Thyroid Tune-up Checklist

Imagine that all the cars in your neighborhood run poorly because nobody bothers to tune-up their autos. I show you how to tune your car and, lo and behold, 80% of the cars now run great. But 20% of cars still run poorly because their transmissions are bad. In other words, tuning the engine works when that’s the only problem with the car; if something else is wrong, then you car will not run properly.

So it goes with eliminating wheat from the diet. It works for the majority of people: substantial weight loss and shrinking waist size; reduced blood sugar and blood pressure; relief from arthritis, leg edema, acid reflux, irritable bowel syndrome symptoms, etc. But some people complain that, despite saying goodbye to all things wheat, they still have problems. Obviously, as big a problem as modern wheat is, there are other causes for health conditions besides wheat consumption. There are  infections, injuries, sensitivities to other foods, inherited conditions, etc. While wheat exposure is a cause for an incredible amount of human suffering, it is not the only cause.

How about weight loss? If all things wheat are eliminated, most people can expect substantial weight loss. Some people will also need to reduce exposure to other carbohydrates, especially if a lot of body weight needs to be lost and/or pre-diabetic or diabetic patterns are established. We cannot say “eliminate wheat and eat all the ice cream and candy you want.”

Then there are people who do all that and still cannot lose weight. This is when it’s time to give serious consideration to thyroid dysfunction.

By “thyroid dysfunction” I am referring to various degrees of hypothyroidism, i.e., low thyroid hormone levels. (I’m going to ignore hyperthyroidism, since this is much less common and does not impose any limitation on weight loss.) This is a big issue, so I’m going to cover it as a check list, a series of bullet points that you can run down to cover as much territory as possible. There are three blood tests that everyone should have assessed to even start thinking about thyroid dysfunction: TSH (thyroid stimulating hormone), free T3, and free T4. Optionally, a reverse T3 and thyroid antibodies (to identify thyroid inflammation/autoimmunity) can also be helpful. You do not need all the other nonsense often run, such as total T3 and FTI; these are outdated and often misleading.

Important issues to consider in deciding whether hypothyroidism is contributing to stalled weight:

Hypothyroid symptoms–Beyond stalled weight loss, the most common symptoms of low thyroid hormone status include cold hands and feet; low energy; mental “fog;” increased loss of hair and eyebrows; constipation; leg edema.

Low first a.m. oral temperature–While not validated in clinical trials, anecdotally an oral temperature immediately upon awakening can help you decide whether a thyroid question is present or not. Using a digital thermometer, take your oral temperature immediately upon arising. If it is consistently below 97.3 degrees F, then hypothyroidism is likely; the lower the temperature, the more likely and severe the thyroid dysfunction. However, note that disruptions of cortisol can do the same. (Contrary to some older discussions from the 1960s, axillary temperature should not be used due to excessive variation.)

Iodine deficiency–Though it’s not even on most people’s radar, iodine deficiency is a common and underdiagnosed cause for inadequate thyroid hormone production. The thyroid requires iodine to manufacture thyroid hormones, T3 and T4, the “3” and “4” referring to the number of iodine atoms per thyroid hormone molecule. Iodine deficiency was a huge public health issue up to the last half of the 20th century, pretty much solved by the introduction of iodized salt. Now that salt overexposure in some populations has been fingered as a potential health problem, the FDA and other “official” providers of health advice tell us to reduce salt and sodium. But what about the iodine? Everyone forgot about the iodine.

Many people, including physicians, assume that iodine intake from diet is sufficient. Nope. Even the NHANES data have uncovered substantial deficiency in some demographic groups, such as women of childbearing age, using their relatively lax definition of iodine deficiency. I’m seeing iodine deficiency and even goiters (enlarged thyroid glands due to iodine deficiency) frequently. Beyond having a goiter, a low free T4 and highish TSH (e.g., 3.5 mIU) is suggestive of iodine deficiency.

Iodine is not optional; it is necessary for health, including breast health, oral/gastrointestinal health, and the health of a developing fetus. The RDA for non-lactating adults is 150 mcg per day, the quantity required to not have a goiter, but not necessarily ideal thyroid health. I’ve therefore been advising 500-1000 mcg per day from an iodine supplement, such as kelp tablets (dried seaweed), available at health food stores (not pharmacies). The only adverse effects of iodine arise in people who have inflammatory thyroid disease, such as Hashimoto’s thyroiditis, unsuspected thyroid nodules, or longstanding and severe iodine deficiency. In most cases, very low doses of iodine, e.g., 100 mcg per day, can be introduced and increased gradually over months. (Ideally, this would be undertaken by your healthcare provider, but good luck finding one knowledgeable about iodine.)

For most people, restoration of iodine usually develops over 3-6 months.

Ideal TSH–Notice I didn’t say “normal” or “reference range” TSH. I look for ideal TSH. Contrary to the values often cited as “normal” or “reference range” on laboratory values, ideal TSH is in the range of 1.5 mIU or less. This is the level at which thyroid dysfunction no longer contributes to stalled weight loss, as well as distortions of lipid (“cholesterol”) values and cardiovascular risk. The higher the TSH above 1.5, the greater the hypothyroidism.

Ideal free T3 and free T4–The upper half of the “reference range” quoted by your laboratory can serve as a reliable guide to desirable or ideal levels of these thyroid hormones. In particular, low free T3 levels are becoming a common problem and a frequent cause of stalled weight loss. It is not clear why T3 levels are impaired, but potential explanations include disturbed circadian variation of cortisol levels and exposure to organochemicals such as perchlorates (residues of synthetic fertilizer in your produce and water) and others. Unfortunately, the endocrinology community (which is woefully unhelpful with thyroid issues except in the most severe cases) sooner prescribe antidepressants than treat low T3 levels, which they regard as a non-issue. (I had low T3 personally with normal TSH and free T4, along with flagrant symptoms of hypothyroidism and a body temperature of 94.6 F, all corrected with thyroid hormones that included T3.)

Reverse T3–Less commonly, some people develop a T3 thyroid hormone mimic, reverse T3, or rT3, that blocks the activity of T3 in the body. In this situation, it is worth more seriously considering disrupted circadian cortisol variation and using higher doses of T3 thyroid hormone to overcome the blockade.

Should prescription thyroid hormone replacement be chosen, most people do best by including the T3 thyroid hormone, liothyronine, along with T4, levothyroxine. They can be taken separately and as a single tablet in desiccated thyroid gland preparations like Armour thyroid and Naturethroid. Alternatively, if you already take a T4 preparation like Synthroid or levothyroxine but have stalled weight loss or persistent symptoms of hypothyroidism, then adding T3 nearly always solves the problem.

Unfortunately, the biggest hurdle in obtaining helpful feedback on your thyroid is usually your doctor, who will declare your thyroid status normal usually by just looking only at TSH and seeing whether it is in the “reference range” quoted by the laboratory–if he/she even bothers to check it at all. Lately, the naturopath community has been very helpful to many people in my area eager to have their thyroid status intelligently assessed. As a last resort, you can purchase fingerstick test kits to obtain thyroid measures, such as the ZRT test kits we make available in my Track Your Plaque heart disease prevention program.

Once properly corrected, the majority of people enjoy resumption of weight loss, not to mention feel happier, more energetic, with improved overall health, including reduced cardiovascular risk. Add that to the health and weight benefits of wheat elimination, and you can make substantial strides in regaining ideal health.

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Comments & Feedback...

  1. Shirley

    Dr. Davis,

    OK, my weight is 118 for about 9 weeks, down from 144. Shall I stop or reduce the Kelp tablets? I don’t salt my food and recently started eating more fish.

