If your thyroid workup was just TSH, you got the first page of the story.
Fatigue, cold hands, weight gain, thinning hair, brain fog. If you have these symptoms but your doctor says your labs are fine, the issue is usually what was tested. We run TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies, then correlate them with your full metabolic and hormone profile.
Last updated: March 2026
What It Is
Your thyroid is the master regulator of your metabolism. It influences energy, body temperature, weight, mood, cognitive function, hair growth, digestion, and heart rate. When it underperforms, the effects ripple through every system.
The standard approach checks TSH, sees a number within the reference range, and calls it fine. TSH alone tells you whether the brain is asking for more thyroid hormone. It does not tell you whether your body is actually converting, using, or blocking it.
Our panel includes TSH, Free T3 (the active hormone your cells use), Free T4 (the storage form that must convert to T3), Reverse T3 (an inactive form that can block T3 receptors), and thyroid antibodies (TPO and TG, to screen for Hashimoto's). We correlate these with your metabolic and hormone panels because thyroid dysfunction rarely exists in isolation.
With the full picture, we design a protocol that addresses the root cause. We are not limited to T4-only medications. We prescribe T4, T3, combination T4/T3, or desiccated thyroid depending on what resolves your symptoms and brings your labs into functional range.
Who It's For
What's Included
All protocols medically reviewed by Dr. Ann Drayton, M.D., Medical Director
The Process
Full Thyroid Panel
Full thyroid panel plus metabolic and hormone markers to get the complete picture.
Analysis
Clinical team review correlating labs with your symptoms, history, and goals.
Protocol Design
Individualized medication selection and dosing. We're not limited to T4-only medications.
Monitoring
Regular labs and symptom assessment to track your progress.
Optimization
Ongoing adjustments for optimal function. We don't stop at 'normal.'
If this sounds familiar
A significant portion of our patients come to us after trying something similar somewhere else and not getting results. In most cases, the protocol was under-dosed, the labs were incomplete, or another condition (thyroid, cortisol, nutrient deficiencies) was never addressed alongside the primary one. We are used to untangling these situations. If you have been on a protocol that did not work, bring your old labs. There is almost always a reason.
What Patients Experience
Common Questions
My TSH is normal but I still have symptoms. Can you help?
This is exactly who we help, and it is one of the most common scenarios we see. TSH alone misses critical information: poor T4-to-T3 conversion, elevated Reverse T3 (which blocks your active hormone), suboptimal Free T3 levels, and autoimmune thyroid activity. Thorough testing almost always reveals the missing piece that explains why you still don't feel right despite a 'normal' TSH.
Do you prescribe desiccated thyroid (Armour, NP Thyroid)?
Yes, when appropriate. Unlike many conventional providers, we are not limited to T4-only medications like levothyroxine or Synthroid. We prescribe whatever works best for each patient: levothyroxine (T4), liothyronine (T3), combination T4/T3 therapy, or desiccated thyroid. The right medication is the one that resolves your symptoms and brings your labs into optimal range.
What about Hashimoto's?
We test for thyroid antibodies (TPO and thyroglobulin) as part of our standard thyroid workup. If Hashimoto's is present, we address it thoroughly. That includes optimizing thyroid medication, identifying nutritional deficiencies (selenium, zinc, vitamin D), discussing dietary factors that can influence autoimmune activity, and monitoring antibody levels over time to track the condition.
Why does my doctor only check TSH?
Standard medical guidelines recommend TSH as a screening tool because it is the simplest and cheapest test. For detecting overt thyroid disease, it works well enough. But for identifying subclinical dysfunction, conversion problems, and autoimmune thyroid conditions, TSH alone is insufficient. Most conventional practices do not run expanded panels because of insurance constraints and time limitations. Our model allows us to run the full picture every time.
Can thyroid problems affect my weight?
Yes, significantly. An underactive thyroid slows your metabolism, makes it harder to burn calories, and promotes fluid retention. Many patients who struggle to lose weight despite doing 'everything right' have an underlying thyroid issue that has never been properly identified or treated. We often see dramatic improvements in weight management once thyroid function is optimized.
How long does it take to feel better on thyroid medication?
Most patients begin to notice improvements in energy and mental clarity within 2-4 weeks of starting or adjusting thyroid medication. Full optimization can take 6-12 weeks as we fine-tune your dosing based on follow-up labs and symptom tracking. Thyroid medication adjustments are gradual by design, because overcorrecting too quickly can cause its own problems.
Find out what your thyroid is actually doing.
Schedule your free discovery call to discuss your symptoms and goals. If we're the right fit, we'll map out your path to optimization.
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