COMPENDIUM ON FUNCTIONAL MEDICINE - Flipbook - Page 171
Further testing reveals TPO antibodies of 220 IU/mL (ref < 35),
suggesting early Hashimoto's thyroiditis with subclinical
hypothyroidism.
Case 2: The Conversion Problem
A 35-year-old male complains of fatigue, brain fog, and
depression despite being on levothyroxine for hypothyroidism. Lab
results show:
● TSH: 1.2 mIU/L (ref range 0.4-4.5)
● Free T4: 1.6 ng/dL (ref range 0.8-1.8)
● Free T3: 2.1 pg/mL (ref range 2.3-4.2)
● Reverse T3: 28 ng/dL (ref range 8-25)
The conventional approach might consider this patient
adequately treated based on the normal TSH and T4. The
Rockwell analysis recognizes:
● Low Free T3 despite adequate T4
● Elevated Reverse T3
● T3:T4 ratio of 0.13 (below optimal range)
These findings suggest impaired T4 to T3 conversion, possibly due
to chronic stress, inflammation, nutrient deficiencies, or
environmental factors that should be addressed alongside thyroid
hormone replacement.
Case 3: Non-Thyroidal Illness vs. Central Hypothyroidism
A 58-year-old male recovering from pneumonia shows:
● TSH: 0.3 mIU/L (ref range 0.4-4.5)
● Free T4: 0.7 ng/dL (ref range 0.8-1.8)
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