Mocktail Minutes

Labs Part 3: Thyroid Panel

• Mocktail Minutes • Episode 127

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We are wrapping up lab series with the thyroid panel. We will break down the different tests you need to be doing to assess thyroid health and why!


Link to cholesterol episode: https://www.buzzsprout.com/2145831/episodes/16573064

If you have questions, or topics that you want to hear about, head over to our Instagrams https://www.instagram.com/bayleethedietitian/ or https://www.instagram.com/brianna.dietitian/ and send us a DM! You can also follow the podcast https://www.instagram.com/mocktailminutes/


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Baylee:

Hello everyone. Welcome back to this week's episode of Mocktail Minutes. This is Bailey.

Brianna:

And this is Brianna.

Baylee:

This week I am drinking a chocolate element with vanilla drink, wholesome protein. I, I only do a half pack. I can't do a full element except for when I was pregnant, which was really weird, but I feel like my adrenals need a little bit extra help this week. So we had a little bit more salt than usual.

Brianna:

You're like T minus not that long out from your wedding. You need all

Baylee:

recording 10 days when this is live. Eight days.

Brianna:

Yeah. That's wild. I'm doing one of the bloom. I didn't realize it was one of their energy drinks, but it's the strawberry watermelon. It does taste very good, but it has like 180 milligrams of caffeine, so there's,

Baylee:

Oh, wow.

Brianna:

I can't, I'm not gonna be drinking this whole thing.

Baylee:

Accidentally drinks the whole thing and like wire

Brianna:

Wired. I'm just like on calls all day, just like sweating.

Baylee:

plug eye.

Brianna:

Yeah. Talking really fast. No, I don't need it, but it does taste good, so,

Baylee:

Oh, good. Mm-hmm. Speaking of the wedding for those of you who don't know. Fun fact, Brianna and I have still never met each other in person. It's been over five years since we've known each other almost exactly five years. It was like October of 2020,

Brianna:

That's wild. Yeah. So we're meeting at Bailey's wedding.

Baylee:

which some people might find weird, but we have like, we've always talked, well now I feel like it's like more on a daily basis, but like we've always talked on a weekly basis and so like it feels like. We've met each other and we've known each other for a while, but yeah, we've never like touched each other.

Brianna:

Yeah.

Baylee:

weird. Like give each other a hug.

Brianna:

We've never like, just physically been in the same place, which is so weird to me.'cause I feel like I like really know you. I is this like adulthood? I don't get it.

Baylee:

I know. It is weird and Josh makes fun of me. He is like a lot of your like closer friends. They don't even live in the same state or you've only seen'em in person like two times.

Brianna:

I know that's how I am too. But I'm like, I think this is just like 2025. I don't, I don't know. But yeah, so I'm super excited for that.

Baylee:

Yes, it's gonna be fun. But today we are talking about thyroid panel. So a lot of times if you are getting your thyroid checked through your doctor or you're just kind of like getting a general check-in a full thyroid panel is not often. Being ordered, I feel like we're getting part of the picture and like, eh, it's good. We don't really need to check anything. But even with that, I have seen when they're like, oh, it's good. We're good. Keep trucking. It's actually not even in the optimal range. It's in the normal, not so much in the optimal. So we're gonna talk about the thyroid panel and like the full thyroid panel and what all that entails today.

Brianna:

And so if you're like, I don't know, did I get a full thyroid panel? I would say it's TSH, which is the normal one. That's what everyone's checking. But then also free T four, free T three, reverse T three total, T four and T three. And then thyroid antibodies like. That would be, if you have all of those, that would be like a complete thyroid panel. And this is important because like we talk about the thyroid a lot, but it really is like the thermostat to the body. And so if you are having an underactive thyroid, things are gonna be more sluggish. Your metabolism's gonna be slow, your energy's gonna be slow, you're just not gonna feel really great. And typically you can have an underactive thyroid without like your TSH being out of range. So this is why it's really important to have a full big picture.

Baylee:

Yes, so TSH, this first one, TSH, is made by. Your pituitary gland in the brain, and it signals the thyroid gland to produce more or less hormone. So if you have a high TSH, it's kind of signaling, okay? The pituitary is like telling the thyroid to make more, and this is due to like an underactive thyroid. If you have a low TSH, pituitary is kind of like backing off. Thyroid is making too much, or maybe you're taking too much of like a thyroid medication If you are on one, I would say optimal range is 0.8 to one. these optimal ranges are optimal. So if you're like, well, my doctor said it's normal and I'm at like 1.2, okay, it's only higher. End of optimal, not quite in that optimal range, but it could still be considered. Normal, and we're gonna add a disclaimer to all these episodes that we're not diagnosing you with hyper or hypothyroidism, hashimo, anything like this. This is just for general education, general knowledge to help you understand your labs a little bit better and to kind of empower you, I think, to get a little bit more curious of your labs. Like if you feel like something is off, I think I'm a firm believer and something is off, and so. Maybe this can kind of help you dig into what do I need to look further at? Yeah. TSH. This does change slowly. It might look normal even when the thyroid is already struggling. But stress, illness, pregnancy can all alter TSH, independent of thyroid function.

