endocrine system and mental health ( and thyroid)

Test	What It Measures	Standard MD Interpretation	Typical ND Perspective
TSH (Thyroid Stimulating Hormone)	Pituitary signal to the thyroid	Normal: 0.4–4.5 mIU/L. Many MDs don’t treat unless TSH > 4.5–5.0.	Prefer optimal range: 1.0–2.0 mIU/L. Treat symptoms even if TSH is 'normal'.
Free T4 (Thyroxine)	Main hormone produced by thyroid	Normal: 0.8–1.8 ng/dL. Used to evaluate thyroid hormone production.	Looks for 'optimal' levels in upper half of range. Values < 1.2 may trigger action.
Free T3 (Triiodothyronine)	Active form of thyroid hormone	Often not tested unless hyperthyroidism suspected.	Considered crucial. Low Free T3 even with normal TSH/T4 can prompt treatment.
Reverse T3 (rT3)	Inactive T3 competing with Free T3	Rarely ordered or considered.	Used to assess stress-related thyroid suppression. High rT3 seen as problematic.
Thyroid Antibodies:- TPOAb (Thyroid Peroxidase)- TGAb (Thyroglobulin Antibody)	Autoimmune activity (e.g., Hashimoto’s, Graves’)	Positive antibodies confirm autoimmune thyroid disease but may not alter treatment unless TSH is abnormal.	Positive antibodies may prompt early intervention even if TSH/T4/T3 are normal. Emphasis on reducing inflammation.
Total T3 / Total T4	Bound and unbound hormones	Less commonly used; more important in older protocols.	Sometimes used to evaluate hormone binding issues, but Free hormones are preferred.
Thyroid Ultrasound	Physical structure of the thyroid	Used if nodules, goiter, or cancer suspected	Also used to monitor goiter or subclinical issues in autoimmune thyroiditis.

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example

Normal: 0.4–4.5 mIU/L. Many MDs don’t treat unless TSH > 4.5–5.0.

Prefer optimal range: 1.0–2.0 mIU/L. Treat symptoms even if TSH is 'normal'.

TSH normal range 0.27 to 4.20 uIU/ml

my score under medication is 2.360

Normal: 0.8–1.8 ng/dL. Used to evaluate thyroid hormone production.

Looks for 'optimal' levels in upper half of range. Values < 1.2 may trigger action.

example

FREE T4 normal range 0.71 to 1.70 ng/dl

my score under medication is 1.04

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Jane Leu Rekas, LCSW