Why You Still Feel Off Even When Your Labs Are “Normal”
If you’ve been feeling off—struggling with vague symptoms, unexplained weight gain, fatigue, dry skin, hair loss, brain fog, or general muscle aches—you might suspect your thyroid is to blame. Like many people, you probably went to your primary care provider hoping for a diagnosis and some relief. You had your labs drawn, including your TSH (thyroid stimulating hormone) level, and were told everything looks “normal.”
And yet, you don’t feel normal. You're still tired. You're still not yourself.
That’s because a TSH test alone doesn’t always provide a full picture of thyroid dysfunction. And that’s where this blog—and hopefully, my approach—comes in.
TSH Alone Is Not Enough to Diagnose Thyroid Dysfunction
Many people experiencing classic thyroid symptoms are told their TSH is fine, so everything must be fine. But a normal TSH (thyroid stimulating hormone) level doesn’t rule out thyroid dysfunction.
Let me break it down simply.
Hormones are messengers. They travel between glands and organs to deliver instructions—like little text messages. Think of your brain as sending a dinner invitation (TSH) to your thyroid. If your thyroid doesn’t respond, you follow up—maybe a phone call or even knock on the door with muffins in hand. Still no answer? You might think they’re just rude.
But what if the problem is a language barrier?
Eventually, you realize that the message isn’t getting through—not because you aren’t trying hard enough, but because they can’t understand it. That’s what happens with thyroid dysfunction. Even though the brain is signaling (producing TSH), the thyroid gland doesn’t always hear the message or respond effectively.
Understanding the Thyroid Feedback Loop (and Where It Can Break)
The anterior pituitary gland in the brain produces TSH (thyroid stimulating hormone) and sends it to the thyroid, signaling it to make mostly T4 and a little bit of T3. T4 gets converted into T3, which is the hormone that actually gets work done at the cellular level—helping regulate energy, metabolism, and mood.
Once T3 levels rise, they signal the brain to stop making TSH. That’s called a negative feedback loop.
But if the thyroid isn’t functioning properly, it doesn’t make enough T4 or convert it to T3 efficiently. The brain, not seeing enough T3, continues shouting instructions via more and more TSH—until those levels rise high enough to finally be flagged by a standard lab.
By then, you’ve probably been suffering for quite a while.
Why T4-Only Treatment Often Isn’t Enough
In conventional medicine, we’re trained to treat hypothyroidism by prescribing synthetic T4 (like levothyroxine). The idea is that your body will convert this T4 into T3, and symptoms will improve.
Sometimes that works. But in many people, it doesn’t. I hear this all the time: “But my labs are normal—why don’t I feel better?”
Even though your TSH has normalized, the real issue often lies with low T3 levels. T3 is the hormone that acts directly on cells, improving mood, metabolism, and more. If T3 is still low, symptoms remain.
Studies show that treatment with T4 alone can lead to increased visceral fat, higher BMI (even when eating fewer calories), elevated blood sugar, cholesterol, and blood pressure—and even depression. People on T4-only therapy are more likely to be prescribed statins, beta-blockers, and antidepressants.
One study even found that low T3 levels, regardless of T4 treatment, are directly linked with high cholesterol.
But Doesn’t the Body Convert T4 Into T3?
That’s the theory—and it sounds logical.
But in practice, it often doesn’t happen efficiently. And that’s the problem.
When we suppress natural TSH with synthetic T4, the thyroid stops producing not just T4, but the small amount of T3 it’s responsible for. And just giving more T4 doesn’t reliably raise T3 levels high enough to resolve thyroid symptoms.
So now we’ve got patients with normal TSH, taking medication as prescribed, but still struggling with fatigue, weight gain, and mood changes. It’s frustrating—for you and your provider.
A Better Path: Treating Thyroid Dysfunction with Both T3 and T4
The good news? There’s another way.
There is both new and longstanding research showing that treatment with desiccated thyroid—which contains both T3 and T4—can often provide better symptom relief and metabolic outcomes than T4 alone.
At Hummingbird Healthcare, I use the most current and comprehensive data available to evaluate your symptoms, not just your labs. I believe in treating the individual, not just the numbers. Together, we’ll create a personalized treatment plan that addresses your thyroid dysfunction from every angle—including nutrition, lifestyle, and hormone balance.
Final Thoughts: You Deserve to Feel Better
If you’re still experiencing thyroid symptoms despite “normal” labs, know that you’re not alone—and you’re not crazy. The thyroid is complex, and the standard approach often falls short. But there are answers.
And more importantly, there is hope. If you’re ready to explore a more complete and compassionate approach to thyroid health, I’d be honored to help guide you.
Also Read: Weight Loss: A Different Approach
