COMPENDIUM ON FUNCTIONAL MEDICINE - Flipbook - Page 170
Each person has a unique thyroid "set point" determined by
genetics, development, and environmental exposures. Significant
changes from an individual's baseline, even within the reference
range, may be clinically meaningful.
T3:T4 Ratio
The ratio between Free T3 and Free T4 offers insight into peripheral
conversion efficiency. Optimal ratios typically range from
0.24-0.32, with lower values suggesting impaired conversion.
TSH Patterns Over Time
Trending TSH values over time often provides more clinically
relevant information than a single measurement. Consistent
directional changes may signal developing thyroid dysfunction
before values move outside reference ranges.
Case Studies in Functional Thyroid Assessment
Case 1: The Missed Subclinical Hypothyroidism
A 42-year-old female presents with fatigue, mild weight gain, dry
skin, and feeling cold. Conventional testing shows:
● TSH: 4.2 mIU/L (ref range 0.4-4.5)
● Free T4: 0.9 ng/dL (ref range 0.8-1.8)
From a conventional perspective, these results would be
considered normal. However, the Rockwell approach would note:
● TSH at the upper end of the reference range
● Free T4 in the lower quarter of the reference range
● Clinical symptoms consistent with hypothyroidism
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