Brianna:

Mm-hmm.

Baylee:

I said optimal range. It's a little bit narrower. Point eight to one.

Brianna:

Yeah, and I think for like context, I don't think we start, like doctors typically start doing medication until it's like three or four. more doctors, like newer doctors are kind of looking at it. Okay, once it's around two, we're gonna start treating then. So definitely if you feel a little bit off and you go back and you look at your TSH and you're like, wow, it's been more than the optimal range, look into it a little bit more. The next thing is gonna be the free T four or thyroxine. So this is the inactive form of the hormone, and this is like 80 to 90% of what the thyroid produces. So what it will. It will produce the inactive hormone and that needs to be activated for it to work. So like let's say it is your, you are, what is it? Like you are stimulating TSH. It's good, but just because that's good and you have a lot of free T four doesn't mean it's actually being used. It's like very similar to like vitamin D, right? Like you can take a ton of vitamin D too, but if it's not converting, it doesn't do anything. So. This is technically like not biologically active. It's active when it gets made into free T three. So low free T four means the thyroid is not producing enough hormone. Maybe you're having some hypothyroid, high, could be hyperthyroid. You have an overactive thyroid, or you're having an over medication of like some of those thyroid medications. But this is not enough to just look at and say, okay, something's wrong. You need to know what your, your T three is as well. So a good optimal range for like free T four is gonna be one to 1.3. That's your range. What is it? Nanogram per deciliter. It's hard sometimes I don't wanna give like the nanogram per deciliter'cause some labs have like different, you know, units that they're looking into. But yeah it would be one to 1.3 nanograms per deciliter. You can Google that to see conversion. If your lab has a different.

Baylee:

Yes.

Brianna:

I'm like, trying to think of what else. It's in off the top of my head. I'm like,

Baylee:

Yeah.

Brianna:

okay.

Baylee:

And then so with that being said, you have free T three. This is that active thyroid hormone that actually drives metabolism, so. It's about three to four times stronger than T four conversion. It's made from conversion of T four in the liver, gut, and other tissues. So if there's a low T three, it can signal poor conversion of T four to T three, common in stress or chronic illness, or just like nutrient deficiencies that where things like HTMA can be helpful to see what do these minerals look like to support processes like this. It can also cause hypothyroid symptoms, even if TSH and T four look fine. High T. High free T three can be an indication of more like overactive thyroid. So thinking like Graves disease or an overuse of T three based medications. Really free. T three is the best indicator of. A good indicator of what T three, free T three is doing is how someone feels, so addressing your energy, mood, metabolism. But your optimal range is going to be three to four, and I believe it's like picograms per milliliter, pg, that's what it is.

Brianna:

This is what I mean. You know what I mean? Like free T three isn't one, free T four isn't another,

Baylee:

Yes. It's so, so annoying.

Brianna:

so kind of pay attention to that. But this is, I think this is a one where like people are like, I feel sluggish. Like this is such a good indicator of that. And so sometimes, again. If your thyroid is stimulating all the hormone, then it, it's, it's stimulating what it needs to, you have a lot of free T four. It may be like, oh, your thyroid looks fine. But again, if you don't have the active form, you're gonna feel really sluggish. And I think the majority of this conversion is done in the liver. And maybe we should have an episode on like why it's important to like, support your liver.'cause I know everyone's like, your liver does its job, your kidney does its job. But like we ask a lot of our liver and if you're not having good, like. Liver support, then you could be having a hard time converting that T four to T three because of that, you know, and it's like, well, hey, like giving your, showing your liver some support could actually maybe help. This is why we talk about it helping your metabolism, liver support. This is why.

Baylee:

Yes, and I have actually, like I have been someone to be like, Hey, if you have a liver, kidneys functioning, you're good. You don't need to like detox or anything.

Brianna:

Mm-hmm.

Baylee:

I think I've always said that under the, that's like under the assumption that you are doing all the things. If you are drinking alcohol every night, yeah, you probably need some more liver support. So I've definitely been one to say that, but it's all, it's all kind of relative and I think everyone could use liver support. I think that would be a good topic to dive into, like how can we support our liver without having to buy like a detox plan.

