McCall McPherson describes three patients with low T4 but normal T3, showing a pattern of morning grogginess that improves after medication, mid-day crashes between doses, and evening energy dips. Low T4 also causes hair loss and metabolic problems, even when T3 stays normal.
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I saw three people in clinic today that had the same thyroid issue. I figured I'd talk about it because it's not one we talk about often. So we so often talk about too little T3, too much T4. But I want to talk today about not enough T4. T4 is your inactive thyroid hormone. T3 is your active thyroid hormone. I saw three patients today whose T3 looked fantastic, but their T4 was too low. And that manifests in, in the following way. In those cases, people tend to ride the waves of their T3 based medication, meaning if they take it in the morning, when they wake up in the morning, they're tired, they're groggy, they can't wake up until they take their T3 or their thyroid medication, and then they start to perk up. If they take an afternoon dose as well, often they dip in between those two doses, perk back up after their afternoon dose, and then crash and burn in the evening. So super, super common. Also, they tend to have issues like that are impacted by chronic need for thyroid hormones like hair loss, metabolism, hormone production, those sorts of things. So I figured I'd give you guys a little perception of the opposite of what we normally talk about and what it looks like when you don't have enough T4 because you do need T4.