    • Dr. Davis

      Only if you have developed hyperthyroidism, or an overactive thyroid, which is unusual.

      I am a big fan of lifelong iodine supplementation. Like vitamin C, if you don’t get some every day, weird stuff happens.

  2. Jane M.

    Dr. Davis,

    Thank you for the valuable information in your book. I am now completely wheat free for three weeks and am slowly losing (approx. 8 pounds so far). I started out the WB journey by checking that my bloodwork results were in order. I got them back last week. The doctor says my thyroid is fine but I wanted to see if you think that there is any room for improvement.

    My results are:

    TSH – 1.57
    T4 – 10.3
    T3 uptake – 32
    Free Thyroxine – 3.3
    T3 – 117
    Also, glucose is 93
    LDL/HDL ratio is 1.9 / tot cholesterol is 247 (Doctor said that’s good).

    Do I need any medications to jump start the weight loss? I also run 3 times a week and do a strength boot camp once a week.

    Thank you,
    New Jersey Jane

    • Dr. Davis

      Actually, these thyroid values are pretty darned solid. While there can be forms of thyroid dysfunction present even with these values, it is very uncommon.

      Stay tuned to an upcoming discussion of all the factors that can impede weight loss success when you’ve eliminated wheat.

  3. LorLor

    I just got the results of my company health screening and I’m freaking out a little bit. My TSH, which was 3.37 several months ago at my last doctor’s visit, has shot up to 6.0. I’ve been on Wheat Belly for about two months and taking iodine for about a month, in addition to my prescription medication.

    Is this a temporary effect of going off the wheat? I’ve lost very little weight so far and with numbers like that, I can see why. I’m starting to go even lower carb but I need to know if this is cause for alarm.

    • Dr. Davis

      It has nothing to do with the wheat. And the only way iodine would do that is if you were taking a toxic dose, e.g., 12 mg.

      It is much more likely that you simply began your wheat-free adventure while you were experiencing declining thyroid function. The diet has not served to stop it and it has simply progressed.

      Find a healthcare practitioner who will treat your responsibly and prescribe both the T4 and T3 containing thyroid preparations, such as Armour thyroid or Naturethroid, not the more commonly prescribed levothyroxine or Synthroid. If that is the answer you get, run the other way and find someone who is interested in health, not in following the drug industry line.

  4. LorLor

    Thanks for the quick reply! I faxed my test results to my regular doctor, who agreed to consider running a full thyroid panel on me (which apparently never occurred to them before). I managed to locate two other doctors in town who have been known to prescribe Armour so if it doesn’t work out with my regular doc, I’m going doctor shopping. I’ve been on levothyroxine for years but apparently it’s not doing much and my doctor (or should I say PA, since I haven’t seen the actual doctor in years), doesn’t seem terribly interested in pursuing better results. Last year at my physical when I mentioned how difficult it was to lose weight, the PA handed me a photocopy of the government’s new plate guidelines. Period.

    You’re the best!

    • Michelle Weaver

      This actually answers some questions I had too, LorLor – thanks for asking. Looks like I need to find a new doctor. I’ve been on Levothryoxine .75 mg for about 10 years now. I swear there are times when I feel “off” and that my levels are too low, but my doctor just checks the basic level and if it’s normal, great. I am going to look for a dr. who specializes in a more natural approach, and also prescribes Armour thyroid.

      • LorLor

        Good luck with your search! Unfortunately in my state, naturopaths are not allowed to write prescriptions, so I would have to look for a regular GP with an open mind; hard to do around here. To get a true second opinion on anything I’d have to go out of town, they all know each other around here and won’t disagree with their colleagues. The nearest functional medicine doctor is two hours away, but I’ve thought about it.

        Honestly, the more I become an informed health consumer, the more I feel almost betrayed by the doctors I’ve seen over the years. I’m just grateful to have access to the miracle of Wheat Belly at a young enough age that I have a real shot of not becoming my parents’ health problems. (Guess who’s getting a copy for Christmas?)

        • Shelley

          My elderly parents both have type II diabetes, heart disease (mom had open heart surgery, dad has had stents in his heart as well as an aorta-bifemoral by-pass on his legs), high blood pressure, and they’re still overweight. It amazes me that they’ve lived to 75/72, respectively. They spend (and I’m completely serious) about $1,700 per month on medications. At this point, I have no real hope that they’ll ever change their lifestyle.

          I thought I would need to take draconian measures to avoid a similar fate, but it turns out that it’s quite simple. Eliminate wheat, avoid grains, and take detailed responsibility for my health. Doctors (most, certainly not all) and Big Pharma are in bed with each other and have no real regard for my health or whether I live or die. It’s up to us to take good care of ourselves. Sounds like you’ve learned that young too! Knowledge is definitely power.

      • LorLor

        Just got a call from the doc, I can do a blood draw tomorrow for thyroid studies and check of my Vitamin D level. I already know my levels are messed up so I’m curious to see if they’ll recommend Armour, etc. or fall back to the same old levothyroxine.

        So glad to have the correction information, it really is power.

  5. Kara

    Hi Dr. Davis! HELP! I am a 40 year old woman, who has suspected a thyroid problem for years, but my bloodwork has always come back “normal.” I was diagnosed with depression 5 years ago (I currently take Celexa) and have battled severely high triglycerides for many years. I started Wheat Belly on September 1st. I initially lost 8lbs, but the last 5 weeks I have lost nothing. Chronic achiness and headaches are gone, but in its place I have developed extreme fatigue, brain fog and sluggishness. I am so frustrated. Any insight would be greatly appreciated. I assume that adding iodine would be helpful. Below are the results of my bloodwork from last week. The good news is that my trigylcerides have dropped over 300 points!
    TSH: 1.32 mIU/L
    T4 free: 1.0 ng/dL
    T3 free: 2.3 pg/mL

    • Dr. Davis

      Great on the triglycerides, Kara!

      However, you have a problem with the 5′-deiodinase enzyme: Something is blocking your 5′-deiodinase enzyme that converts T4 to T3, thereby allowing a low T3 thyroid hormone level, along with fatigue, brain fog, sluggishness, and stalled weight loss. This blocker might be perchlorate from the residues of synthetic fertilizer in your produce. It might be many years of exposure to polyfluorooctanoic acid from non-stick cookware.

      There is a long list of chemical exposures that that could account for such an effect. Problem: I know of no way to undo these effects and, for instance, erase the effects of perchlorates on your thyroid.

      Solution: Take the T3 thyroid hormone (liothyronine), e.g., 10 mcg per day, increasing until these phenomena recede and you feel happy, energetic, warm, and weight loss resumes.

      Problem 2: Getting someone to help you get this done. You may need to consult with a functional medicine practitioner or naturopath. But I predict that, after wheat elimination, restoration of your T3 will be life-changing.

      • LorLor

        I totally relate to Kara’s problem. Although my TSH has shown high for years, last week was the first time I had my free T3 and T4 checked (at my insistence). They came back at 2.37 and 0.77, respectively. Vitamin D was on the low end of the range too, which I understand can be negatively affected by long-term levothyroxine use. Since those numbers are in the “normal” range my doc (or should I say her PA), in her infinite wisdom, just wants to up my dose of levothyroxine for the third time in the last several years.

        After reading this blog and doing some other research, I made an appointment with a nurse practitioner in town who is known to prescribe Armour as needed. Hopefully I can make some progress now. Hang in there Kara!

