naturally? Check out this link.

Want to know the best supplements for your thyroid health? Check out this link.

Want to see case studies of other patients? Check out this link.

Want to know if Levothyroxine or Synthroid is the right medication for you? Check out this link.

I want to hear from you!

Do you have the symptoms listed above?

If so, what have you done to help them?

Have you tried liothyronine or NDT?

Leave a comment below!










use this checklist to see if you have hypothyroidism

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

P.S. Here are 4 ways you can get more help right now:

#1. Get my free thyroid downloads, resources, and PDFs here.

#2. Need better symptom control? Check out my thyroid supplements.

#3. Sign up to receive 20% off your first order.

#4. Follow me on Youtube, Facebook, TikTok, and Instagram for up-to-date thyroid tips, tricks, videos, and more.

136 thoughts on “Complete List of Hypothyroidism Symptoms with Checklist and Lab Guide”

  1. Hi Lizzy~I feel great! I’ve been on Levothyroxin 112 mg since I was diagnosed, and it works great for me. I qluckiy dropped that extra weight I gained and haven’t had any symptoms. My doctor just dropped me to 100mg to see if I can stay symptom free. Have you had yours re-checked? I bet it’s time for a change in your dosage if you are having some symptoms!good luck!

    • Hey Kikit,

      I’m glad it’s working well for you! I find the majority of my patients don’t do well on synthroid, but that’s probably a biased sample as only people who aren’t getting relief will seek me out.

      I would use caution when basing dosing off of blood work – I find this to be highly inaccurate. It isn’t uncommon for patients to go down on medication when inflammation and nutrient deficiencies have been reversed, but this isn’t true for everyone.

      Thanks for your insight!

    • I’m glad to hear someone isn’t affected, however, I on the other hand, have been adjusting my Levothyroxine for 3 years now and was also added Liothyronine (T3) to help me adjust. I started Levothyroxine at 165 and now maintain a 220 weight. I will read this guide much more and do more research as I still don’t feel 100%. The fatigue and weight gain are the most excruciating for me.

    • Hey JoAnn,

      I’m sorry to hear about your struggle. I know that it can be especially hard to find Doctors that take insurance and that are knowledgeable about the thyroid. The best thing you can do is ask around before you head into the office. In general I recommend that you stay out of the insurance model because, for the most part, you will find that all of those doctors will treat you the same way.

      • I also have Medicare, and have discovered that Medicare will not allow doctors who step away from levothyroxin therapy are forced to code billing differently than a regular MD, thereby causing non-payment of claims. MEDICARE is not allowing individuals to seek help outside the norm, unless able to self-pay.

        • Hey Nancy,

          I don’t accept insurance so I don’t know anything about that, but I can tell you that I have plenty of medicare patients (who are self pay) but insurance does cover their medication.

          In general it’s better to pay out of pocket when you are talking about treating thyroid disease because the standard of care is so bad.

          • How do you find a doctor that specializes in Thyroid, if their not endocrinologist. I live in South Carolina, and I don’t think they understand thyroid. Colorado does, but now we live in SC.

          • I agree. I live in Columbia SC and found the same problem. My DR only does T4 test and said he would disregard T3 or other factors even if they did them.

  2. Very informative. My lab results are normal but on the low range. Im suffering from insomnia, falling hair, loss of weight, osteporosis, scoliosis.

    • Hey Fabie,

      It’s more likely that your labs are not normal. I recently wrote an article about why so many Doctors say your labs are “normal” when they aren’t in this post here:

      If you look at your labs in this context you will find things that the Doctors are most likely missing.

  3. Pingback: 5 Ways to Naturally Boost Thyroid Function -
  4. Hi Dr. Childs!

    I am a 53-year-old woman from Finland and my life has been kinda wasted because of UNTREATED hypothyroidism.
    In Finland you cannot get treatment; if you do not accept selective serotonin reuptakers, you are “a bad patient” and the story ends. You will not be accepted again as a patient. You suffer. You cry. You dream of a cheap and easy way of treating your illness but you must dream on and on. Because the truth is that if you do not have money to travel abroad to get your treatment, you just drag from day to day.
    I got sacked from work because of my fatigue, because they thought I was just plain lazy. I spent all my energy to do the job and when I came home, I dragged myself to bed to be able to go to work again in the morning.

    The only option available is to end this all. No one is willing to help.

    One important symptom missing from the list is abdominal pain, poor digestion…

    Wish you were here in Finland so maybe I could get some help!


    • Hey Marja,

      I’m sorry to hear about your situation! It’s not much better over here in the US, there are only a handful of doctors that are willing to try and treat patients. You will be able to find some relief using the recommendations in this blog.

  5. Pingback: Hashimotos Awareness » What you Should Know about Reverse T3: How to Lower YOUR levels and Start Feeling Better TODAY
  6. I have been diagnosed with bipolar disease Epstein-Barr virus anxiety sleeplessness now i’ve just had blood tests and a radioactive iodine uptake and scan’s on my thyroid so far no diagnosis can you help please?

    • Hey Bonny,

      It sounds like you need an extensive history & physical with extensive blood work. Without that kind of data it would be difficult to help you.

  7. I’m on medication for hypothyroid for the past 1 month. Would like to know how long does one have to take medication?

    • Hey Yvonne,

      It really depends, some people may only have to be on it for a while if they can fix the underlying cause of their thyroid dysfunction. Others will have to be on it indefinitely (those with a thyroidectomy or those after RAI).

  8. Wish it was as easy to change doctors in the UK. I’m sure my daughter has a slow thyroid like me. Her bloods keep coming back normal but she shows all the signs Like I did. Took years for my bloods to show I needed levothyroxine. Still feel rubbish most days even though they now regular show up as high.

    • Hey Paula,

      It’s very unfortunate the situation that we are in currently in regards to the state of how the thyroid is treated.

  9. Hi, Thankyou so much for this website. I am in Australia and I am currently looking for a new GP, wish me luck. I am diagnosed with Hashimotos and i have made progress, but one of the things that is bothering me is High Cholesterol, this has stayed high despite AIP, huge changes in my lifestyle losing 20kg in weight, no mean feat for me. I am hoping that I can sort it out, but I have read that persistent high cholesterol goes hand in hand with hypothyroidism, so I am hoping with some more targeted blood tests, I might be able to determine weather I have T3 resistance. I take porcine extract, and T3 ATM but may need this adjusted. Thanks again

    • Hey Heather,

      Also realize that high cholesterol levels can really only be determined if you get an NMR lipoprofile. Alternatively you can get an idea by looking at the HDL/triglyceride ratio or evaluating your non-HDL level. LDL levels and total cholesterol levels are largely useless for determining your risk of heart disease.

  10. I’m on a combination of NDT and T3, but my FT4 is low, out of range. Does it matter about the FT4? My FT3 is in range.

