The thyroid system: how it works, common problems, hypothyroidism, T3, T4, TSH, & more | Peter Attia

Ғылым және технология

Peter provides a comprehensive overview of the thyroid system. This video is a segment from The Drive podcast Episode 256 - The endocrine system: exploring thyroid, adrenal, and sex hormones. The full video can be found here: • 256 ‒ The endocrine sy...
Watch the full episode and view show notes here: bit.ly/432u3eB
Become a member to receive exclusive content: peterattiamd.com/subscribe/
Sign up to receive Peter's email newsletter: peterattiamd.com/newsletter/
--------
About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
Learn more: peterattiamd.com
Connect with Peter on:
Facebook: bit.ly/PeterAttiaMDFB
Twitter: bit.ly/PeterAttiaMDTW
Instagram: bit.ly/PeterAttiaMDIG
Subscribe to The Drive:
Apple Podcast: bit.ly/TheDriveApplePodcasts
Overcast: bit.ly/TheDriveOvercast
Spotify: bit.ly/TheDriveSpotify
Google Podcasts: bit.ly/TheDriveGoogle
Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies.

Пікірлер: 83

  • @MegaTeeruk
    @MegaTeeruk11 ай бұрын

    It took my doctor 4 years to figure out my thyroid was not working correctly and another 6 to figure out I had Hashimotos. Dr. Attia just did a better job in 15 minutes than my doctor did in a decade.

  • @Loha2005

    @Loha2005

    2 ай бұрын

    It's sad that you will find a bettter solution WITH REASONING to you're issue on the internet than in a doctor's office 🤦‍♂️

  • @user-wh7or3wv1q
    @user-wh7or3wv1q11 ай бұрын

    I have been taking a Cytomel & Synthroid cocktail for 20+ years with excellent results. Thank you Dr Attia for a clear and concise video explanation.

  • @iggybiggy821
    @iggybiggy82111 ай бұрын

    Loved this video. Things to talk with my endocrinologist about! I fortunately have a dr that says: "I don't just treat a number on a page, I treat the symptoms and the patient". This is invaluable. I'm having breakthrough symptoms so perhaps time to have the rT3 tested too. Thanks for the content Dr. Attia, much appreciated.

  • @laurahebenstreit9597
    @laurahebenstreit959711 ай бұрын

    Excellent teaching! Years ago, after still having hypothyroid symptoms despite high T4 numbers & being told by one doc I should be ok, a different doctor checked T3 & explained it was like having food on a plate, but I couldn't eat it. He prescribed the desiccated medication, & I finally improved. Now I understand it all & will be more careful with interpretations of my lab testing. Thanks! ! !

  • @agsjnsks4538
    @agsjnsks45382 ай бұрын

    I would like to hear more about D1 and D2 for conversion. Also about iodine deficiency and why it’s helpful. When it should be avoided. And the role of selenium.

  • @v2plus10_
    @v2plus10_11 ай бұрын

    Absolutely love this video, we are extremely lucky to get this knowledge shared with us. Thank you Dr. Attia! 🙏🏼

  • @simonpc123
    @simonpc12311 ай бұрын

    Awesome conversation again. Thank you so much. Wonderful stuff.

  • @user-wc1em7pc2p
    @user-wc1em7pc2p11 ай бұрын

    This is fantastic, I've been talking to my doc about hypothyroid recently and this made it much simpler to understand.

  • @absbi0000
    @absbi00002 ай бұрын

    Great Intro Dr. Attia! Thank you for making this.

  • @meganbrown7484
    @meganbrown748411 ай бұрын

    Wow! You teach so clear and concise. Thank you!