        Dr. Davis, one more question. The lab also said I had low alkaline phosphatase at 19 U/L. I Googled it and found that hypothyroidism can cause that, but is it anything to worry about?

        • Dr. Davis

          I know of no adverse consequences or concerns with that alk phos level, Lor.

          And good move on the Armour! It’s really SO simple but so neglected.

        • LorLor

          New doc, new results – after two weeks on the PROPER medication, my thyroid levels are dead-on. I actually lost 1 1/2 pounds over Thanksgiving week! Skipped the rolls and gravy and cookies and pie. I made the apple-cranberry crumble recipe from this site and even my sugar- and wheat-loving relatives thought it was great!

          • Dr. Davis

            That’s great, Lor!

            You can see how easy it SHOULD be if we are given the proper diet advice and rational thyroid information-painfully easy!

  6. Dr. Davis,

    I am a huge fan of your work! You really explain things that would otherwise be so confusing. I was hoping you would have an opinion on my situation which me be similiar to Lor Lor. In August I had my blood taken and my Total T3 was well below range 80 (92-178). My TSH was .9. Keep in mind I had this taken after I took my unithroid and Armour. So my meds were changed…I was taken off my 50 mcg unithroid and moved from 60mg Armour to 90 mg. My tests the next month, early morning and I hadn’t taken meds, my Total T3 was 62 and my TSH was 1.78. So, this is fun, because they put me back on 50 mcg of unithroid and kept me on 90 mgs of Armour. My tests this month showed NO change in my total t3 even with the 30 mg of Armour added and my TSH is .0056.

    This is the fun part. My doctor was dumbfounded, so called another doctor in and argued about it in front of me! Now I did start having a high pulse rate at night and some pain in my left shoulder which usually means heart palpitations, so they were concerned. But one doctor said cut her Armour in half and up her Unithroid. The other one said no…up her to 120 mg Armour no unithroid. I am on Wellbutrin for a couple years at 150 mg, that could cause palpitations. I am really tired, I’m 40 years old with my own company, and a 3 year old daughter. Since I had her, they have never been able to get this right. So yes…I have been doing this fun medication swap for 3 years at about 4 times a year. My pharmacist o so confused she doesn’t do automatic refills for me because I have 10 different prescriptions!

    I follow fairly clean wheat free diet, everyone once in awhile I succumb to some gold fish or a cookie. I eat organic fruits and meat. I am really trying here! But my doctors are making me crazy!!! I can’t stand the constant med swaps. Am I missing something, didn’t they go to school for this???

    I would LOVE your feedback. I am so ready to get off this train! I didn’t even take my meds today because I don’t even want to look at them. My own little personal boycott.

    Lots of love and appreciation for your work Dr. Davis,

    • Dr. Davis

      Wow, Amy.

      It’s great that your doctors are at least willing to think about things. But it really should NOT be this tough. A few thoughts:

      1) The total T3 value should never be used to judge adequacy of T3 status. The free T3 value is what you need. (The total value is subject to too many extraneous influences and may reflect other phenomena not relevant to T3 status.)

      2) Think of Armour as your default preparation, not the Unithroid.

      Because your doctors have been blundering around and not truly understanding some basic and very simple principles, they are never quite getting it right. It sounds like you may NEVER get the answers you need from the Three Stooges act they are carrying on and you need a new doctor.

      It is really painfully simple once the basic principles are understood.

    • Abby

      Hopefully you’ve gotten things sorted out by now (!), but just in case you haven’t — be very careful with the meds with a TSH that low. A value of .0056 is your body’s way of saying it already has waaaaay more thyroid hormone than it needs (hence the heart rate issues).

      I’m not a Dr., but am speaking from experience. After not one, but TWO trips to the ER for what felt like a heart attack (at the age of 34), I ended up in the psychiatric ER with what was later determined to be thyroid psychosis. This was only after I completely freaked out on a trio of doctors who insisted Valium was the solution. I live at the low end of the energy scale and knew Valium wasn’t going to fix whatever my problem was. When one of the three stooges finally looked at my intake form and saw I was on Armour, they ran a thyroid panel. When my TSH came back as .0002, I was transferred out of the psych unit for monitoring/treatment.

      The story gets longer from there, but hopefully this serves as a warning to listen to your body and be your own advocate. Don’t be afraid to freak out on the stooges if you have to :)

  7. Thanks Dr. Davis,

    So let me clarify, when I speak to my doctors, it sound like I need to push for the Free T3 test and ” humbly” suggest they lower my unithroid and up the Armour? After that, run and find new doctors! LOL. Not as easy as I thought, Charlotte NC is very conservative with treatment.. When I was pregnant, 2 of the best endocrinologists tried to take me off Armour.

    The one doctor was really adamant about there being an inappropriate amount of T3 in Armour. It not being the human golden ratio of 90/10 made him think it was dangerous for my heart.

    I greatly appreciate your time, more than you know!

    • Dr. Davis

      I wouldn’t do anything humbly, Amy!

      I say tell them to all go to h— and find yourself a health advocate, not people who are great at mucking up your health. And don’t waste ANY time with an endocrinologist: a more useless breed of specialist you could not possibly find.

  8. Bonnie

    Hi Dr Davis
    I had graves disease about 18 years ago. I’m on Armour Thyroid and I’m happy with that. I’ve gotten your wheat belly book; mostly because my sister was diagnosed with ciliac disease (All the women in our family have had either graves; hoshimotos or thyroid cancer. We are very similar) I was checked for ciliac by blood but it’s negative. I’m post menapausal and have gained 50 lb’s in the last 10 years no matter what I eat or how much I excercise it keeps climbing. All of my labs are normal and the Doc is checking more than just the TSH. I am currently taking an iodine supplement; but, often find I’m shaky at the end of the day) Any suggestions?
    I’d be very happy to finally reverse this weight gain issue… ps I still have brittle hair; dry skin ; lethargic most days etc.

    • Dr. Davis

      Gee, Bonnie, it sounds like you are still hypothyroid!

      It means finding someone truly capable in managing thyroid hormone restoration, which is almost NEVER an endocrinologist. You may be someone who has a specific impairment of the 5′-deiodinase enzyme that is supposed to convert T4 to T3. If impaired or blocked, no amount of Armour thyroid or levothyroxine will correct. You need to take T3 specifically above and beyond what you are getting from the Armour.

  9. Rindy

    My GP thinks that the generic levothyroxine is unreliable so he only prescribes Synthroid. My thyroid has been more stable since switching.

  10. Karen

    Hello Dr. Davis,
    I am so excited to have received your book! I truly feel it will be life-changing. I have Hashimotos Thyroiditis. What kinds of adverse effects can iodine supplementation have on this disease?

  11. Karen

    “The only concern with iodine is in people with Hashimoto’s thyroiditis or (rarely) an overactive thyroid nodule. Anyone with these conditions should only undertake iodine replacement carefully and under supervision (monitoring thyroid hormone levels).”

    Thanks for responding Boundless. I re-read the threads and specifically am curious at to the possible adverse side effects of iodine supplementation with regard to Hashimotos and thyroid nodules, as I have both. I would like to start supplementing with kelp tablets, but would like to be as informed as possible when I speak with my PCP. My thyroid antibody is 5X the normal limit. My TSH is in the 3.0-4.5 range.

    Thanks again,

    • Boundless

      Well, Karen, the material I re-posted was already more than I know :)
      I just happened to recall the discussion, and know how to search this blog.

      Dr. Davis may or may not respond further (and I don’t speak for him), as your inquiry may be getting into patient-specific web diagnosis, which is a risky area.