    • Hey Vita,

      It depends on the patient, some do a lot better with higher levels of free T4 and others it doesn’t seem to matter as much.

  11. My GP said that they can’t prescribe T3 in the UK. Which was a bit shocking. She must think I need it because she said before I mentioned it. I’m now on 50mcg levothyroxine.

    • Hey Julie,

      I’m sure they can prescribe it, they just choose not to or don’t feel comfortable doing so.

  12. I don’t have a thyroid because of cancer i am on 120mg of armour thyroid meds my body rejects all the medicines I want sleep all time hair falling out can’t remember anything slur words I have sever pain under arms thank you

    • Hey Brenda,

      Some people don’t tolerate armour thyroid but that doesn’t mean you won’t tolerate other medications. You will just have to give them a try one by one to see what works for you.

  13. I’m 58 and taking 75 mcg levothyroxine, my labs show normal, but I gain weight easily and my hair is falling out really bad. Does levothyroxine make your hair fall out or is that a sign that my thyroid isn’t functioning properly?

    • Hey Debbie,

      It could be one or the other or both. Most likely you are just being under treated, but levothyroxine can cause hair loss by itself.

  14. Yes I have hypothyroidism trouble losing weight, sugar problems, stomach problems. Tired all the time. I’very told my doctor time and time again I don’t feel any better. He keeps says it’s in its normal range. First thing is test kidney. That’s the thing I get. I’ve been on every heartburn medicine too. Many foods including water give me heartburn.I’m going to give your diet plan and supplements a try . Going to give it my best shot. I’m tired of being tired.

    • Hey Debra,

      Great! Also, just remember that many people still need to change their medication and add T3 to their regimen in order to lose all the extra weight and reduce symptoms.

  15. Thank you for this great information, I have been diagnosed with hypothyroidism, and I have a goiter. February was 2yrs that I have been taking only .25mg of levothyroxine. Also have high blood pressure 40 mg of linosapril. (Spelling). I have most of these symptoms I see my specialist August 30th. I have been reading so much I’m afraid I still won’t know how my doctor will react to what I’ve learned, or make me think I’m crazy. I also started taking B-1 & B-12 and a refrigerated probottic and seem to feel just somewhat better. My sister 8 to 10 yrs ago had hers radiation and she is really messed up!! Her personality has totally changed!! She doesn’t speak to half of her family, and it’s all so heartbreaking!! I’m one of the family that she doesn’t want much to do with. And most people that I talk to about how I feel with hypothyroidism just don’t understand. Thank you!

  16. Dr. Childs,

    Thank you for writing this article. I have Hashimoto’s Disease. I am a thyroid advocate, after being mistreated for several years (under medicated, due to reliance on the TSH result, and prescribed ineffective Synthroid medication).

    Something I’ve noticed, is that many of us with Hashimoto’s have a greater need for more T3 than what’s contained in Natural Desiccated Thyroid (NDT). It’s refreshing seeing a doctor write about combination dosing of T3 and NDT. I’ve been taking combination dosing for almost four years. The dosage Ive been taking for over two years is 60mg NDT and 100mcg T3, split into three doses per day. My 17 year old daughter takes the same amounts as I do for optimal treatment.

    When reading your article, you stated that an optimal range for Free T3 is mid-range. Based on several years assisting others with interpretation of their labs, I’ve noticed that a more optimal range is the upper quarter to top of the range, and sometimes, over the top of the range, depending on where the labs were done. In my own experience, I feel best with a FT3 of 5.1. There are always going to be a few who feel well with mid-range FT3, but most have a greater requirement. Also, you state that RT3 should be less than 15. Many have issues, when their RT3 begins climbing past 11-12. There are a few, but not many, who feel fine with RT3 at 14.

    That being said, I pray that those who read your article, would know that symptoms speak volumes, and labs are only a guide. It’s a shame that many doctors treat individual symptoms, rather than as a whole from an underlying cause. I hope that, someday soon, we can see more open-minded doctors, like you, in practice.

    • Hey Wendy,

      Great thoughts.

      Lab ranges in general are not very helpful, especially since you can manipulate the data to say whatever you want. If I want your free t3 to be 10 I can simply check your labs 1 hour after taking T3 medication. Once you’ve introduced medication into the mix the value of the labs decreased tremendously. Furthermore, some people can tolerate a T3 of 10 while others are symptomatic with a T3 on 2.1.

      When I refer to lab values I am really only referring to them in the setting of being un treated with any thyroid medication, because once you’re taking it – the labs have very little value.

  17. Hi,
    I have tons of these symptoms. Been to a rheumatologist, dermatologist, primary doctor, and allergist. The allergist ordered more in-depth labs and found I have the markers for Hashimoto’s. I eat healthy but have since cut out all diary, caffeine and alcohol. I have adrenal fatigue for sure and have had major stressful situations in my life recently. I am 58 by the way. I also have had a major rash on my face for over 6 weeks that itches 24 hours a day. Dr. Izabella Wentz’s information has been helpful so far and your website is a huge source of helpful info I just found today. I have always exercised and have been eating protein, healthy fats and vegies for several years (cut out sugar and gluten a long time ago). I feel awful right now: exhaustion, irritable, rashes, itching, cold, edema (ankles), headache, bloating, weight gain, dry skin, depressed, weakness, brain fog, slow resting pulse, cold skin, heat intolerance, hearing loss, trouble with balance, dry ridges down nails, thin nails that easily break, numbness and tingling, blurred vision, slow pulse, no sex drive. Yet I’m told my labs are okay except for the markers for Hashimoto’s. So no medical professional has given me any direction. I am going back for a 2nd dermatology opinion and seeing my regular doctor to beg for more labs. I figured I just need to do this on my own. I’m in the health arena with my job and thankfully there is a lot on the internet to help. I am worn out researching and trying to feel better. Do I rest? Do I push myself? Thank you.

    • Hey Diana,

      I think the issue is looking in the wrong place. If you stick in the insurance model there is a very small chance you will ever get any real help because all of these professionals are trained the exact same way.

  18. I am 48 years old and I need a NEW thyroid Dr in Austin TX. Any suggestions? I’ve had hypothyroidism for many years. 2 yrs ago a began a health and wellness journey with supplements. In the first 6 months I lost 50 lbs. and started feeling better immediately. I started exercising, eating healthy, sleeping better, no more constipation, better moods, no more chronic fatigue and pains, no more hair loss and so much more. However after the first 6 months I stopped losing weight and haven’t lost anymore since and now I’m gaining weight back. I NEED HELP FAST!! I’m getting discouraged. I still feel better BUT I need to lose more weight and I can’t no matter what I try! My current endocrinologist is so OLD school. I’ve been on synthroid for many years. Please help me Dr. Thank you.

