Thyroid, Metabolic Rate & Energy

This report may be useful if you experience any of these symptoms:

Your thyroid makes T4 (the storage form, mostly inactive). Most of your active T3 is made outside the thyroid in your liver, brain, muscle, and brown fat. The conversion is the slowest and hardest part for your body to do. Many people have normal TSH and T4 but low active T3. When this happens, they feel hypothyroid symptoms (fatigue, weight gain, sensitivity to cold, dry skin and hair, constipation, etc) even though their labs "look fine." Beyond the thyroid itself, a handful of metabolic master switches (AMPK, mTOR, PGC-1α, sirtuins, leptin, adiponectin) set your basal metabolic rate, how easily you gain or lose weight, and how well you bounce back from exercise.

• Sensitivity to cold, cold hands and feet
• Persistent fatigue, slow morning waking
• Weight gain despite diet, weight-loss resistance
• Hair loss (especially outer one third of eyebrows), brittle hair
• Dry skin, brittle or ridged nails where ridge runs top to bottom (longitudinal)
• Constipation
• Brain fog, slow processing, memory issues
• Depression, low mood, low motivation
• Slow heart rate at rest
• Visible thyroid (Adams apple) enlargement (goiter)
• Hoarseness or unusually deep voice
• Puffy face / lower-leg swelling
• Heavy menstrual periods, infertility
• Decreased libido
• Muscle aches, joint pain, morning stiffness
• High cholesterol despite reasonable diet
• Slow recovery from exercise
• Persistent low body temperature (under 97.8°F first thing AM)
• You feel hypothyroid but labs look normal
• Better on T4/T3 combo or Natural Desiccated Thyroid (NDT) than T4 alone
• Hashimoto's diagnosis or elevated TPO (anti-thyroid) antibodies
• Heat intolerance, palpitations, tremor (Graves spectrum)
• Persistent hunger despite eating enough (leptin resistance)
• Post-exertional malaise after moderate workouts
• "Tired but wired" cortisol-driven pattern
• Trouble fasting- get shaky, foggy, irritable easily

Answer the symptom questions below as honestly as you can. Combined with your DNA file, your answers help map which parts of the thyroid–metabolic axis may currently be underperforming and what to do about it.