      I’d suggest working with the sort of physician recommended in the various discussions here. One that, for starters, recognizes the worthlessness of typical blood tests for lipids, thyroid (and PSA, I might add). The tests that most people get are little more than emotional placebos.

  12. Lisa Davis

    Hi Dr. Davis,
    I was told by my doctor about six weeks ago that my TSH levels were elevated above the “normal” limits at 5.54. My doctor ordered a thyroid ultrasound and additional bloodwork. The ultrasound showed an enlarged thyroid and a nodule that appeared to be benign. I started taking kelp almost immediately when I was told that my TSH levels were elevated. I had some blood work done about 3-4 weeks later which showed my TSH levels had come down to 3.5 but also showed that there were some antibodies built up against my thyroid. She has now placed me on a low dose of Synthroid.
    I do have a weight problem and the typical “wheat belly” which I have recently been working to eliminate. My question is do you think the Kelp was helping to bring my TSH levels down? My doctor said probably not since there were antibodies built up. Do you think I should continue the Kelp? My doctor didn’t tell me not to but I’m wondering if it was just an oversight on her part.
    Also, could a sensitivity or allergy to wheat cause the autoimmune disease in the first place? Sorry for being so lengthy but brevity was never my strong point! :-)
    Lisa Davis

    • Dr. Davis

      Well, I am not a thyroid expert . . . but clearly your doctor has a limited understanding of thyroid health.

      Yes, iodine may indeed have partially restored thyroid function to the extent that iodine deficiency was limiting thyroid hormone production. And the least desirable way to correct the residual degree of thyroid dysfunction is Synthroid. This is the path of the doctor who accepts everything from the drug industry hook, line, and sinker.

      My advice: Get a new doctor, one who understands thyroid health and starts with prescriptions like Armour thyroid or Naturethroid that gives you the chance to assess whether you will lose weight faster, feel happier, and have more energy with restoration of the T3 as well as the T4 thyroid hormone.

  13. Rob

    Dr Davis,

    My mother in-law who is 65 yrs has had atrial fibrillation since her triathlon days when she was in her late 30’s – 40’s and has been prescribed 200mg Teva-Amiodarone and Pradax 150 mg for this.

    She has been about 75% paleo for the past 3-4 years but still indulges in whole wheat and still does 1/2 marathons. She also has high blood pressure (usually 140’s/90 sometimes 150’s) and her doctor gave her Teva-Valsartan 320 mg and Apo-Furosemide 20 mg.

    In the last few weeks her thyroid has been low, AND NOW she has been prescribed Synthroid 50 mcg.

    Her HCL and LDL are fairly normal, she still has lots of energy and no noticeable side-affects.

    She does not take any multi vitamins or minerals and her doctor is typical, have a symptom – prescribe a drug.

    Any advice? Thanks from Manitoba Canada!

  14. Lindsey

    Hi Dr. Davis,
    I just caught on to the wheat belly lifestyle and it make so much sense to me! I have not fully started yet (building up a stockpile of good food). But I have struggled with my weight since I turned 20 ( I am now 28). I have been on Synthroid for over 2 years. My TSH was 6.5 before taking it and I was extreme achy and overly tired all the time. But one thing that has lessened but not gone away are panic attacks or a rushing adrenaline feeling. I just recently had my vitamin D checked, haven’t got the results. Oddly though, when I have taken a dose of vitamin D it felt as if it cancelled out my Synthroid (strange!), so I stopped taking it. Also since I have been taking Synthroid, my calcium and potassium have increased to a point where they were checking my kidneys and the PTH (?Peri-thyroid). My calcium and potassium where normal before taking Synthroid. Ever heard of that before? My doc had no idea and checked with others, but I never got a straight answer. I doubt my doctor will be excited to switch me to Armour, so I would like to know if you have any suggestions on doctors in the Daytona Beach, FL area. Thanks so much for all of your research and dedication to helping us lil guys:)


  15. Season

    Hi Dr. Davis –

    Hoping you can give me some insight/feedback.

    I had my thyroid partially removed in 2006. I was then diagnosed after the fact with Hashimoto’s.
    Have been trying to get my levels in an ideal range and have tried all sorts of meds.
    I am currently on 75mcg of Tirosint for the last 9 months.
    My levels are currently:
    TSH 1.34 (was around 5.0)
    FreeT4 1.1
    FreeT3 3.0

    My dr says these are all within range although I feel like I am having worse hypo symptoms, I have put on more wieight in the last few months than ever. So decided to go gluten free just recently but wondering if my levels ARE indeed ideal. I am hoping to see my weight stabilize or drop by going gluten free. I am feeling like if I look at food I gain no matter what.

    Thanks in advance!

  16. My biggest problem was finding a doctor that would listen. Most see a middle aged, overweight woman and blame everything on their weight or depression. I have a good doctor now that thinks I have low thyroid function but when he ordered the tests – the lab ran the TSH only. It was within range, so they didn’t do the FT3 and FT4 that he had ordered. I recently had half of my thyroid removed due to hyperparathryoidism and early nodular hyperplasia – but my thyroid was sluggish before that. He has ordered the tests again written hemithyroidectomy in the notes, so I am hoping they actually do them this time.

    My TSH is always normal – between 1.4 and 2.85, I have low level antibodies and my last FT4 (done almost a year ago) was 11 (range 9-22). Previous doctor told me this was fine and refused to discuss it. The one before that practically threw my results at me and told me I didn’t need drugs because my thyroid was fine. I have changed doctors quite a few times in the last few years and finally found a good one. I had a really low FT4 8years ago when I was pregnant of 6.3 (range was 7.5-21) but no one seemed concerned about it once I had my son and it was back to ‘normal.’

    • Ron Standridge

      I can relate on the doctor issue. I was just diagnosed as hypo. My doctor REFUSES to put me on anything other than Synthriod. I am currently looking for a new doctor.

  17. heymom

    Dr. Davis,

    I have been on WB for 1 month. I have not seen any change in my weight. I went to see my Dr. 2 weeks ago and she switched my thyroid to Armour thyroid and put me on Metformin. How long will it take for these to things to kick in and I begin to see some weight loss? Waiting for some results….and trying not to get discouraged.

    • Dr. Davis

      Well, it’s not an all or none situation.

      Just changing to Armour is a start, but the dose may have to be adjusted, which can require weeks to months. However, if you were on the ideal dose to start (unlikely), you should to lose weight almost immediately.

  18. Bethany

    So frustrated. When to my primary to have thyroid panel run and all he did was TSH (2.67) and t4 free (.9). He asked me to call his office after running the tests and just said they are fine and that was it. No, let’s discuss what we can do to fix the issues you are having since you came into my office with complaints. My tsh was 2.0 7 months ago when I had my physical. I had a total hysterectomy in March and wonder if that can have an effect.. I was on WB for 2 months and lost 4 pounds (I have about 60 to lose). I thought when I went to my GP that I would have a panel run instead of just those two tests. So, thinking I was doing the right thing, I went to an APRN and the suggestion was made to return to Zoloft. I am not depressed, I am overweight and can’t lose weight. She did agree to run a thyroid test see if my thyroid has an immune problem and is checking my estrogen, progesterone and testosterone. Sigh … I don’t like to doctor shop but what can I do? Is there a study that shows that 2.67 is not optimal for the TSH. I just found out yesterday that my dad has been treated for hypothyroid disease for years as was his mother. I am 50 and have been overweight since about 32. It has always been written off as depression but I am convinced it could be my thyroid. I’ve slipped the past week or 2 from WB because I am so angry at the doctor for just placating me but will get back to it tomorrow although I’m not sure that the weight will leave as long as I may have an outstanding thyroid issue. Can you provide a list of the thyroid tests that should be run? Also, is there available research that I can print and share with someone in the medical field to try and convince them that this is something I’d like to focus on even thought the numbers are “in range”?