  • @georgettekolkman5622
    @georgettekolkman562211 ай бұрын

    Thank you so much for sharing this valuable information Dr Attia. 🙏

  • @mickkali
    @mickkali11 ай бұрын

    Thank you for a very helpful explanation. I’ve been on Armour or NDT for decades with the last several years of feeling super crummy and low numbers Time to explore some changes in meds. Grateful for your channel Dr A ❤

  • @blackgirldiary2363
    @blackgirldiary236311 ай бұрын

    Thank you for bringing the science of our body to the rest of us. I look forward to more videos- I’m especially curious about the heart and liver.

  • @NoahZeus
    @NoahZeus11 ай бұрын

    Great info, thanks as usual.

  • @sharronvoth6208
    @sharronvoth620811 ай бұрын

    Awesome explanation. Thank you! I have Hashimoto disease and I was hoping to learn more about it too. Maybe you will discuss how it affects the numbers at a later date?

  • @ginamarrone5532
    @ginamarrone55325 ай бұрын

    Thank you for explaining this in a way I could understand. I was given anti anxiety and anti depressants when my thyroid was out of whack. I ended up in a naturopathic doc office because my heart palpitations would not stop. I knew it was something more than anxiety/ depression.

  • @TheKitty1952
    @TheKitty195210 ай бұрын

    Thanks for mentioning compounded thyroid. We can compound specific ratios of T4:T3, as well as sustained release T3.

  • @bluedevils81
    @bluedevils8111 ай бұрын

    Thank you for all these shorter very helpful videos. How u don't have over 1 mil subscribers given the public exposure you've had is crazy. Anyone that reads this go get his book. I feel like I've been to an abbreviated medical school after reading it lol

  • @kealiiaumokuklein6301
    @kealiiaumokuklein630111 ай бұрын

    Wonderful video! Thank you for keeping it simple. I wonder if you would be willing to comment on the idea that there might be an optimal range for a healthy adult depending on age, sex, symptoms, etc. Most doctors will see that you fall “in range” and move on much like how they treat sex hormone dysfunction.

  • @kagefisk
    @kagefiskАй бұрын

    Watching this wjile in medical school very good for introduction to thyroid pituitary hypothalamus axis

  • @stephanieaya3992
    @stephanieaya39922 ай бұрын

    Thank you for this. My current in-network doctor only checks TSH, and I’m not doing well. I’m not sure how he’ll respond y to o this information, but it’s worth a try!

  • @ramonmuniz8439
    @ramonmuniz843911 ай бұрын

    I read your book, great chapter on physical fitness, but the rest of the book, I could do without. Good thing that Amazon has a great return policy. With the money saved, I went to the local farmers market.

  • @tobywollin8978
    @tobywollin89784 ай бұрын

    I've been on levothyroxine for 20 years and I'm still cold; I still have weight and constipation issues and so on. But they never test me for RT3. Having viewed this fantastic explanation - I have another question: why not provide D1 and D2 as well?

  • @gmjo5300
    @gmjo53005 ай бұрын

    Dr Attia, starting from scratch here. What blood tests should I take to make sure all the information is there for analysis by the doctor?

  • @Manjeera
    @Manjeera6 ай бұрын

    Dr. Attia, the ratio of t3/rt3 that you explained sounds like have different units? What are ideal values for free and total t3 and reverse t3?

  • @laurasofiabayona2288
    @laurasofiabayona2288Ай бұрын

    id like you to talk in a more day to day things you can do to improve quality of life clients with thyroid issues, that can go in conjunction with the medication strategy

  • @B.Robinson19
    @B.Robinson194 ай бұрын

    I’m curious bc you said fasting caused your d3 to d2 ratio to be off, is there a way to improve the ratio when it’s off? What are the physiological reasons that your d1 and d2 would be down regulated and how can you upregulate them?

  • @sebasrand2385
    @sebasrand23854 күн бұрын

    Does anyone know of any links to clinical trials for rt3......as Im currently getting thyroid testing done for hypothyroid symptons but I'm within normal ranges of t3,t4....also have a pituitary tumor...Unfortunately doctors in australia dont recognise rt3 as relevant...thanks in advance

  • @mariamathews5312
    @mariamathews531211 ай бұрын

    What about if your levels of dhea are slightly high?