  19. I had my throid removed in 2000, i get blood test often i,m on 125mg of syntroid a day. I have very sore muscle ,my eyesite is bad .i can,t hardly geet around because my hips are killing me all the time , someone i should be test for lupus, i do not sleeep good at all. I,m accident prone, please any input will great

    • Hey Jennjenn,

      Many TT patients do better when taking T3 in addition to T4 medications. This may improve your symptoms drastically.

  20. I am in England and have just been to see a so-called thyroid specialist. He didn’t know me. After 2 minutes he said I had no thyroid problems, I was just fAT! aFTER HALF AN HOUR OF DISCUSSION AND ARGUMENT AND BEING TOLD THAT ALL MY SYMPTOMS (ON YOUR LIST) WERE SYMPTOMS OF OVERWEIGHT AND THAT ANYTHING I READ ON THE WEB WAS LIES, i FINALLY GOT HIM TO AGREE TO FREE T3 AND T4, AND THYROID ANTIBODIES.

    When I get the results, do you think they will be enough to show anything up?

    • Hey Jane,

      I generally recommend against arguing with your provider because even if they do order the tests they won’t know how to interpret them and they will tell you they are “normal”. Ordering the tests is actually the easiest part, the hard part is interpreting the test results and getting on the treatment.

  21. I have an under active parathyroid. We increased Vit D3 to 2000 units and calcium to 500 it seemed to be working at first now it’s not. Do you have any information on this problem. I also have hypothyroidism and take Synthroid 0.1 mg a day and have been for a few years now. My hair is still falling out my nails ridged and brittle. I have a majority of the symptoms on your list all still active. I was diagnosed as Celiac a year ago and have been gluten free healing my digestive system ever since. I was diabetic until a couple months ago I’ve lost 40 pounds and am way more active. But the thyroid and para thyroid issues are still there. What would you suggest?
    Thank you

  22. Dr Child’s,
    I am soo very anxious to set up an appointment to see you and have submitted a rather long email to your office.
    I would like to know the chances of seeing you this next Month of November.
    If I submit my first initial payment when could I expect to be scheduled? Please let me know as I live in Washington State but have friends in Arizona where I lived up until 2014. I am so very desperate to find the proper doctor to treat my Hypothyroidism and all the issues related to it.
    Was first diagnosed Oct 2015.
    Please let me know so I can arrange my flight out and arrange for staying in Arizona.
    Please..I need someone to help me to save me..I feel like I’m slowly slipping away!
    Thank you from the bottom of my heart!
    Lydia Perales

  23. Dr Child’s,
    I am going to an endocrinologist and he is running some blood test and cortisol testing. I haven’t received the the rest until December 22, 2016.
    The doctor is not very nice, acts like he doesn’t care.
    My background is 4 major back surgeries, tons of metal and a spinal cord stimulator. I also have major depression so much so that I want to commit suicide. I tried on April 1st but was unsuccessful. I also have RA and I take Stmponi Aria. I have regular Medicare and AARP. I just need someone to help me feel normal. I’ve been depressed most of my life I think but it manifested itself when I was 25. I have more to say but please if u read this please help me feel normal. I don’t want to be here if I can’t feel better. Help Me!!

    • Hey Nora,

      I’m not taking patients anymore but there are other physicians out there that have the knowledge and capability to help you.

  24. I’ve had hasimoto’s for 40 years. My regular doctor retired and cant believe the problems I’ve had trying to find a doctor that understands the issue. they all follow the “book” with no independent, creative ideas. I’ve been to 4 doctors over 2+ years. 2 endo’s, 1 internist, 1 homeopathic + 40 pounds later, I am still not good. I am with an M.D. now as an interim doctor until a recommended endo is free in several months. I seem to know more than the M.D….

    Dr. Childs is 100% correct that the doctors that understand thyroid issues is rare. I also am thinking about surrendering to the symptoms. I am living but not alive. It’s a horrible problem that can be solved easily!

  25. Hi, I’m so pleased I found your blog, finally someone who understands. Please could you give me any advice? I have been diagnosed with hypothyroidism and am currently taking levo 125mg daily. I can’t loose weight, no matter what I try and have been told I am in the normal range. I still feel awful all the time. Below are my latest round of tests results which were done by an encro:

    Serum TSH level 2.22 mU/L
    Serum cortisol 13 nmol/L
    Serum sex hormone binding globulin level 33 nmol/L
    Serum testosterone 2.4 nmol/L
    Non HDL cholesterol level 5.18 mmol/L
    Serum LDL cholesterol level 4.6 mmol/L
    Serum HDL cholesterol level 1.24 mmol/L
    Serum triglycerides 1.27 mmol/L
    Haemoglobin A1c level – IFCC standardised 36 mmol/mol
    Haemoglobin A1c level 5.4 %
    TSH – thyroid stim. hormone 2.36 mU/L
    Serum chloride 104 mmol/L
    Serum FSH level 6 U/L
    Serum LH level 12.7 U/L
    Serum free T4 level 14.1 mmol/L
    Serum cholesterol 6.42 mmol/L
    Serum creatinine 77 umol/L
    Serum urea level 4.6 mmol/L
    Serum potassium 4.4 mmol/L
    Serum sodium 137 mmol/L
    Thyroid autoantibodies (PH6545) – positive autoantibodies, FINAL REPORT, Occupation, Onset, Anti-Thyroid peroxidase ab. POSITIVE 364 IU/ml

    Any advise will be greatly appreciated.
    Thanks, Lisa

    • Hey Lisa,

      As I’ve mentioned previously it really doesn’t help for me to tell people what is wrong with them because they still require treatment and that’s the most difficult part. I would recommend you seek out someone near you to help you further to optimize your thyroid function because at a cursory glance your thyroid function is indeed suboptimal.

  26. Hi Dr Childs. I am 63 years old. I was diagnosed with hashimotos in 1988 and put on synthroid. Dr. Childs you can’t believe the incredible nightmare I have been through. After on synthroid I felt better but was depressed I believe due to nutrient deficiencies. This sad story I am sure has been repeated over and over. The antidepressant led to panic attacks which then turned into benzos and then neuroleptics when all along it was my hashimotos not properly treated. It has been a monumental struggle to get off most of these drugs and relearn how to talk, think and finally do research and realize the sad truth. At this point in time, I have found a Naturopath willing to learn and is committed to helping me restore my health. I am very sick. TPO is 178 as of November 2016. TSI 89. As of December 2016 rt3 19.1, t3 2.1 tsh 1.97 t4 1.34 b12 311 mma 68. D3 34. All four iron labs are normal except ferritin 68. Adrenals working overtime. But I have healed my gut. More testing as I can afford it. Hyper sensitive to b12 will you help and anything activating including a try at switching from levothyrixne 88mcg daily and 25 mg once a week to 32.5 nature-throid for nine days which proved disastrous. So much more to report. I would find a way to pay 995 dollars for your consultation services if it would help my provider. He wants to help me heal but just doesn’t habe all the pieces to the puzzle figured out.