    • Dr. Davis

      You definitely need to “doctor shop,” Bethany. Just as you take bids on a construction job and don’t go with just anybody, so it goes with my colleagues. Your current doctor failed a simple test. Look for a functional medicine doctor.

      Search in for “Hunt study” + thyroid, as well as the many other studies that associate any TSH of 1.4 mIU/L or higher with escalating cardiovascular risk.

  19. jess

    i have hashimoto’s thyroidism, and i was told that you can’t take iodine as it would make it worse. but i tried it anyway and ended up having to take 4 times as must armour as normal. i quit the iodine and eat fish once a week. slowly my need for a high dosage went away. i was down to around 45 mg before i started the wheat diet. i am now taking 30 mg and am trying to see what happens if i cut it in half. why? waiting for a dr. and tests do not work for me. insurance doesn’t want to pay for them that often. also i had so much energy at 30 mg. that i was not tired all day and into the night. but hashimoto’s i understand can swing. so i don’t know what to think.

    have i lost weight? no. do i feel better. 100 percent. my shortness of breath is almost gone, as is my acid reflex which was not something i noticed often, but i can now eat beef again although dr. didn’t know why i couldn’t. i stick to lean beef and very little for now. my b/p went down to normal, which pleasantly shocked me, especially since my dr. thought maybe i needed drugs for it. my indigestion is gone.

    and so now i am cutting out all sugar and lost one lb. but i don’t trust that yet because i get swings in my weight.

  20. I have been wheat free and starchy carb free since Jan. 2, 2013 and have not lost a pound. I have every symptom of thyroid disease and wake from a sound sleep with terrible leg cramps 3-6 times/ night, at least twice a week.. I drink 6-8 20 oz. glasses of water /day, exercise and lift weights 3-4 times a week, take a multi vitamin with fish oil, vitamin D (5000 iu) and magnesium (400mg).
    I have an appointment with Dr. Nickels on April 3 but would welcome suggestions for the cramps before then if anyone has any tips. My tsh last year was 3.15.
    In June I told my doctor my laundry list of issues so she ordered a bunch of tests and told me I look really good for my age(64). The test results were mailed to me without any interpretation just a bunch of letters and numbers and a note saying everything was normal. I have had thyroid symptoms for 5 years and have been to 3 different doctors and keep hearing that I’m fine, its all just part of aging. Really????

    • Dr. Davis

      Since I personally know that Dr. Michelle Nickels is one of the few truly knowledgeable and effective with thyroid, I believe you will find that everything starts to fall in place with her advice.

      For the leg cramps, we use magnesium malate, 1200 mg twice a day. Most magnesium is nothing more than a laxative; you want forms that are absorbed, such as the malate. Many people also need to add back some salt, e.g., sea salt, due to the removal of the sodium-retaining effect of wheat.

  21. Boundless

    > … you can purchase fingerstick test kits …

    Those, however, don’t seem to test for reverse T3 or thyroid antibodies.

    If one wants to press the GP to please test more than just the useless TSH and total T4, what’s worth asking for. It appears that the list is:
    free T3
    free T4
    reverse T3
    thyroid antibodies

    And are there any particular lab providers to seek or avoid?

  22. Jen

    Hi Dr. Davis, I really am grateful for all the info on wheat – your book, this blog, etc. Thank you!

    I’ve heard about issues with iodine deficiency and found kelp powder in bulk (frontier foods) at a natural foods store. I’m hoping that using it occasionally will be helpful. Any idea how much is good/safe to use in this form?

    • Dr. Davis

      In order to know, you really need to know the iodine content.

      I generally advise my patients to get 500-1000 mcg iodine per day.

  23. Elizabeth


    What if you can’t find a doctor to test beyond tsh? My tsh is 2.58- or it was last June. I am overweight, exhausted, can’t think, can’t function, I hurt, and my eyebrows are falling out. My latest symptom is peripheral neuropathy, which is not linked to any other condition. I had a GTT and that was normal.

    How do I find a doctor who will look beyond tsh? Alternatively, one that will recognize that 2.58 is too high???

  24. This is a great checklist. I have Hypthroidism. My doctor figured out that I was producing low levels of thyroxine. I gained weight and was feeling tired all the time. I am now on an all natural thyriod supplement that I use with a strict siet plan. This post was very helpful thanks.

  25. Todd

    Dr. Davis, thanks for this article. While you mention that thyroid issues can stop weight loss from occuring, I thought that I read somewhere on this site (I could be wrong), that stopping wheat and white bread can actually improve your thyroid function, are there any success stories or theories about stopping wheat leading to improved thyroid health?

  26. Anne Ralls

    Hello Dr. Davis,
    I mentioned not losing weight on the WB diet (and feeling really tired when I cut back on calories) and you recommended I read your blog post on thyroid Tune-ups. Thank you for pointing me in this direction. I have many of the other symptoms besides stalled weight loss. I have cold hands and feet; low energy; mental “fog;” increased loss of hair and constipation. I also took my temperature several mornings and it was averaging 96.5. Is that extremely low? I bought some kelp supplements and am taking 600 mcg per day. I am not sure if my current doctor will be open to running just the tests you advise but I plan to ask next week. Is there anything else you recommend a person to do to improve their thyroid with food or herbs or something else?
    Thanks again,
    Anne Ralls

  27. jyoti

    hello doctor davis,
    I am from India, i stumbled upon your blog some time back and it’s like…. everything is falling into place.. like a jigsaw puzzle. i have reduced my wheat intake. being an indian, wheat is a staple, i still managed to reduce to once or twice a week. thanks a lot, i am feeling so much better.
    i got my thyroid tests done. results are –
    Free T3 – 3.03 (ref range 2.30 – 4.20)
    Free T4 – 0.85 (ref range 0.89 – 1.76)
    TSH 4.248 (ref range 0.35 – 5.50)
    please advice what is wrong with my thyroid profile.
    i suffer from PCOD and have been taking low dose combined oral contraceptive pills since many years. i have IBS, anxiety disorder, migraine, sometimes ocd, mental fog, poor memory, and since past few years a lot of stress.
    please advice

    • Dr. Davis

      Great start, Jyoti, though I believe that your success will be far greater with absolute wheat elimination.

      Your thyroid values reflect mild hypothyroidism with TSH sufficient to add to cardiovascular risk. This needs to be addressed by your doctor, hopefully somebody well-informed with an open mind.

      • jyoti

        thank you dr davis. i wish there were more doctors like yourself in all the parts of the world

  28. Cecile

    Before my pregnancy I had gained 20lbs in 6 months. I knew something was wrong so I started eating healthy, counting calories exercising more than I ever did but the weight continued to pack on. I went to my gp and the only thing he tested was my TSH. Since that was normal he didn’t pursue it further. I got pregnant, gained 70lbs without changing my eating habits. Baby was born. Lost 20lbs right away ( she was 9lbs 8 oz and I had undiagnosed hydramnio). She was born November 2011. I have exercised, eaten right, done everything I could bar starve myself and the weight just has been extremely slow to come off. I was a size 14 prior pregnancy and now can’t get below an 18. I was diagnosed with hypothyroidism in April of last year and put on armour thyroid. M energy came back and my basal temp is no longer below 97. My hair is the thickest it’s ever been in my life. I started getting tired again so went to get my levels checked.
    TSH 1.03 range 0.358-3.74
    Free T3. 3.1 range 1.7-5.2
    Free T4 0.8 range 0.7-1.6
    Thyroid peroxidase <10 standard <35

    M doctor said everything looked fine but I still go through phases of exhaustion. I started cutting out gluten 3 days ago and my bloat is gone. However I'm feeling exhausted today. Withdrawal symptoms?
    Anyway am I still considered hypothyroid with these results or in the range?

