What are Your Optimal Thyroid Levels?

What constitutes an optimal thyroid level? When we talk about things like normal TSH levels or your thyroid’s “normal” range, we need to make some key considerations.

It’s not one size fits all, but there are tighter ranges that doctors who specialize in endocrinology are trained in, and can help you with.

In this article, I will explain to you how you can learn the best thyroid levels for you. And, if you are not there yet, I’ll also cover some strategies and considerations to help get you there.

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Table of Contents

What Do We Mean By “Best” Thyroid Levels?
How do you Determine Normal TSH Levels?
Take Your Health Into Your Own Hands

What Do We Mean By “Best” Thyroid Levels?

First, you need to think about the thought process itself when it comes to optimal thyroid levels. How do we know which levels are going to be best?

The “normal” values most common in laboratory ranges are known as statistical averages. This means that researchers take a population of people, and they average out the most common scores. The issue arises when we consider the population.

Most often, populations may not be reflective of those who have the best health. This may lead to a skewed vision of what constitutes “normal” or “best.” Especially in the case of diagnostic tests, where the people who are tested the most are typically dealing with the biggest issues.

There have been studies done, though, that have focused on people who were free of thyroid disease. This is a super interesting one. This includes those who have:

• No known history of thyroid disease
• No family history
• No big symptoms
• No other medical conditions that would affect the thyroid

To get a good idea of an optimal thyroid level, we would look to this population that lacks thyroid disease. That is one way to approach an understanding of a normal thyroid range.

Another way to look at this would be to look at those who have thyroid disease but have different health outcomes. For example, those who have more weight problems or fewer weight problems – and determine if there are differences in their scores.

The third source of data would be those who have thyroid disease. In this case, we would monitor them to see how they experience changes in their thyroid levels over long periods of time. We might ask questions like:

• Who amongst them gets the most heart disease?
• Who might be struggling with diabetes the most?

We would then look at those who have risks, versus those who do not, and then analyze how their blood levels differ.

What Do These Blood Levels Predict?

We know that our blood levels are important. But, just how specific can they get? Knowing our blood levels can help predict:

• Overall quality of life
• Better or worse symptoms
• Tendencies toward disease progression
• Risk for other related diseases

I want to stop here to make one key point. I want us to distinguish between initiating medication to titrating medication. This comes down to those who are already on medication, versus those who are not yet on medication.

There are times when someone who is not on medication may not have the best thyroid blood levels. It can be really tempting to assume, in these cases, that they need medication to correct these levels. But, one does not always follow the other.

In many circumstances, one may have thyroid levels that are not so great. But, if they were given thyroid medication, they still would not improve (even if their levels improved).

On the other hand, there are those who are already on medication. In cases like these, they may benefit from having their medication adjusted.

As we make our way through this article, I will speak on when certain levels would justify starting to take thyroid hormone and when they would justify changing it.

How do you Determine Normal TSH Levels?

How do we know what is best when it comes to determining an optimal thyroid level? I want to map out three approaches that can help guide our thinking on this subject…

For starters, let’s talk about the main values that are going to be relevant here. We have:

• Reverse T3
• T3 & T4
• TSH
• Thyroid antibodies

Reverse T3

As part of today’s discussion, I will mainly discuss the markers of thyroid output (as listed above). That said, we will not discuss reverse T3 in too much detail. I have discussed it before on my blog, though, and would recommend diving into the topic here.

T3 and T4

As far as T4 and T3 are concerned, we also need to quickly hit on the ideas of ‘total’ and ‘free’ levels of T4 and T3. When options are available for testing, I would typically recommend the ‘free’ version of testing.

But, I don’t mean free because it costs nothing! A free test will determine the levels of hormones that are ‘freely active’ in the body. It is a more accurate reflection of the hormone that is available to someone in their body (rather than inactivated and inaccessible).

TSH

Last, but certainly not least, we have TSH. It is always important to remember that TSH is a backward marker – the more your body lacks thyroid, the higher your TSH score. The more thyroid you have, the lower your TSH score.

Essentially, your TSH score is the rate at which your pituitary is asking your thyroid to work and create more thyroid hormones.

There is a great deal of data saying that, within the normal range, there are differences depending on which end of “normal” you find yourself.

Most labs now call the normal range 0.45 – 4.5 – or 0.4 – 4.5. Those are the typical numbers you will find when it comes to the higher and low ends of the range.

Data has found that those who are on the lower side, generally tend to do better. But, what does better mean? Better can look like:

• Less risk of thyroid enlargement
• Less risk for weight problems
• Less risk for heart disease
• Better energy levels
• Better quality of life

A lot of things end up being better when that TSH score is on the lower side of normal! This also differs by age, gender, population, and pregnancy status. But, for most adults, that range is going to be around somewhere 0.5 – 2.0.

Now, let’s dive into the approaches that some have taken to what might be considered normal TSH levels and determining optimal thyroid levels…

Approach One: Assume Higher Is Better

As we mentioned, healthier people tend to have a lower TSH score. This has led to a lot of practitioners taking the approach that, if healthy people have low TSH, they must have high levels of T4 and T3. But, is this true?

While it is possible at the extremes, it does not work for the levels that are appropriate for day-to-day average health.

One thing we see is that people that have better health outcomes, alongside lower symptoms, tend to have low-normal levels of T4. And, they have a large diversity in their T3.

For some it is low-normal, for some it is mid-range, and rarely is it high-normal. But, there has been an argument that you need to have your T3 levels on the high side of normal.

But, I am here to tell you that you really do not. There is a lot of evidence that people who have higher levels of T3 are not the healthiest people in various populations.

Those that have higher levels of T3 are more likely to have tendencies toward:

• Weight gain
• Fatty liver disease
• Higher blood pressure
• Excessive visceral fat

Approach Two: Assume Mid-Range is Best

The second prevailing approach that we find is people suggesting that all your levels should be smack dab in the middle – not too high and not too low.

I also see the logic in this one. If you look at a range, it may be safe to assume that you’d be safe to find yourself somewhere in the middle. It is the middle, after all!

The problem is that typical ranges come from people with thyroid disease. Healthy folks tend to average out on the lower end of normal, so it really wouldn’t be best to be in the middle.

Approach Three: The Recommended Approach

Here is my approach to optimal thyroid levels. First, we need to think about what happens in people and what ranges we find when we look at populations who have no symptoms and good thyroid function, and of those with thyroid disease, the levels of those who are the healthiest.

We really need to take all of these things and pull them together – it helps us pull from the healthiest variety of data that draws the strongest normal TSH levels and ranges.

What we find is that:

• TSH is on the low side of normal
• T4 is on the low side of normal
• There exists a big range for T3 (mid-range to low to high mid-range)

These are all things that you do not need to force. Instead, the body can bring them back into balance with good health and with a good diet.

If someone is on medication, it can be worth adjusting to first get the TSH to that health low-end of the range. But, deeper than that, you may need to question whether you are in a stage that needs medication at all.

Take Your Health Into Your Own Hands

When I was creating the Thyroid Reset Diet, I wanted to create an actionable plan that people could use to bring their thyroid levels where they needed them – on their own terms. That means relying less on medication, and more on a healthy diet.

If you take a look for yourself, you will find an easy way to start enjoying foods more safely, and with confidence, to help bring your TSH levels where they need to be. Ultimately, it can be your first step to an entirely new world of health. I hope you will join me in taking a look today.

P.S. Whenever you are ready, here is how I can help you now:

1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Need A Thyroid Supplement Recommendation? Take My Thyroid Specific Formulations Quiz Now
3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here

Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet, The Metabolism Reset Diet and The Thyroid Reset Diet.

Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.