  • @leilahbugtheboxer8594
    @leilahbugtheboxer85942 ай бұрын

    What about elevated anti tpo, elevated tsh , normal t4 and elevated free t3 ? I have been on Levothyroxine alone and it did not help , I am currently on NP thyroid and it’s not working. I was just prescribed Levothyroxine and cytomel.

  • @christinaalexander9156
    @christinaalexander91566 ай бұрын

    Interesting but he didn't mention the importance of the LIVER and STRESS (Cortisol). A lot of people have toxic livers without any symptoms. The liver converts T4 into T3; if it is toxic it will not do this efficiently and send it to where it should be used in the body. No one seems to know this. ALSO - Cortisol disrupts the functioning of the Hypothalamus so that it can send erroneous TSH instructions to the Pituitary! One would think that the medical profession with all of its research would have figured this out by now?

  • @callmedeno
    @callmedeno2 ай бұрын

    If the T3 and T4 ratio goes low does that imply that the liver (mostly) is struggling to perform the conversion, whether that be due to lack of nutrients or something like alcohol overuse?

  • @Deepak-mk5ne
    @Deepak-mk5ne2 ай бұрын

    My t4 is bit low 4.80 ug/dl but t3 and tsh in normal range what that mean?

  • @VandalIO
    @VandalIO9 ай бұрын

    Can you do the blood test to measure reverse T3

  • @jay-remedy-plz

    @jay-remedy-plz

    6 ай бұрын

    Yes. It’s available as an add on to a comprehensive panel but not a good indicator unless compared over time.

  • @moontrack4625
    @moontrack462511 ай бұрын

    The long half life also posses difficult days with tachycardia and hyper-“ish” symptoms. Shaking and HTN for days!

  • @lexitejeda6209

    @lexitejeda6209

    11 ай бұрын

    Have you considered that you may be taking too much thyroid hormone?

  • @appl314
    @appl31411 ай бұрын

    Any comments as to why hypothyroidism is so prevalent? I think, in general, we are missing a fundamental item because synthroid is an easy fix.

  • @pinkiepinkster8395

    @pinkiepinkster8395

    11 ай бұрын

    If they cure it, then they will lose patients.

  • @lexitejeda6209

    @lexitejeda6209

    11 ай бұрын

    Hypothyroidism is prevalent primarily because we get an excess of iodine in our diets.

  • @DKREALFEEL

    @DKREALFEEL

    Ай бұрын

    It’s not more prevalent it’s just overdiagnosed because symptoms are so benign and common

  • @AASA76
    @AASA762 ай бұрын

    SO can a TSH be high due to fasting?

  • @charityfinke1
    @charityfinke111 ай бұрын

    I had my thyroid removed in 2011 and my blood lab results for t4 have been high ever since. Ranging from 68.-138. ml/UL. I never feel good and for over a decade now, I’ve experienced declining health. Please help me! I have terrible medical insurance and I have to be my own advocate, otherwise Im low priority. What questions can I ask my doctor/endocrinologist that will guide me to a possible solution?

  • @lynncrf

    @lynncrf

    10 ай бұрын

    You need to get T3 and RT3 tested. You are probably rock bottom levels of T3.

  • @lunanakamoto2018
    @lunanakamoto20187 ай бұрын

    What does it mean to have high tsh 4.93 and normal t3 and t4? Do u still have thyroid problems even if u have no symptoms (athletic can runs 60min a day)

  • @zoe-nm2rb

    @zoe-nm2rb

    4 ай бұрын

    Probably nothing to worry about but keep an eye and get checked again if you have symptoms

  • @neetchym1
    @neetchym1Ай бұрын

    can Hypo ever be healed?