    • Hey Marsha,

      Thanks for reaching out and I’m sorry to hear about your situation. I would say the single best thing you can do is find someone who is knowledgable about thyroid function and other hormones to help get your life back. It can be difficult and tricky in some situations, but in almost every case there is significant improvement to be had.

  27. Hi Dr.Childs,
    I’m 41 years old, I have a lot of the symptoms you’ve listed.
    I’ve consulted a doctor, he asked for TSH and Free T4 tests, the TSH results were 2.81 ulU/ml and 0.86 ng]dL for the Free T4 test. He told me the results were totally normal and I just need to lose weight. I consulted another doctor and was told the results are normal and no need for extra tests… Should I have more tests or these results are acceptable??

    • Hey Eman,

      It’s not a matter of the tests you are ordering but the interpretation of the results themselves. You need to find someone who understands the difference between optimal and “normal” if you want the proper treatment.

  28. Hi,
    My doctor diagnosed me with hypothyroidism after I yelled and complained for almost a year about weight gain and lack of concentration. My grades dropped to 60’s from 80/90’s. By the time I got diagnosed in 2010 I was almost done college. My doctor’s office called me in the second the results arrived from my blood work. Now in 2017 I am on Eltroxin and my symptoms are just as bad as they were when I was untreated. I keep getting tested for my TSH levels which keep coming back as fine. My weight is now 169lbs which is the heaviest I have ever been, in 2010 I was at 145lbs. I am now 28 years old, I have gone to 5/6 other doctors who also only check for TSH. No one has referred me to a thyroid specialist either. I take my medication daily but it feels like a waste as I don’t think it is doing anything anymore.

  29. Hi Chris, firstly I would like to thank you for all your helpful information and guidance that you publish on your website. Unfortunately I DESPERATELY need your help in interpreting these test results as my doctor told me not worry and that they were normal. From your article above they don’t look normal. Can you please shed any insight to these results.
    TSH – 1.8
    Free T4 – 12
    Free T3 – 4.3
    Reverse T3 – 247
    Thyroglobulin antibodies – 46
    Thyroid peroxidase antibodies – >1300
    Free T3/Reverse T3 ratio – 0.017
    Many thanks Sassy

    • Hey Sassy,

      I’m not sure who Chris is, but I am only able to provide medical advice to my patients. I would recommend that you find someone who can interpret your labs and put you on the correct treatment.

  30. I’ve been dealing with hypothyroidism for 16 years. Until 1 year ago I was on Synthroid 137mcg but in the past 13 months my T-3 has been too low. My doctor added Cytomel 5mcg but then the TSH got too low. I’ve been on a rollercoaster (3 different dosages in the last year), and now I’m feeling tired, have muscle pain all over my body and have numbness on my hands. My physician is sending me to a neurologist because he thinks I have a neurological disease. He says that hypothyroidism does not cause that symptoms. I know it’s my thyroid, this is so frustrating…

  31. THANKYOU for your informative article. As I looked over your symptom list I found some of mine were opposite. Never being cold, and after very short walk or standing for 5 mins. I am sweating profusely. Doesn’t matter if it’s 90 degrees or 32 degrees. Is that also possibly known symptom ? I am 11 years out of life now. I’m anxious to live again. I will be asking my Dr. For these tests.

    • Hey Eileen,

      Other hormone imbalances may be causing or contributing to your sweating issues, but I wouldn’t necessarily blame those on the thyroid without further testing/evaluation.

  32. I have been on the same dose of levothyroxine since 1988, am very obese but not diabetic. Am 62. My sister urged me to try garcinia cambogia because its helped her with no side effects; she is 68. I tried one yesterday with apple cider vinegar and felt ok. Today I took just one again with the cider vinegar and almost passed out while shopping. Why is this dangerous for me but not my 68 year old sister.
    I’d like to now try ala. Do you have a book?

  33. I am so relieved to learn of you and your site. I have been struggling with all of the symptoms of hypothyroidism for the past 15 years. I have been on Armour Thyroid med for the past 8 years and a T3/T4 compounded before that and under the supervision of a functional medicine doctor. I continually complained about constant weight gain despite interval weight training and healthy clean eating. My doc changed my med to a porcine capsule, then to a synthetic alternative and now added a lower dose of amour (T4/T3) in afternoon. The weight and cellulite keep increasing. After listening and reading your posts on Leptin Resistance and Thyroid resistance, I revisited my lab results from Sept 2106 (incomplete testing) and Oct 2014. My TSH both times were low (.96 and .82), Reverse T3 high (16), Free T3 high (4.9), T4 low (4.6), Pregnenolone low (7), Free T4 low (.83)

    I am going to ask Dr. Rozakis why Leptin Resistance was never considered based on my lab results and my constant complaining of weight gain and cellulite.

    I live in Cleveland Ohio and need to find a new Doctor. How do I begin that process? I would like my current Dr. to order test results per your recommendation.

  34. Hello,
    My name is Laura. I have been having a hard time losing any weight despite knowing how. I was 200 pounds prior to 2011 when I got down to 125. Then in 2012, I quit smoking. I turned 40 also. I did NOT increase eating at all. I slowly started creeping up to 145 now in 2017. I am now 44 years old. NO matter what I do, I cannot lose this 15 pounds. I went to the doctor and she claims it is peri-menopause which I have no symptoms of. As a matter of fact, my period are very normal. Usually right on the money. Never missed one and very regular. I have no hot flashes nor night sweats. I have been exercising and eating 1200 cals a day. So, I did get some blood tests. My good and bad cholesterol was up the thyroid tests came back as this; TSH-1.710 T4 Free-1.12. That is all they tested on me. She refused to do anymore testing of my thyroid. I am always cold when others are hot. I am tired allot. My mom and all 3 of my aunts have hypothyroid. What say you? What do these test results mean? I am going to see an endocrinologist at the end of this month to see if he can help me. I am so puzzled by the weight gain. I lose a few pounds, then by the time I get my period, it all comes back and I start over. I cannot get under 145.

    Please and thank you for any advice.

    Laura J.

  35. RT3 is 22.2. on cytomel only 10 mg a day. Have every single hypothyroid symptom. Have sibo (on treatment now)and candida (will treat next) . Chronic fatigue and fibro. Can barely function, even to hold cell phone muscles are so fatigued. I think my dosage is just not enough. Do you agree ?

    • Hi Julie,

      It’s a possibility, but your symptoms could just as easily be related to something else as well, or more likely a combination of multiple factors.

