12889 Hwy 98, Suite 107B Miramar Beach, FL 32550



Tuning Your Thyroid

Picture of Dr. Richard Chern, MD

Dr. Richard Chern, MD

I strive to educate our patients so they can make informed decisions about their care.

I’d like to start off by thanking everyone who voted us Best In Destin for both Anti-Aging Clinic and Women’s Wellness Clinic.  We are so excited and for readers we will be offering FREE consultations in the month of January so call us today!
Today I want to talk about and how we look thyroid function differently than most clinics.  Even for doctors the thyroid can be confusing.  We still get calls from primary care physicians who worry their patient’s thyroid level is too high or too low.  Unfortunately, these physicians fail to consider the patient and are often looking at the wrong lab values.
Any of my patients will tell you I spend a long time discussing thyroid labs with them and I regularly hear,”Wow, I’ve never had someone explain it to me before”.
To get the thyroid to work, the brain secretes a hormone called Thyroid Stimulating Hormone (TSH) which tells the thyroid to produce and secrete Thyroxine (T4) and Tri-iodothyronine (T3).  T4 and T3 are the two main hormones produced by the thyroid in response to TSH.  T4 goes back to the brain to tell the pituitary to reduce the amount of TSH produced and also converts to T3 throughout the day while T3 regulates every aspect of our metabolism.
T4 turning off TSH while TSH turns on T4 is called a negative feedback loop.  I think of this like a parent and child.  The parent yells louder and louder at the child to clean his room until the child eventually cleans their room and the yelling decreases until, of course, the room becomes a mess again.  The parent is the TSH, and the child is the T4.  TSH increases overnight and causes T4 and T3 to increase in the morning, which in turn causes TSH to decrease, and then the cycle repeats as T4 decreases through the day.  This thyroid cycle occurs every day of our lives.
T3 is the active thyroid hormone that regulates body temperature, heart rate, body weight, muscle strength, cholesterol, menstrual cycles, mental health, concentration, hair growth, energy, and all the other aspects of our metabolism.
As physicians, we are trained to look at the TSH to determine if the thyroid is functioning properly.  We are taught that no other lab is needed to determine if the thyroid is functioning or not.
Unfortunately, this misses testing the ONLY hormone that actually regulates your metabolism which is T3.  Secondly, giving TSH values to patients causes confusion for patients and doctors because saying, “Your thyroid is high” could mean your TSH is high and thyroid is not functioning or your thyroid is over functioning and your TSH is low.  I find that most patients coming from other doctors are completely confused about whats truly going on with their thyroid.
The number one thing that many physicians miss these days are the symptoms the patient is having.  We MUST listen to the patient!  Most physicians are now looking at a computer rather than looking at or listening to the patient.  Not with us.  We listen to you first, then look at the labs to help us determine the best treatment.  
Properly optimizing T3 and T4 will often cause your TSH to be low.  This is perfectly fine, but most physicians get scared and don’t treat patients effectively.
So if you have fatigue, tiredness, difficulty concentrating, joint and muscle pain, depression, anxiety, weight gain, trouble sleeping, coarse hair or hair loss, temperature sensitivity, weakness, high cholesterol, constipation, dry skin, or menstrual irregularities, you might have a thyroid disorder even if your doctor tells you,“your thyroid levels are normal”.
Call us today at 850-837-1271 and make an appointment.  
Come find out why we’ve been voted BEST IN DESTIN year after year!