  • @user-kq9dp5sg4n
    @user-kq9dp5sg4n11 ай бұрын

    Can you speak to the source of most hypothyroidism? is medicine always necessary or are there ways to heal the thyroid without it?

  • @pinkiepinkster8395

    @pinkiepinkster8395

    11 ай бұрын

    They won't make money if they figure out why people are becoming hypothyroid...they are only interested in throwing symptom relieving pills at it.

  • @fhowland
    @fhowland9 ай бұрын

    The question is.. do you treat a persistent TSH of 5? Age 40.. normal T4, but on the low end

  • @Captain_Tiger

    @Captain_Tiger

    16 күн бұрын

    T4 and T3 in combo

  • @skykingimagery899
    @skykingimagery89911 ай бұрын

    In other words, a TSH alone is wholly inadequate to fully evaluate thyroid and clinical status. That is driven by cost saving economics and not good medicine.

  • @susanhorton9492
    @susanhorton949211 ай бұрын

    ARMOUR WORKS BEST FOR ME !

  • @AASA76
    @AASA762 ай бұрын

    My son TSH HIGH and normal t3 normal t4 he is SUPER healthy!!! Does keto or carnivore diets and no processed foods no seed oils exercises and why would he have a high TSH is it because he intermittent fasts?

  • @CHENDY666

    @CHENDY666

    2 ай бұрын

    subclinical hypothyroidism. Don't worry unless he becomes symptomatic

  • @saschafuchs6806
    @saschafuchs68066 ай бұрын

    What about a normal t3 and t4 but still a high TSH about 6 or 7?

  • @Captain_Tiger

    @Captain_Tiger

    16 күн бұрын

    Hashimoto

  • @startingtoday4663
    @startingtoday466311 ай бұрын

    could a nutrient deficiency potentially be the root cause of TSH/T4 / T3 imbalance ?

  • @jirihutecka9020

    @jirihutecka9020

    11 ай бұрын

    not just micronutrient deficiency, but also life style, bad diet, too much stress etc.. Unfortunately doctors don't care about the cause of your thyroid problems..

  • @startingtoday4663

    @startingtoday4663

    11 ай бұрын

    @@jirihutecka9020 with the exception of Dr Attia (just finished reading his book) I agree with you and thanks for your reply

  • @La_sagne

    @La_sagne

    11 ай бұрын

    iodine deficiency could be.. especially if youre supplementing boron (for its testosterone boosting effect for example) your iodine from food might not be enough

  • @LaryEcker

    @LaryEcker

    11 ай бұрын

    Vegans may have iodine deficiency. Will iodine supplementation improve the TSH?

  • @usernwn7qe

    @usernwn7qe

    11 ай бұрын

    nope, the root cause of your imbalance is called menstrual cycle, they just relabeled it into "thyroid" disease.The beta fraction of hCG is 85% homologous with TSH. These so called bio markers are utterly and completely useless exept when elevated for a prolonged period. You can litterally have pneumonia or sepsis with a normal bloodwork. That's the reason people drop dead after being diagnosed completely fine.

  • @memoirs84brighter12
    @memoirs84brighter1211 ай бұрын

    Wish I could find a doc to give me cytomel

  • @giorgikuprava1055
    @giorgikuprava105511 ай бұрын

    Why there haven't been invented D3 inhibitors?

  • @jirihutecka9020
    @jirihutecka902011 ай бұрын

    I have TSH over 10 in most blood tests, but free T3 is in the middle of the ref range.. I was taking synthetic T4 many years, but felt like complete bag of shit so I just stopped and feel much better. Btw you can look up for a papers where you can read about how high TSH can regrow thyroid tissue. For example if someone had autoimmune issues like hashimoto and had some thyroid damage. Stopped gluten or whatever was causing the autoimmune issues thyroid can grow back, but if you start to take hormones that will lower TSH this regeneration of the tissue will not happen. Simply once you start taking hormones thyroid gland is no longer stimulated to do anything and will die of basically.. It is exactly the same like when you take testosterone and your testicles shrink to the size of a green peas lol...