  36. Hello

    I’m so happy I discovered your site. it’s so informative and so helpful!
    I’m on Synthroid and my blood test showed I’m within the normal range.

    For one year my levels were.
    FT4 – 14.4, FT3 – 4.5, TSH 3.1

    I felt few symptoms of hypothyroid but my doctor despite my complains said …every thing is OK.
    I decided to raise the dosage with 50mcg and got this results.

    FT4 – 15.1, FT3 – 4.9 , TSH 2.6

    Before I got the graves disease I’ve used to be quite active. Cycling around 40 – 50 miles a week and some times in one day. Since I’m on the thyroid replacement I can barely cycle 15 min. and in a good day 20 min and very slowly but than I’m quite exhausted.
    I tried to push my self but I made it worse and felt very bad. The feeling was like I crossed a line and felt many of the hypothyroid symptoms all most half of the 68.
    It took me more than 2 weeks to recover.
    I should mention that a heart check was OK.

    Whats not working? what did I do to my body when I pushed my self?


  37. Yes i have all the symtoms i was on levothyroxin didnt realize how it was affecting me until i quit taking it.I feel so much better after being off of it for 3 months now. I have more energy.

  38. I really hope that this gets to you because it’s been a while since you made this but I’m at a loss and need your help terribly! I love in a small northern ca. town with very few doctors and especially that take my insurance so I am forced to see uneducated tired doctors who just don’t care. I had a baby in 6/2015, I told my doctor numerous time since then that something is not right. I went from having tons of energy and working out everyday being very fit to so exhausted I can barely get out of bed let alone have energy to go workout and when I do I feel even more exhausted whe I used to feel energized from working out. I stay very active chasing around a toddler and going in bike rides and eat very healthy yet I am gaining weight and my hair is almost gone compared to what it was. I told my doctor all of this and he keeps telling me it’s normal I just had a kid and I’m not young anymore…I’m 39. I asked him to run hormones tests and thyroid tests and all he ran was a tsh, fsh and said that I’m in normal range and sent me home with Wellbutrin which caused me to want to kill myself so I stopped after 4 months. My daughter will be 2 and I’m getting worse. I have every single symptom you mentioned that said I most definitely have hypothyroid but he won’t test for it telling me I’m fine. I cried reading the information you wrote because it was like you were talking about me. I cannot keep on living this way. I would rather die. Please help me. I have an image of the test that he ran and what the levels were but like I said he didn’t check for much. Just told me I’m not menopausal.

    • Hi Nicole,

      Thanks for reaching out and sorry to hear about your situation, unfortunately it is not that uncommon. The single best thing you can do is look outside of the insurance model and seek out new doctors to help you order the right tests and get the diagnosis correct. The problem is that your current doctors aren’t even willing to order the right tests and even if they do, they really won’t know how to treat you so it’s not worth the struggle.

  39. We are going through the whole having symptoms and antibodies are high but the doctor won’t prescribe a medication for my daughter. She is 16 and is having acne quite bad, weight gain and fatigue. Would love to find the right doctor in Colorado

  40. Hello. I have almost all the symptoms listed. I went to the doctor and asked for a full thyroid panel to be done as well as hormone levels. My doctor is a nice man, but doesn’t always listen. He only ordered the standard lab draws. He added on a reverse T3. I was in thyroid medication 3 years ago. I’m not sure why they took me off of it. I’m tired of feeling this way and I really want a doctor to help. Any advice would be greatly appreciated. Thanks for your time. This article describes me to a T. Nice to know I’m not alone.

  41. I enjoyed your article. I am pretty sure I have issues with my thyroid for a long time. I have my TSH looked at several times over the last 4 years. I have at least 8 of the symptoms on your list. 2 years ago they found a multinodular goiter and the nodules are small so I am checked yearly. I got checked again and they were still stable. I saw an endocrinologist last year she said my antibodies were negative but my TSH was too low and that meds would do more harm than good. In the last several months I have gained 38 out 45 lbs that i had lost. I exercise daily and i eat pretty well. I have trouble sleeping, irregular periods, anxiety Which I am.on Lexapro 10 mg for and i just had to have carpal tunnel release surgery on both sides along with other issues. I had a regular blood test with TSH and T4 too. My TSH was .485 and T4 was 1.07. I go yearly check up on 9/13 what would your advice be to talk with her about since I dont think she thinks there is something wrong.

  42. Alright so when I was first diagnosed with hypothyroidism my tsh lvl was over 7.0. This was about 5 years ago. Well I was on levothyroxineat 25 Mcg. It helped but wasn’t the best, about a year ago it was upped to 50 mcg and I was feeling better then I had in a long time. Well about 2 months ago I couldn’t afford my med any longer, and as you know I feel worse then ever. But my resent tsh test was 2.35 so the doctor took me off. The doctors won’t late to me at all. I even asked if he would do the t3 and t4. All he said was I had to wait to see a different doctor. On top of this I’m having new symptoms which was basically told I’m just to depressed.

  43. Hello!

    I am a 59 year old woman who has been diagnosed with Myasthenia Gravis in 2004 and recently with Fybromyalgia. I have suffered with chronic pain for years. I am extremely tired all the time, even when I can sleep 10-12 hours at a time. I many times still need a nap. I get swelling at the base of my neck/top of my spine and you can totally relate my overall pain level based on how much my “hump” has raised. I also have a lot of spinal pain. I am very frustrated about the lack of proactiveness with my doctors. Your blog has been very helpful and encouraging. How do I go about finding a doctor (I am in NC) that will take my concerns seriously and follow through what needs to be done for me? Thank you for your insight on this matter!

  44. Hi there! Thank you for this information! Is there a possibility that an individual has at least ten of these symptoms, yet does not have hypothyroidism? Also, how likely is hypothyroidism in a 21 year old? I feel many of these symptoms,and have a family history, but could it also be my crazy busy college lifestyle that is causing my body to react adversely?

  45. Hi Dr Childs.
    I read your post with great interest. I had my thyroid removed in Jan 2016 because of very large nodes that caused me to stop breathing in certain situations (like sleeping on my back). I have felt like crap and I am sick all of the time ever since. I also suffer from HLA-B27. I am on a restrictive diet since I learned of the HLA-B27 in July of 2011. I am on 88mcg of Levothyroxine. I am sick and tired of being sick and tired! I had 25 of the listed symptoms. I live in the Portland OR area and have had my endocronologist for about 12 years. Early on I had an over active thyroid that corrected itself. I was not on any meds until after my surgery. I have an appointment with him next month and would like to know exactly what I need to request from him to get the proper tests. Many many thanks. This the most hope I have had in months to maybe start feeling better again.

