Factors to Consider in Treating Patients with Elevated TSH Levels

Dr. Bianco recently published the book, Rethinking Hypothyroidism: Why Treatment Must Change and What Patients Can Do. 

Today I'll be speaking to Dr. Bianco, whom I deeply respect,  about his approach to thyroid health—and mine. 

While we already had a lot of overlap in our approaches,  I walked away with new, incredible insights on hypothyroidism. 

I think you'll feel the same way. 

• https://pubmed.ncbi.nlm.nih.gov/25305308/

• https://pubmed.ncbi.nlm.nih.gov/36079838/

• https://pubmed.ncbi.nlm.nih.gov/29615976/

• https://pubmed.ncbi.nlm.nih.gov/10378389/

• https://pubmed.ncbi.nlm.nih.gov/27700539/

• https://pubmed.ncbi.nlm.nih.gov/35445422/

• https://pubmed.ncbi.nlm.nih.gov/34185829/

• https://pubmed.ncbi.nlm.nih.gov/26940864/

• https://pubmed.ncbi.nlm.nih.gov/35570696/

• https://pubmed.ncbi.nlm.nih.gov/34457140/

• https://pubmed.ncbi.nlm.nih.gov/34340589/ 

• https://pubmed.ncbi.nlm.nih.gov/31396154/

• Rethinking Hypothyroidism: https://press.uchicago.edu/ucp/books/book/chicago/R/bo183892827.html 

• Thyroid Self-Management Course: https://drruscio.com/thyroid-course/ 

• My articles: https://drruscio.com/blog/

• My book: https://drruscio.com/getgutbook/ 

• Courses, free guides, and more: https://drruscio.com/resources?utm_source=youtube&utm_medium=link&utm_campaign=drruscio.com_resources

00:00 Intro 

03:33 Diagnosis is pretty straightforward 

08:00 2 ways to diagnose hypothyroidism 

12:20 Hypothyroidism prevalence 

24:13 1 in 3 might be on meds they don’t need

29:15 TSH is 6. Should we treat or not? 

33:25 TPO values & risk

35:16 Normal labs, but there’s symptoms

38:32 The misuse of T3 levels 

45:15 Should patients start with combination therapy? 

52:41 What to do step-by-step 

55:10 What about liquid T4? 

58:12 Side effects & risks of adding T3

Dr. Bianco received his MD from Santa Casa Medical School and a PhD in human physiology at the University of Sao Paulo, in Brazil. He’s the former president of the American Thyroid Association (2015-2016) and author of the book "Rethinking Hypothyroidism" . 

Currently, he’s a Professor of Medicine at University of Chicago in the research unit called the Committee on Molecular Metabolism and Nutrition which focuses on thyroid hormone metabolism, more specifically, how certain enzymes called deiodinases control thyroid hormone action & metabolism. This research forms the basis for his understanding of the variable response to thyroid hormone replacement among individuals. 

He has been published in over 200 peer reviewed papers. 

Learn more about his work at www.deiodinase.org 

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DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment.

Music featured in this video: "Modern Technology" by Andrew G, https://audiojungle.net/user/andrew_g 

*Full transcript available on YouTube by clicking the “Show transcript” button on the bottom right of the video.