    • Dr. Davis

      Wheat withdrawal is the most likely explanation, Cecile, this early in your wheat elimination experience.

      However, should they persist beyond, say, 4 weeks, then it is time to reconsider thyroid. Next step: Reverse T3 assessment.

  29. Deb_AK

    I am a 55 year old postmenopausal woman who had my thyroid removed 20 years ago and went through radioactive iodine treatment – I’ve been on Levoxyl or Synthroid since the surgery. I currently weigh 168 pounds at 5’5” with an ideal weight of 140. Moderately active.

    I’ve been on the Wheatbelly diet since the beginning of January, and have lost only 2 pounds so far. No cheating – staying extremely dedicated to the diet. Thinking the lack of weight loss was due to my thyroid medication, I asked my physician for the below thyroid tests to be run, with the following results:
    TSH – 0.144
    Free T3 – 3.0
    Free T4 – 1.60
    Reverse T3 – 25.0
    TPO – 9
    Antithyroglobulin – <20
    (Price tag: over $1,000 through my physician's office. Still working on my deductible…ouch!)

    Since my TSH levels were so high, my physician lowered my Levoxly from 125 mcg to 112 mcg. Since my T3 results were within the normal range, she didn’t think I needed to switch to Armour.

    After reading the other reasons stated on this blog for stalled weight gain, I'm guessing it's either adrenal or dairy products as I do eat cheese and drink non-fat milk occasionally. Any other possibilities?

    Thank you in advance for your help…

  30. Sally Ann Quinn

    Dr Davis, I have just received my bloodwork and go into discuss tomorrow. I’m so confused at how dramatic the changes are. I switched from 125 mg Synthroid to 65 Amour 2 1/2 months ago after seeing no results from the synthroid, in Fact getting worse being on lexothor then Syntroid for a combined 12 years. The first month seemed fine. I have also been grain free, soy free for about 4 months now. Tis past month, I am waking up at 3:30 every morning with a racing heart and feel like I’m so toxic. This racing lasts up to 4 hours before settling down. I cannot lose weight to save my life. Here are my numbers:

    Jan 10′ 2013 results
    TSH .552
    T3. 2.6
    T4. 1.89
    Pregneolone. 33

    April 4, 2013 Results

    TSH 6.140
    T3. 2.1
    T4. .75
    Reverse T3. 11.4
    TPO. 41
    Pregneolone 52
    RBC. 5.40.
    Hemocrit 47.9
    Carbon dioxide 17L

    What does this mean that my TSH is now so high and T4 so low. Iodine deficiency? I do have Hashis and mild adrenal fatigue from my saliva test. Been taking 500 mg kelp and a natural adrenal supplement for 3 months.

    Any advice would be great. This racing heart is scaring me. It is better if I take only half my dose off Armour, it afraid that I’m screwing up my system more. I see my dr tomorrow.


    • Dr. Davis

      This is getting way beyond the scope of what we can manage on a blog, Sally. But I can make a few observations:

      1) Whoever switched you from levothyroxine to Armour was way off on the dose conversion. The Armour equivalent is 90-120 mg per day (1 1/2 to 2 grains). Since the dose chosen was too low, you are now substantially hypothyroid.

      2) The symptoms you are experiencing sound like excess T3, but your T3 is actually quite low. It could be that you are just very sensitive to T3 and the restoration of T3 needs to proceed slowly and/or adrenal dysfunction needs to be corrected alongside your thyroid.

      3) And you have some sort of acidosis (acid-base disturbance). This can signal something else wrong that really needs to be addressed.

      • Sally Ann Quinn

        Thank you Dr. Davis,

        So, would you suggest I have my gal increase the dosage tomorrow or do I need to build up to that level? What is an acid based disturbance?

        I am taking an adrenal supplement as my morning and noon levels were off.

        Thanks for any advice you can offer. I’m a little scared about how to proceed…

        • Juliane


          I’m hypothyroid and when I started I found a doc to switch me from Synthroid to Armour. Your doctor is not treating you properly. In making the switch he needs to follow the conversion chart from Synthroid to Armour and then monitor the results monthly (with labs and how you are feeling) until you both arrive at a dosage where you are feeling better and labs look better.

          If you are not feeling well it is always a sign that something is off with the dosage. Your doc and you need to be on the same page when treating hypothyroid.

  31. Lucky

    After a terrible recovery time AFTER my thyroidectomy, I am finally being treated well with a combo of Snythroid 137mg + Cytomel 5mg 2x a day… Now that I am beginning to feel a bit stronger, I am ready to take it to the next level in my trip back to my former healthy self. This article is spot on, in all points, and (sadly) so true in my turbulent experience with the endocrine community. Our health is in our own hands. And, finding an integrative doc who was sympathetic, thorough, and knowledgable has made all the difference for me.
    I greatly appreciate your words and expertise. Thank you for confirming what I know I must do to live my happiest (new) lifestyle. Wheat Free will be for me!

    • Dr. Davis

      That’s great, Lucky! And the answers can be so simple, though so elusive when we rely on conventional thinking!

  32. Tina

    Dr. Davis

    I have been wheat and gluten free since February 4, 2013. I initially felt bone pain that went away. I have not lost any weight. I went to my doctor who checked my hormone levels. They were “normal”

    TSH 1.57
    T3 2.66
    T4 0.95

    She sent me to an endocrinologist who tested more – and cortisol levels which were normal. Told her I was gluten and wheat free. I avoid all processed foods and eat a clean and mostly organic diet. She prescribed a “diet pill”. Went back to general practitioner. She prescribed low dose of synthroid 25mg. Been on this for three weeks and absolutely hate it. Feel depressed, tired, etc. and still have lost no weight. I am not taking the “diet pill”
    I was going to go to a natureopath – but very expensive and they said they have to take all the blood tests again. i just can’t afford it right now, and I just feel lousy.

    I have been told that I am going thru an early menopause – I am 46.

    Any suggestions???

  33. Tammy Hall

    Dr. Davis,
    I have autoimmune graves. I am HYPERthyroid and have been for several years. I am a 41 year old female. My endo put me on methimazole. I have experienced weight gain from 145 to 165 now i’m at 195lbs, 5.3 height and lost most of my muscle mass. 47.5″ hips, 43.5″waist, 14.75″ arms & 28.25″ thighs. I mostly have a sedintary life style as i work at my desk for 8 hours. I’m tired when i get up and all thru the day no energy at all. I have the brain fog/forgetfullness. Mood swings from angel to demon and back in 2.5 seconds. I have osteoarthritis and bone spurs. My body hurts all over. I get out of breath walking to and from my car and the smallest amount of stairs. I have been told that i have IBS, poly cystic ovaries, blood in urine that drs can’t determine where it’s coming from, anemic and low vitamin D/calcium. I hate feeling miserable, tired and fat. I started reading your book and am attempting to go wheat free since Saturday 1/13/13. I love pasta, and breads, and sweets. I am not to big on meats or veggies but i’m trying and i hope that this works for me. So far i think im having withdrawls from no wheat. Headaches and tired (more than ususal). Any suggestions would be greatly appreciated.

