We treat patients from across metro Atlanta — Dunwoody, Buckhead, Brookhaven, Chamblee, and beyond. Hashimoto’s and primary hypothyroidism typically require long-term support. You can have hypothyroidism without Hashimoto’s, but Hashimoto’s is the most common cause of hypothyroidism in the US. Hypothyroidism is what results from that damage. Hashimoto’s is an autoimmune condition where your immune system attacks the thyroid gland. Many people with Hashimoto’s have normal TSH for years while the damage builds. Elevated antibodies indicate Hashimoto’s thyroiditis — an autoimmune condition where your immune system attacks your thyroid. Your body can convert T4 to either active T3 or to reverse T3 — a mirror-image molecule that blocks the T3 receptor without activating it. Some tests measure the bound and free hormone together. Test measures must distinguish total T4 from free T4. High free T4 with low T3 may indicate conversion problems. These do not involve thyroid peroxidase antibodies or thyroid cancer. This pattern may appear as TSH and low free T4 or tsh and low free t4 on labs. However, TSH is often the last test to become abnormal. Today, free T4 measures direct levels more accurately. Free T4 index was used historically to estimate active hormone. T3 testing and evaluation of free T3 are important when symptoms persist. Free T4 and Free T3 measure only the unbound hormone. That is why reviewing reference range values and clinical symptoms is essential. Addressing gut health is often part of a complete hypothyroidism treatment plan. This is especially common in perimenopause, when progesterone drops and estrogen becomes relatively dominant. But for many patients — especially those under chronic stress, dealing with gut issues, or with elevated cortisol — the conversion is impaired. You can have plenty of T4 on paper and still have all the symptoms of low thyroid. Your thyroid makes mostly T4, which your body then converts to the active form. Free hormone testing helps clarify true thyroid levels. Most hormones circulating in the blood are protein bound. Total T4 and Total T3 reflect all hormones circulating in the blood. The total T4 test measures the bound and free hormone circulating in the blood. A combination of aerobic (increase in heart rate) and resistance (weightlifting) training has been found to increase the production of testosterone. In fact, management of obesity may prevent declining total testosterone in the aging male. With every one-point drop in your body mass index (BMI) your testosterone level will increase by approximately 1 point. As belly fat increases, there is an increase in activity of the enzyme "aromatase" which converts testosterone in the fat cells to estrogen. Although low testosterone ("low T") is a diagnosis being promoted by the makers of testosterone medications, it is not as simple as just prescribing hormone replacement. Many of these symptoms overlap with other conditions — adrenal fatigue, hormone imbalance, depression. We look at the full picture — Free T3, Free T4, Reverse T3, thyroid antibodies, and body temperature patterns — because that is where the real answers are. Poor nutrition is at the root of many diseases and can also create an imbalance of male hormones. Over a 10-year period, the risk for developing abnormally low testosterone levels more than doubles in diabetic individuals. Developing diabetes increases the risk of having a total testosterone level of less than what is considered normal. Improper injection protocols, such as infrequent, large bolus doses, exaggerate this conversion. This video will explore estrogen's effects in the male body, the consequences of high and low estrogen, and how to manage estrogen levels through lifestyle, diet, supplementation, and selective use of AIs. Nutrition, stress, and sleep influence release of thyroid and production of thyroid hormone.
