Most thyroid testing stops at TSH. We run free T3, free T4, and reverse T3 alongside it — because that is where the answer usually is when you feel unwell and your results came back "normal".
The thyroid sets the pace of your metabolism, and when it slows, the symptoms overlap almost perfectly with low testosterone, perimenopause, and burnout. It is the reason we test thyroid on every hormone panel rather than waiting to be asked.
The most common presentation, and the one most often written off. Low thyroid output leaves you tired in a way that rest does not resolve.
A slowed metabolic rate makes weight gain easier and loss much harder, regardless of how disciplined the diet is.
Feeling cold when nobody else is — particularly hands and feet — is a classic sign of an underactive thyroid.
Slower recall, difficulty concentrating, and a general sense of mental sluggishness frequently track with thyroid function.
Thinning hair, dry skin, and brittle nails are downstream of thyroid hormone reaching your tissues in sufficient amounts.
Low thyroid states are commonly mistaken for depression — and treated as such for years before anyone runs a full panel.
These four markers are run on every hormone panel at Juvenis Medical. If Dr. Paul takes on your thyroid care, testing goes deeper from there as the clinical picture requires.
Thyroid stimulating hormone is your brain asking the thyroid to work harder. It is useful, but on its own it tells you nothing about how much active hormone actually reached your cells.
The bulk of what your thyroid produces. T4 is largely inactive until it is converted, so a healthy T4 with symptoms points the investigation downstream.
This is the form that does the work. Free T3 is the number most closely tied to how you actually feel, and the one most often never ordered.
Under stress, illness, or dieting, the body can convert T4 into reverse T3 — an inactive form that blocks the active one. It explains a great many "normal labs, terrible symptoms" cases.
There is no house protocol here. Some patients do well on T4 alone. Some need T3 alone. Some need a combination of the two. Dr. Paul makes that call from your results, your symptoms, and your response to the first round — and revisits it at every recheck.
Talk through your symptoms and any thyroid testing you have already had. Bring old labs if you have them — the trend matters as much as the number.
TSH, free T3, free T4, and reverse T3, run alongside 70+ other factors so the thyroid is read in the context of everything else going on.
Dr. Paul explains what the four markers are telling you together, and whether thyroid treatment is warranted — or whether something else is the real driver.
Thyroid medication is a daily prescription with a recheck cadence. Follow-up labs confirm the dose is right and the form of hormone is the right one for you.
Yes. A TSH within the reference range says nothing about how much free T3 and free T4 you actually have available, or how much of your T4 is being diverted into reverse T3. That is precisely why all four are run together.
When the labs call for it. Sometimes T4 alone is right, sometimes T3 alone, sometimes a combination. It is decided case by case, not by policy.
Not by telehealth. Hormone care including thyroid is Florida-only for telehealth. Patients from any state are welcome in person at the Oakland Park clinic.
A free 15-minute call with Dr. Paul is the starting point. If you have had thyroid labs before, have them handy.
Hormone telehealth available to Florida residents. In-person available to all states.
Thyroid and estrogen symptoms overlap heavily in the forties and fifties.
Fatigue and low drive can be either — which is why both are on the panel.
Metabolic evaluation and GLP-1 therapy. Available nationwide.
The full hormone hub — men, women, thyroid, and the GH axis.