    • Rhonda

      Hang in there, Tammy. You can do it. Just cut it all out and try to tough out the withdrawal. Mine lasted 3 weeks and it was terrible-it you have any time off you can take, do it, even one or two days so that you can nap if you need to. On Day 22, I woke up and it was over-felt better than I have felt in over 15 years.

  34. Tammy Hall

    My endo is angry with me. He wants me to do RAI to kill off thyroid gland and i don’t want to. He increased my meds which made me feel depressed. I lowered the dosage on my own and thyroid levels went into what he calls the normal range. He said what i was doing was working, to take the methimazole however i wanted. I quit taking them about two months ago but symptoms of hyper are back now.

    • Dr. Davis

      I know of no way to become wheat-free and reap all the tremendous potential benefits except . . . go wheat-free! Just as an alcoholic must go alcohol free and endure the withdrawal, so it goes with wheat, too.

      It sure sounds like you’ve got a knucklehead for an endocrinologist (95% of them are, after all!). Have you considered consulting with a functional medicine practitioner and the heck with endocrinologists? If you require some thyroid insight beyond what can be provided by a functional medicine practitioner, then ear-nose-throat specialists can be helpful, much more so than ignorant endocrinologists.

      • Tammy Hall

        It never crossed my mind to check with an ENT and i have never heard of a Functional medical practitioner, until now. I had a drs appt yesterday after work. I thought it was the graves flaring but it was my blood pressure. They started me on bp meds. My b/p was 160/90, i have been dizzy with headaches. I will definitely look into those types of doctors. I’m willing to do what it takes to feel normal again. Still wheat free ;))). My family is very supportive. They are eating the healthy meals that i cook and enjoying them. My children and husband are asking questions now like,”does this have wheat in it?” and “is this ok to eat?” Im so excited to see the changes, not only in me but in my family.
        Thank you so much for your book and your time.

  35. As a recently diagnosed hypothyroid, and someone who has a family history of R.A., osteoporosis, arthritis, bursitis, stenosis, and heart disease, I am trying to clean up my diet. I am trying to be wheat free in a house fill d with wheat lovers. My husband is the biggest offender, buying white pasta because it’s cheaper. Friends at work don’t quite understand either because I have not been diagnosed with celiac. Thank you for your information.

  36. Amy Rock

    Dr. Davis,
    I would like to thank you for this blog and for the time you have taken to answer others’ questions…I have learned so much from you!
    I am 34 years old and have been taking synthroid for the past 20 years (steady at 75mcg for the last 5 years). My new doctor ran a complete panel and found that I have Hashimoto’s. He is not changing my current synthroid dosage, but instead suggested that I pursue a gluten free diet (which led me to you!) I am committed to the wheat-free diet, but I am still quite concerned about my numbers.

    If you had a moment to look at my panel results and offer any additional advise, I would appreciate it beyond measure!!!!!!!! Thank you in advance, Amy R.

    Free T4 1.15
    Free T3 3.0
    TSH 10.700 — this number concerns me!
    Thyroid Peroxidase Ab 744

    • Dr. Davis

      Hi, Amy–

      Your TSH suggests flagrant undertreatment of your thyroid, sufficient to quadruple–quadruple–cardiovascular risk. In other words, your degree of hypothyroidism is sufficient to actually add to long-term mortality. Eliminating wheat/gluten, while powerful, usually does NOT result in a reduction in TSH into the ideal range (<1.0 mIU).

      It means that 1) you need to insist on better treatment of your thyroid that starts with an increase in your T4 intake (i.e., Synthroid), and 2) INSIST that adding the T3 thyroid hormone be considered either by changing to a combination tablet, such as Armour thyroid or Naturethroid, or adding T3 as liothyronine.

      Thankfully, it sounds like you’ve got an open-minded physician, despite the flagrant neglect of your thyroid status.

  37. Lady Tate

    What a book, blog, and what an unexpected phenom!! I am 57 and have a TCH reading of just over 10. With all of the classic signs of thyroid (hypo), I’ve recently begun medication (125 Lex). I am suppose to utilize the treadmill to help lose my 50 excess lbs. and I am too fatigued and feeling only like resting most of the time. A month ago, I’d get breathless changing my clothes or making my bed. I gave up wheat for a mere 5 days, and could walk up the stairs with ease (even my knee pain was missing)! Then I ate Fetticini Alfredo for dinner and yikes! It took 3 days to get back to being ok again….. I am stunned!! Dr. Davis has been very wonderfully forthright in his pursuit of this important problem, and I enjoy reading the blog; and I’ve a question: I am so wishing to get my concentration and energy back, that I sought online for something to remedy the awful fog and persistent inertia…. an amphetamine called Adderall is reviewed most favorably, and I am hoping that my doctor will prescribe it for me, as I really want to try it! I cannot tolerate caffine pills any longer (very rough on my system), but I feel so down physically, and even my mind seems tired-out! I want to get energized and be smart, and clear mentally too, but my entire body/mind is just bogged…. this is a ridiculous state to be in! It is as though I am elderly…. could Adderall possibly help me out?

    • Dr. Davis

      Wow. Before you go down the path of Adderall, I would strongly urge you to:

      1) Get rid of your current doctor.

      2) Insist that your T3 thyroid hormone be assessed and likely replaced. You are getting only the T4 thyroid hormone (levothyroxine). I would bet you a dollar that your problem is not ADHD as much as it is deficiency of the T3 thyroid hormone, but you will need a better-informed doctor to get this accomplished.

      • Lady Tate

        Thank you for the advice, and I will certainly be discussing this with my doctor. He may be more than willing to proceed with the T3 . My spark is missing, and I thought that Adderall might provide a stimulus.

  38. Anthony D

    Dr. Davis I gave up wheat a year ago based on your book and feel great but didn’t lose the weight. I recently had my blood work done and here are my results.

    T3 free 3.2
    T4 free 1.20
    TSH 2.020 up from 1.640 5 months ago

    I suspect my TSH might be responsible for the stalled weight loss


  39. jo

    Dr D because of you I was able to finally get my Hashimotos diagnosed after 16 years of them telling me mine was fine . But my Question to you is I started Armour Nov 12 and I am now on 90 mcgs but what I noticed looking over labs is that my Free T4 is lower now then it was before taking thyroid meds and my Free T3 has moved up from 2.5 to 2.7 Why would my T4 go down ?

    • Dr. Davis

      This can happen and is usually harmless when you are taking a preparation, such as Armour, that contains T3. It has to do with a feedback loop when the real form of thyroid hormone (T3) is being supplemented.

      16 years? Wow. I hope you aren’t still seeing the same blundering doctor!

  40. Ellen

    Dr. Davis
    I have been on Armour 90 mgs for 1 year they added 5 mcgs of T3 in August . My labs just came back and my FT 3 & 4 numbers were lower then they were a year ago before starting thyroid meds !! Why would this be happening ?
    Can I wean myself off of this medicine since it is to helping anyway ?

    • > … would elimination of wheat be helpful for gout?

      It has been reported by users on this blog. Favorable outcomes are unsurprising, particularly if you follow the WB guidelines, and replace the removed wheat with fats and non-starchy carbs, rather than high glycemics. Also, reduce fruit intake and zero-out added fructose altogether (as it leads to uric acid).

      For anyone who might already be obese and have gout, eliminating the wheat has multiple benefits, because obese commonly have a bacterium that converts fructans to fructose. The primary dietary source of fructans? Wheat.