Brianna:

Right. Well, and I think too, like I say that a lot too, but I think it's says most people aren't ready to really focus on liver support'cause they're doing all the other stuff, which I'm like, just start there. Don't worry about detoxing your liver if you're like drinking every day, you know? The next one is reverse T three, and this is the inactive form of T three. And this matters because it competes with the T three cell receptors and like it blocks it. So this is like the body's way of saying, Hey, we don't need you to bind anymore. We have enough. And so it'll compete and it'll make it to where T three can't bind. So high reverse T three could suggest thyroid resistance. So the body is making hormone. But it's not letting it work. And so cause of this could be like chronic stress, high cortisol illness, infection, inflammation starvation or like very low calorie diets, fasting liver dysfunction, poor clearance in the liver, again, supporting your liver. Low reverse D three is usually not problematic if both of T three and reverse T three are low. But I think this is one. Where we're not really too sure of how to interpret it like in its best way yet, but it should be ideally under 20.

Baylee:

Yeah, I would say those are good initial ones to really think about. And then even addressing further, like I think that's kind of like a good full thyroid start there. And then if it's like, okay, these are off and maybe we need to take another deep dive into, do we have some autoimmune issues? This way you test. Thyroid antibodies, they help identify autoimmune thyroid disease, which is the number one cause of thyroid dysfunction. So TPO antibodies attack your thyroid peroxidase enzyme, which damages the thyroid's ability to produce hormones. This is gonna be high with like Hashimotos, and it can rise for years before TSH or T four become abnormal. And then you also have TG antibodies. So. Can be seen in Hashimoto's as well, and sometimes even like thyroid cancer surveillance. So if it's high, thinking about autoimmune response, we have inflammation. These can also be signs of like low iodine, so thinking about those, but ideally, TPOs under 10, TG antibodies under 20. So it's kind of like your optimal reach there.

Brianna:

Yeah, and I would say that one is important, especially if you're worried about autoimmune.'cause sometimes I'll get people that are like, oh, if I have underactive thyroid for a while, like, does that mean I have Hashimoto's? Or it's gonna turn into it. That's like your body attacking. Your body, if that makes sense. So you can have underactive thyroid forever, and it doesn't mean it's gonna turn into Hashimoto's like that happens if you're truly having an autoimmune disease. So they're not the same. I think we link'em a lot and some people are like, oh no, I got tested. I don't have Hashimoto's, so I can't have an underactive thyroid. But you, they're completely separate. You can have an underactive or overactive thyroid without having any sort of autoimmune.

Baylee:

Yes. Yep, exactly. And that's again, we're not diagnosing you here. Feel like, oh my gosh, my TPO antibodies are high and great. Now I have hashimo. That's not what we're saying.

Brianna:

I will say too,'cause I get a lot of questions of like, can I ever get off medication? I think this is a really good thing to like really think about if you're having a true autoimmune, most likely not, because that's an issue with like your, again, body attacking certain part of your body. Whereas if it's not autoimmune, you can support the thyroid in the way it needs to and likely manage it without medication. But it's, they're just, I think, look at'em differently. That's what I would say.

Baylee:

So I would say those are honestly the big hitters for a full thyroid panel. There are other things that you can kind of get along with it, like total T four and total T three your TSI, your. TBG Thyroxine binding globulin. So there are other thyroid markers, there's other related markers, even like iodine, selenium, zinc cortisol drain, looking at adrenal function, all things that actually, again, HTMA can help there too. But I think that was a good. Just like overview of your high hitters for those pieces. And then it's looking at the full picture, like high TSH plus the low free T four. Do we need to look at? That's like classic hypothyroidism.

Brianna:

Yeah.

Baylee:

it's normal, TS, H, low free T three, high reverse T three. Okay. Thyroid resistance. Maybe it's more stress related. So again, looking at that full picture. Just give you an idea of what these things are that are on your labs, what do they mean? So that way you can get curious about them too.

Brianna:

Yeah.

Baylee:

All right, everyone. We hope you have a good rest of your week and we hope. Three part series has been helpful to understand what's going on. We were gonna cover cholesterol and like lipid panel today, but we already have a cholesterol episode, so make sure you go back and listen to that. If there's other things you want us to cover, let us know, but we felt like we didn't necessarily need to hit it again because we had a pretty in-depth conversation on it before.

Brianna:

I'll put, I'll put the link in the show notes.

Baylee:

Perfect.

Brianna:

That was, if you wanna go back'cause it's been a little bit, but yeah, we have one.

Baylee:

A good rest of your week everyone, and we'll be back next week with a new episode.

Brianna:

Bye.

Baylee:

Bye.

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Baylee

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Brianna

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