  • @usernwn7qe

    @usernwn7qe

    11 ай бұрын

    I've taken 40mcg T3 + 160 mcg T4 for 4 Months, stopped within two weeks my TSH was 0.04, felt like crap being on it (way too hot) my rT3 was like 340 or so but i didn't notice anything negative comming off. In fact all my Thyroid labs went (noticeably) better after than before. Even after 6 months, better than before, plus i felt better.

  • @jirihutecka9020

    @jirihutecka9020

    11 ай бұрын

    @@usernwn7qe yeah taking thyroid hormones is not like taking testosterone.. With testosterone you can take lets say 100mg every 7 days forever and you will be ok, but metabolism is changing all the time and the body is regulating thyroid hormone production all the time. For example if you don't eat a good diet. For example you don't have all the nutrients (because by taking thyroid hormones your body is burning calories and using all the vitamins and minerals like crazy and you). So you can run into issues very fast. A lot of people ended up with damagd teeth for example or crazy hair loss etc. Because their body simply didn't have all the nutrients needed to support fast metabolism like that from taking thyroid hormones... Also making thyroid hormones is making a lot of oxidative stress so if your body can't handle this oxidative stress for some reason the body will again lower thyroid hormone production, but if you take just whatever and you keep taking that dose forever it can do a lot of damage in the body.. That's why I don't know what is doing more harm if having elevated TSH, but "normal" T3 or taking hormones, lowering TSH and hoping that it will not damage my body even more..

  • @lexitejeda6209

    @lexitejeda6209

    11 ай бұрын

    I believe you have good insight here, that taking exogenous thyroid hormone can suppress your thyroid from making its own hormone. My TSH got as high as 12, yet I de-prescribed my (natural desiccated) thyroid hormone with the help of my doctor, and my TSH is now normal and I feel good. I have Hashimoto’s, but I’ve recovered by keeping a healthy diet and restricting iodine intake. The key is iodine. You can still improve. When your TSH is high, it’s your body yelling at your thyroid to produce more hormone. If your thyroid makes the hormones, that is much better than taking hormone.

  • @jirihutecka9020

    @jirihutecka9020

    11 ай бұрын

    @@lexitejeda6209 interesting. But why you think iodine is the problem here? Iodine is needed in the breasts, prostate and other tissues of the body. It is the key component for estrogen metabolism. With iodine deficiency you can end up with estrogen dominant cancers and they are very aggressive.. What is your diet? I keep avoiding gluten, dairy(expet whey protein) and eggs. I know that I had hashimoto from gluten as well.. I take iodine from lugol as well.. But just like 1mg a day.. Also selenium, molybdenum etc.. I did some hair tests so I know what minerals I had low. Also low thyroid makes people toxic in copper and vit A. So I am on low vit A diet for like 5 years now + I try to limit copper, take some zinc.. It wuld be great If my TSH would go down to some normal numbers.. But maybe in my case it is also about physical stress. I always have physical jobs + I like riding bike etc.. I should go on vocation, just rest on the beach for couple of weeks and after that retest my thyroid labs. I am sure the TSH would be much lower than testing when I am stressed like crazy.. Also low carb is bad for thyroid. Many people lowered TSH and increased T4/T3 with high carb diets.. But I feel the best on mixed diet like 40% carbs, 30% fats, and 30% protein..

  • @Debbie3360
    @Debbie33608 ай бұрын

    Armour & cytomel

  • @weich1q2w
    @weich1q2w11 ай бұрын

    For god sake someone talk about hyperthyroidism and not hypo

  • @CynthiaTheHealthExperience

    @CynthiaTheHealthExperience

    11 ай бұрын

    This!!! 😢

  • @usernwn7qe
    @usernwn7qe11 ай бұрын

    Don't believe the man a word your TSH is fine, it's all in your head !

Келесі