    • Hi Sue,

      The complete list of thyroid lab tests (and rationale) can be found in this post which I recommend that you read:

      The testing includes: TSH, free t3, free t4, total t3, reverse t3, thyroid antibodies (both TPO and TGAb) and sex hormone binding globulin (depending on the person).

      Hope this helps get you started!

  46. I am 24 years old and have had hypothyroidism for almost 15 years, it runs in the family. For about the past 3 years, I have an awful cystic acne around my jaw and chin. It’s not cyclic, there are no monthly changes to my acne. I have been to the dermatologist multiple times, and have used everyone topical in the books! I’ve even started on birth control and spironolactone in hopes of clearing my acne, with no luck! Also, about a year ago my endocrinologist told me I have hypothyroidism due to Hashimoto’s. I’m beginning to think my acne and my thyroid may have some connection. What do you think about this, and what are some solutions to this?

  47. I am a 49yo female who had RAI almost 10 years ago after being diagnosed with Graves disease. I honestly think the diagnosis was incorrect because I had every symptom of being hypo but the doctor said my TSH indicated hyper. I was put on T4 only medication after the RAI and started gaining even more weight. Eventually, I got on Armour and had problems getting my dosage right. Most recently I’ve had a suppressed TSH .01 but my FT3 is 2.6 (low end of the reference range) and my FT4 is .84 (low). My RT3 is 15. My T4 is 5.2, and T3 99. My doctor decreased my NDT med to 30mg from 120mg due to my TSH and doubled my T3. Before this test I was on 25mcg T3 so am now on 50mcg. My body temp has been 96.7 to 97.5 on 25mcg of T3 so hoping I won’t feel so cold. We don’t think I’m converting T4 to T3 well, so hoping the T3 only will help. She had also diagnosed me with Hashi’s about 6 months ago but with recent blood tests, it is not present anymore. I have been on LDN 4.5mg since I was diagnosed so maybe that actually helped.

    My big question is, do I care about the TSH being suppressed? If so, how do I raise my TSH, T4 and FT3 levels while decreasing my RT3??

    Ugh, what a mess.

    Thank you for taking time to have such a great site for us to turn to.


  48. I have been tested and told for 3 years in a row that I’m healthy and my labs are normal. Yet my symptoms keep growing and my current state is so frustrating and depressing. I’m not sure if it’s related but I’ve had blurry vision for 5 months which fluctuates day to day and hour to hour… new prescriptions have not helped. I also have had intense headaches and migraines… Along with the common symptoms (chronic fatigue, foggy memory, muscle aches, depression, etc).
    My mom has fibromyalgia and hypothyroidism. I’m no longer in touch with her so I don’t know where her levels were before they finally diagnosed her but it took 10 years.

    What can I do to figure out if I truly have a thyroid problem if the bloodwork is “normal”? I haven’t found a doctor who treats holistically or functionally. Any advice would be appreciated!

    Thank you!

  49. I am actually wondering if Doctors are purposely taking a blind eye to the symptoms of hypothyroidism due to the added business they receive when the patients being treated are not responding well to their therapy. I am in constant argument with my doctors regarding test ranges and side effects. I swear they have a pill for all your aches and pains, but nothing that works for getting your thyroid numbers where they should be.

    • Hi Stephen,

      It may seem that way, but there is truly an unlimited amount of people that need medical attention so I don’t think this is motivated out to greed. Instead, I think it’s a falling behind on the science and a failure to accept a new paradigm of treatment.

  50. Good Morning Dr. Childs.

    First and foremost, may the Lord continue to bless you in your your mission to help thousands of misinformed, mistreated, and abused innocent patients all over the world.

    I have searched and asked my colleagues all over the world regarding the SAFE AND LEGAL use of porcine derived NDT products in patients with an established diagnosis of Hashimoto’s with obvious elevated thyroid antibodies.

    I have cautiously used NDT in patients with Hashimoto’s concomitantantly with proteolytic enzymes and LDN while monitoring antibody levels with mixed results.

    Unfortunately, these patients vehemently decline Cytomel or any compounded recommendations!

    Pub Med is ambivalent in its conclusions!

    Any literature, sites, comments or suggestions would be greatly appreciated.


    Jose L. LizardiMD
    Advanced Anti Aging & Integrative Gynecology LLC

  51. Dr. Childs,

    I happened upon your site this morning while searching for natural thyroid supplements. You have a wealth of information here-it’s going to take some time to go through all of it, but I am happy you are sharing this information for us who need straight forward info concerning thyroid conditions.

    I’m giving your website to the surgeon I’ve been referred to at my local VA hospital this week.

    I’ve been diagnosed with a multi-nodular goiter the past 10 yrs. Various testing/labs (needle biopsies, nuclear medicine, blood work, ultrasound) findings are always within ‘normal’ ranges. I’m 59 y/o and I have 4 of the typical hypothyroid symptoms but my doctor doesn’t say I have hypothyroidism.

    Thank you for your work and sharing this information which I am going to be sharing with my physicians.

    P.S. I believe your bio would read better (I’m taking a writing course) if it read-
    I’m a physician who specializes in helping people……

    God bless

  52. Hi, Dr. Child’s,

    Hope you are good? I’m hoping somebody can make sense of my recent revelation!

    I’m a 42 year old female living in Ireland and for years I have lived with most of the symptoms on your list. I have had my thyroid checked but they only check they TSH which was normal and so I continued to live in a half-dead state. I can say that confidently now because two weeks ago I discovered by chance what it felt like to be symptom-free.
    My Doctor put me on 20mg of prednisone to treat a case of contact dermatitis on my scalp.

    By day two I was ME again! I didn’t even realise that person still existed. The mind-numbing brain fog was gone, the hearing difficulties, the excruciating eye pain, I could BREATHE! I had not realized that I wasn’t getting the air into my lungs! I felt fluid, sharp, level-headed. The aches and pains were gone and I smiled and laughed at ease throughout my days.

    I now knew 100% that there was an underlying reason I felt like a zombie on a daily basis.

    Everything I have read points to my thyroid but when I marched into my Doctors office with news of my discovery she told me that the steroid could not affect my thyroid and it’s function.

    I am desperate to find somebody that can help me join the dots.

    Thanks a million,


  53. I have already seen a specialist who is only ordering yearly ultrasounds for benign polyps and cysts on my thyroid. He says that he can,t do anything more than keeping an eye on them to make sure there is no change. In the meantime, I have several of the symptoms of hypothyroidism.

    • Hi Marcie,

      Your Doctor is right that he/she can’t do anything about the nodules but something can certainly be done for your symptoms! Make sure you get started with a complete thyroid lab test to determine if your thyroid is functioning appropriately. If you need treatment it will show up on your labs.