  41. WannaGetWell

    There are some doctors out there with really interesting perspectives. Years ago I had gotten to the point that I had to lie down on the couch when I got home from work–couldn’t even make it to the bedroom to change clothes. Went to a doctor who tested TSH (it was over 20) who said “that was certainly a lab mistake,” and then to another who said “I don’t diagnose non-specific symptoms like ‘no energy’,” I finally found a doctor who diagnosed hypothyroidism. That was nearly 20 years ago. As I’ve gotten older, my TSH would rise and then my dosage of levothyroxine would be raised. My current PCP was really happy with his treatment that kept my hypothyroidism “well-controlled” (as defined by the TSH) despite the fact that I was depressed, still losing eyebrows, mid-day temperature running 96-97 degrees, brittle nails, cholesterol elevated, and the like. My lack of initiative has really put me in fear of, if not losing my job, making it difficult for me to progress in my career.

    After I started being wheat-free, grain-free, and low carb (under 25 per day), I didn’t lose any weight. I read all the information Dr. Davis provided about thyroid and did some independent research. Armed with data, I went to my doctor’s appointment and told him about my inability to lose weight, despite the fact that I’d eliminated wheat, grains, carbs, sugar, and was regularly exercising. I asked about T3 and he said “that won’t help.” He went on to explain how the T4 I’m taking works and all is well in the world since my TSH was 1.71.

    Thanks to Dr. Davis’ checklist, I went out on my own and got Free T3, Free T4, and RT3 tests which showed that my T4 was high, T3 was low, and RT3 was very much elevated. The ratio of Free T3 to RT3 was over 25!

    Yesterday I saw an endocrinologist who took one look at the test results I ordered and said, “we need to introduce T3 along with your levothyroxine. You have tissues that are starved for T3.” I was so relieved. I didn’t even have to show him the results of my literature search. I just started to take the T3 along with a reduced dosage of T4. It is amazing that my next labwork orders include Free T4, Free T3, thyroid antibodies, adrenals (serum cortisol and DHEA, whatever that is). He didn’t even order a TSH test. Wow. I had not been hopeful, based upon my own experiences with internal medicine doctors and the posts here about many endocrinologists.

    Now I have some hope. Too early to tell yet how effective it will be, but I feel as if I may be on the right track now.

    • Dr. Davis

      Wow! You found an exceptionally rare thing in this world: an open-minded endocrinologist!

      Please come back in a few weeks and update us on your progress. I predict wonderful things as your T3 dose is adjusted to the ideal range.

  42. WannaGetWell

    Dr. Davis, thanks for your information–I would never have known anything was amiss (except how I feel) without it. And I wouldn’t have realized it was possible for me order lab tests on my own and challenge my PCP with the results.

    Incidentally, I found my new endocrinologist on prescriber checklist (which I learned about from a post on the Wheat Free Forum). Looked for one that had T3 and Armour Thyroid in his top prescribed drugs. I just looked you up and saw that your number 1 is T3 and Armour is also on your list.

    Thanks again!! Will keep you all posted.

    • Jeanne

      Hello, I am trying to find a doctor in my area that prescribes T3 and am on the web site mentioned. I input a doctor but where does it list the drugs prescribed?? Please reply

  43. Julie

    Wondering if you would entertain interpreting more results:

    T3= 2.8
    TSH= 0.52
    T4= 0.99

    Doctor believes this is normal. Friend reports they look low from her experience. I have no clue how to read.


  44. Hechy

    I am seriously wondering if the low carb diet has caused my thyroid problem. I never had a thyroid problem and up to a couple of weeks ago I did not have the symptoms. I have been wheat/grain free for a couple of months and then decided to restrict my carbs to 30gr a day a couple of weeks ago. So I took out the almond breads/pizza’s and such. Now only eating vegetables, eggs, cheese, meat and fish. I suddenly started experiencing hot flashes at night, a constant feeling that I have drunk too much coffee, and fatigue. On top of that I noticed I had much more hair loss then usual. I went to the doctor for a blood test. I was informed last Friday that I have lower Thyroid values (I didn’t get the values) and that they would do another test in 6 weeks time. My sister who started the diet with me a couple of months, also experienced the same things in the last couple of weeks when we went low carb (max 30gr carbs). By doing some research I do think that the symptoms are caused by the radical decrease in carbs. That does not seem to be working well for everybody. I will therefore increase my carb intake again and see if the symptoms dissapear and then gradually decrease it again.This is one of the sites I found: “”
    What do you think Dr. Davis?

    • Dr. Davis

      There can be a relative increase in iodine need with a reduction in carbohydrates.

      For this reason, I have all of my patients supplement iodine, 500 mcg per day, from kelp tablets or other iodine supplement.

  45. Valora

    TSH 2.1 up from .86 1/2013…T3 is 2.3, T4 is 1.3. Endo is saying this is in normal range. Even though I’ve been on Wheat Belly diet for 8 weeks with no weight loss.

    • Dr. Davis

      You have marginal hypothyroidism, possibly impaired 5′-deiodinase conversion of T4 to T3.

      Expect absolute ignorance or resistance to this notion from your endocrinologist. Find yourself a functional medicine practitioner or naturopath, someone more openminded and better read in the new arguments on thyroid health. Sadly, this almost never comes from the drug pushers who work for the drug industry called endocrinologists.

        • Faye

          I am also happy to say that the endocrinologist I chose does not even check TSH. Only Free T4 and Free T3 (and thyroid antibodies, for a data point–she suspects I have Hashimoto’s).

      • Valora

        Thank you for your response…I am impressed you take the time to address the comments/concerns. I asked my endocrinologist to consider a trial on some thyroid meds, she said there are too many side effects to treat someone with normal lab results. I should add I have TI Diabetes…this complicates things. I have read Dr. Bernstein’s Diabetes Solution and have adapted the Wheat Belly diet accordingly but with no weight loss; in fact I gained 3 lbs. Very discouraging as I only want to drop 10-20 lbs; I am 51, 5’4″ and 146# so, menopause is complicating things, too. I am not sure what else I can do, my endo has no answers for me in regards to what else I can do to loose weight, which I find disappointing. Seems as though I am more than lab results…I am going to search for an additional provider who will treat me as a whole. Thanks for your time, Dr. Davis.

  46. After a few years of suffering and poor responses from GP and EndoPrats – I had many symptoms including low body temps, fatigue, weigh gain, thinning hair and eyebrows, low mood etc etc – but the usual ‘normal’ TSH – I did my own research and now self treat on T3. Using support of Thyroid Patient Advocacy and seeing a private (unfortunately no longer under the General Medical Council) Dr Peatfield diagnosed. I now wake albeit briefly around 3am and pop a T3 pill under my tongue and go back to sleep. This helps with the circadian/cortisol and when I awake I no longer feel dreadful, many of my symptoms have gone and although I still have some weight to lose, I hope going wheat and gluten free and introducing things like coconut oils and flours etc will help.

    why are so many people allowed to suffer this awful thing? How can someone in one country be diagnosed and treated at TSH 2 and in another (UK) over TSH 5 and in many cases holding back till people hit TSH 10.

    I work with people over 65 in social care and when I do assessments I am seeing a lot of hypothyroid listed in their med notes – along with atrial fib and other health issues – not least dementia which I think could be prevented by proper diagnoses and use of things like T3, Natural Desiccated Thyroid etc – scary to be at the mercy of un-co-operative medical profs who are unbending and blinkered.

    So – despite presenting at my GP saying look at me now after taking T3 they still would not prescribe me T3 – very telling how much they are controlled b the bigger so called health bods!

    Your website has been a brilliant education for me, I will use it as a resource to help me back to even fuller health.

    Thank you.