  54. I am 29 years old and experience the symptoms of hair loss, anxiety, thick tongue, swelling of my face, neck and feet, sparse eyebrows, low basal temperature, swelling of eyelids, super dry skin, swelling, hoarseness, choking sensation, difficulty swallowing are what have upped the ante for me. The last three are driving me nuts and have caused me to loose my appetite and loose a lot of weight. The sensation of choking makes me afraid to eat. I want this to go away. Thank God I am not crazy. I have been telling doctors it feels like there is a lump in my throat and that I have difficulty swallowing. No one is believing me. I need help. I have lost like 20 lbs in the past year. I just started interpreting my own labs and saw that they are low! I have begun reading Dr. Wentz book but need a very good practioner nearby in Atlanta GA if anyone can refer me to one. Please this is dire for me. And I didn’t even list all the symptoms that I feel! Where do I start? I have fired my doctor (conventional)?

  55. For the FT3/rT3 you need to provide units of measurement. The 0.2 value comes from dividing pg/ml by ng/dl. If you use ng/dl for both numerator and denominator the value is 0.02.

  56. I have a lingual thyroid. It was discovered at age 2 . You can visibly shine a light and see it at the base of my tongue. I’m am 31 years old and have been on thyroxine since 2years old. I have many symptoms on this list but also have some opposite symptoms such as the difficulty gaining and maintaining a healthy weight. I’m exhausted all the time . Stressed and anxious. I’m also treated for ADHD. I have a wonderful family practitioner who makes me feel heard but typically test me traditionally. He has been open to a vitamin D and calcium test when I told him about the amount of route canals and cavities have developed and my teeth literally feel like my body.. rotting from the inside out. My values were low and for a while I took supplements but it didn’t help enough and eventually just stopped. Probiotics helped with my gut but I eventually stopped that habit too. And haven’t experienced the extent of symptoms before them. I clear my throat constantly and wish I could find a surgeon who has removed a lingual thyroid. What little research I’ve found shows it to be a dangerous and rare surgery.any direction you can point me in would be amazing.

  57. My pain, fogginess, depression, lethargy, and exhaustion make it difficult to be compliant with my treatments.
    How do I get better if I don’t feel like taking care of myself?

    • Hi Debbie,

      You may have luck by finding someone who is willing and able to keep you accountable! In addition, if you are on the right therapies then you should see your symptoms improving fairly rapidly (over the course of a few weeks).

  58. Thank you for all of the info you’ve made available. I was diagnosed w/ hypothyroidism in 1998 after my 2nd child was born. I saw one of the top endo’s in my area who is incredibly thorough & spent a great deal of time explaining everything to me. He conducted all of the tests you also recommend & used his own lab due to not trusting the frequent inaccuracies & ranges used by many of the area labs (Quest, LabCorp, etc.). I was told that due to my mothers hypothyroidism – she later had her thyroid removed at Johns Hopkins years later due to repeated problems & concerns it would become cancerous – that I didn’t have the postpartum type, but the “permanent type.” I was placed on Synthroid at 88mcg & did well for years on that dose w/ a few tweaks when I was pregnant w/ my 3rd child.
    Fast forward to last year… I switched insurer’s & ended up not having my thyroid meds for 2+ months. When my new doc tested my thyroid functioning, she said my levels were “normal” which blew me away!! I told her I wanted to retest in 3 weeks & she agreed since it can take awhile for thyroid levels to register the change. 3 weeks later it was slightly abnormal so she put me on 25mcg, significantly lower than the 88 I had been on for years. Since then I’ve continued to have a # of symptoms though my doc says my bloodwork is fine. I just don’t buy it & am going to try & get her to do more detailed bloodwork, but could be a struggle since I have Kaiser.
    Is there a reason I could be stable on 88mcg for 2 decades, & now only need 25mcg despite having the “permanent type” of thyroid disorder? What is the minimum tests you recommend at this point? Kaiser has only tested TSH, T4, & Free T3.
    Thank you

  59. Hi Dr. Childs, I’ll try to make this short. I’m 55 yrs old I was having a lot of hair loss. I was put on Iodine 25mg a day by a naturopath. I instantly felt better, lost about 4 lbs without trying and my hair stopped falling out in 4 weeks. I was fantastic!! I found an MD who knows about Iodine and I just wanted to have someone that I could use my insurance with. He found my RT3 to be 33.5, put me on cytomel 50mcg a day!! He told me to lower dosage if tachycardia started, and it did! I lowered immediately so it stopped, but drastic hair loss started, I showed him but he said I would have to put up with. it. I stayed on Cytomel(5 months) 25mcg then last 6 weeks of taking it, I did 12.5mcg. I stopped at the end of Dec 2018. I still have hair loss which is I now a total of 9 months! My eyes are also puffy underneath now. PLEASE, CAN YOU TELL ME WHAT TO DO? I don’t feel I needed the cytomel at all! I’m scared and don’t know what’s going on. I just want the hair loss to stop and puffy under eyes to go away. Will my hair grow back? I’ve lost about half of it. I don’t see any new growth as of yet.

    • Hi Laura,

      I would take a look at this article which will help you determine why you are losing your hair:

      It may be because your dose was excessively high or it may have been secondary to the medication itself as it is known to cause and exacerbate hair loss. Either way, the article listed above should help. Whether or not it will grow back depends on what caused it to begin with.

  60. I had my labs done recently and I was alarmed by my doctor because of the following results and he kept referring to me having Hashimoto’s. I have never been diagnosed as such, nor do I feel I have the symptoms listed above, but maybe I have been able to keep it at bay with my diet? I know that you can diagnosis me, and I am definitely not asking you to do that, but if you could point me in the right direction, I would greatly appreciate it.

    Thyroid Peroxidase Ab: 7 (ref 0-34IU/mL)
    Thyroglobulin Antibody: 17.8 (ref: 0.0 – 0.9 IU/mL)
    TSH+T4F+T3F+T3R: 1.480 (ref 0.45 – 4.5uIU/mL)
    T3F: 3.8 (ref 2.0 – 4.4 pg/mL)
    T4F: 1.39 (ref 0.82 – 1.77ng/mL)
    RT3 Serum: 18.6 (ref 9.2 – 24.1ng/mL)
    Homocysteine: 9.5 (ref 0.0 – 15umol/L)

    I did a Genova Lab Test which also had the following results he said was alarming. Not that I don’t trust him, but an unbiased look at these results tells you what?

    Alpha-Lipoic Acid – Borderline – recommended 100mg daily
    Cobalamin – Borderline – recommended 500mcg daily
    Folic Acid – High Need – recommended 1,200mcg daily
    Magnesium – Borderline – recommended 600mg daily
    Manganese – High Need – recommended 7mg daily
    Omega-3 – High Need – recommended 2,000mg daily

    Selenium – 107 – Borderline – range 109-330mcg/L

    Benzoic Acid – 0.03 – range <=0.05
    Pyruvic Acid – 5 – range 7 – 32
    Succinic Acid – <dl – range 0.4 – 4.6
    Vanilmandelic Acid – 0.9 – range 0.4 – 3.6
    Homovanillic Acid – 0.8 – range 1.2 – 5.3
    Formiminoglutamic Acid – 3.2 – range <=1.5
    Orotic Acid – 0.31 – range 0.33-1.01

    Most of my amino acids were on the low end within the reference ranges.
    Arginine – 7 – range 3-43
    Histidine – 210 – range 102-763
    Isoleucine – 6 – range 3-25
    Leucine – 15 – range 6-61
    Lysine – 40 – range 15-231
    Methionine – 3 – range 2-16
    Phenylalanine – 15 – range 7-92
    Taurine – 217 – range 39-568
    Threonine – 54 – range 9-97
    Tryptophan – 20 – range 8-58
    Valine – 22 – range 5-43
    Glycine – 45 – range 47-435

  61. Thank you Dr Childs for taking my question. I was diagnosed with thyroid cancer and had a complete thyroidectomy including 2 parathyroid glands in 1982. I have been doing well with my Levothyroxine , .1 mg until now. My current TSH level is .24, down from my average of about 1.7-2.2. I am experiencing hair loss, sensitivity to cold, and hives. The hives are the size of a quarter, swollen and itchy. They do not subside even though I have been taking antihistamines for three days. Right now they are limited to my hand, wrist, neck and chest I am. now 64 and am very uncomfortable with lowering my Levothyroxin dosage. I am afraid of suppressing my TSH any more, since my body cannot replace the thyroid function. Is this a good course of action?

  62. Hi. I have been told that I have a thyroid problem as the outer ends of my eyebrows stopped growing. Is this true? I do have some hair loss and it is getting worse. I am diabetic, have a cholesterol problem, weigh 200 pounds, have high blood pressure all night but it is a high normal all day. I am 85 years old, retired and bored which unfortunately makes me somewhat lazy. Thyroid tests come back normal.

    • Hi Loreenn,

      The loss of the lateral 1/3 of the eyebrows is a very sensitive sign for hypothyroidism so if that is what you are referring to then you may have a problem.

  63. I hope this is seen. There’s no way I could give a complete picture of the nightmare that I have been going through since 2015. I have seen 49 dr’s/practitioners since then. Prior to 2015 I owned and ran a masonry business and home inspection business. Now I can’t even work. But I can’t get disability because I can’t get a diagnosis. My family is suffering because of my health.

    *Thyroid question- Am I actually hypothyroid?
    Without levothyroxine, my TSH has been as high as 8 or 9. But the question I have is… Why are my T3 & T4 always normal, no matter if I am being treated (taking levothyroxine) or not. I have never had an abnormal T3 or T4 lab test. A functional medicine dr did tell me recently that my T’s were not high enough. But would that make me feel like I do? Like I’m slowly dying? Now, as far as TSH is concerned, I have read that opiate pain medication can elevate TSH, and I have taken pain medication for a back issue for years now. I just don’t know what’s going on. None of the doctors I’ve seen can figure anything out. My GI dr is telling me I should go to the Mayo Clinic because she & no one has been able to help me. Even if my insurance would pay for that, I can’t finance the trip.

  64. Hello. Thank you for this informative article. I hope this comment is seen. I’m hoping to keep this short, but I have been suffering from several GI and endocrine issues (at least) since 2018 and was only recently diagnosed. I have seen over 15 doctors, most of which told me I just needed antidepressants. After finally finding good doctors, and after being on treatment plans for 5 months now, things are not improving. I am looking at other culprits. I have had my thyroid levels tested repeatedly (but only TSH, free T3, free T4, and reverse T3), all of which have been “normal” (according to doctors). My last TSH level, in April, was 1.321… more indicative of hyper rather than hypothyroidism. However, I have 15-20 symptoms of hypothyroidism as you listed above. Any thoughts or advice? Could something be wrong with the test, or is it likely something other than hypothyroidism? Anything would help. Thank you!

  65. Hello I am 44yoa. When I was 16 I had my periods for maybe 6 months always with horrible cramping and then they stopped. My doctor ran thyroid test and showed as hypo. He put me on synthroid for one week did labs and then ran labs after two weeks or on the synthroid and stated my hypo was no longer n had corrected. So I seen specialist and was diagnosed w early menopause. But now I have way more than ten of the symptoms on list including my most traumatizing of any being dry brittle hair and hair loss, dry mucous membranes, pounding heartbeat, anxiety, emotional reactions out of whack, and more! I just wonder if it wasn’t the thyroid after all and The early menopause could have been reversed w proper treatment?!?!

  66. I was diagnosed a couple of months ago with hypothyroidism, my primary Dr diagnosed me and sent me to see a endocrinologist. I go to see my endocrinologist for the second visit at the end of October for a second blood draw, and ultra sound. I have been on various thyroid meds and have the same side effects. Headaches, aches and pain in my neck and body, etc. I am on levothyoxine 50mg right now. I usually take it in the morning on an empty stomach as always. So as the day progresses I star to feel terrible, so i am going to try taking it before i go to bed.
    Can I take supplements and if so what would be recommended.

  67. Hi! Dr. Childs,

    I skimmed the info because there is so much of it. That’s a good thing and I will read more when I have more time. I don’t think I saw anything about taking temp before getting out of bed to test basal temperature or the role of the adrenals, in addition to iron and sex hormones, in conversion of T4 to T3 and using DATs (daily average temps) to assess the health of adrenals. Without having insurance since my husband lost his job a few years ago, I use temps to determine how I’m doing and if they are low or unstable in relation to the adrenals, then my doc will run labs.

    • Hi Tami,

      I’m not sure if I discuss the use of temperature testing/monitoring in this article or not but I have over 500+ articles that I’ve written over the years and it’s been discussed in others. You can search for specific topics using the search function if you are looking for something specific. I’ve written on just about every topic related to thyroid function over the last 7 years.

  68. Dr child’s I have posted in the past, it was helpful. However I started taking t3 but my dr will only prescribe 5 mg. I do save them up and double The dose every other mo. It’s helpful. However, I have no thyroid and I take 112 sybthroid. My TSH is .035 for almost a year, free t4 high end normal and t3 low end normal. So I should be hyper but All my symptoms are hypo! Can you please help explain this? My Dr doesn’t know what to she wants to lower the synthroid. What should I do, and please tell me where to find your reply? Email? I’m not tech savvy.

    • Hi Linda,

      Of course. The assumption that a low TSH means guarantees are hyperthyroid is absolutely false. Many thyroid patients have low and even suppressed TSH levels and are still hypothyroid because their body isn’t able to properly convert and utilize T3 and T2.


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