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Testing Thyroid Function Thyroid Testing and Bioidentical HRT in Anti Aging

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The Carlton Clinic
Richard Snouffer, MD
1713 Hamric Dr. East, Suite B
Oxford, Alabama  36203

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Testing Thyroid Function

A good handle on thyroid function may be obtained easily at home by testing your basal temperature.  Basal body temperature is tested first thing in the morning, right after you awaken, but before you move around much or get upright—even just for a second.  Upon awakening, take the covers off without sitting upright.  Wait 5 minutes, moving as little as possible, and test your temperature either under the armpit with a standard medical thermometer or over an artery with an arterial thermometer.

Normal temperature is reported in the range of 98.6 degrees F.  However, this is just an average.  Every day it is normal for your body to fluctuate a bit around this average.  Higher than normal range temperatures (99.6 or higher) can be due to fever (although technically, fever starts at 100.4 degrees F), but higher temperatures are usually due to local inflammation. (perhaps a sinus infection if you are measuring an oral temperature, etc.)  However, your temperature should not be less than 97.8 deg. F.  Less than 97.8 indicates a state of low metabolism.  This is nearly always due to a low thyroid state. (hypothyroidism)

For testing basal body temperature, Dr. Snouffer recommends the Exergen arterial thermometer, used on the carotid artery.  This gives an accurate temperature, but usually avoids artificial local elevations of temperature caused by severe arthritis, other local inflammatory processes or sinus disease (etc.) which may artificially elevate the reading.  If the temperature is artificially elevated, a hypothyroid person may be fooled into thinking their temperature is normal.


Although one should get a panel of laboratory tests, not just an isolated thyroid indicator, the single most important test to assess thyroid function is the free-T3.  It is the free portion of the T3 floating around in the fluids of the blood that is the single most important test of thyroid function.

Most physicians only test total-T4 and TSH when they suspect thyroid disease in a patient.  This is unfortunate.  T4 is only a transport molecule and have very little activity in terms of being able to regulate cellular metabolism.  Multiple studies have shown TSH to be a very poor indicator of thyroid malfunction.  So why do they do this?

The first answer is easy.  That is the way we are trained in medical school.  Decades of over-reliance on laboratory tests, even when it flies in the face of our patients’ symptoms, have produced generations of doctors who do these tests and tell you that, “You are normal, you just need to eat less,” or, “You are normal.  You are just getting old.” 

The second answer is less palatable.  Insurance companies make it difficult for physicians to obtain the proper tests.  Even if the insurance companies let your doctor test a T3, they usually only allow the TOTAL-T3, and then only if you had an abnormal T4 or TSH in the first place.  Total-T3 includes both T3 that is free to leave the blood stream and regulate your cells’ metabolism, and T3 that is bound to proteins in the blood, which is not seen by the body’s cells and does not help metabolism.  Because it shows a significant portion of T3 that does nothing to regulate your body’s metabolism, the total-T3 can be misleading.

If an attempt is made to obtain the free-T3 test through insurance, it is often denied.  When this happens, the fee the patient gets charged is much higher than if they had just gone ahead and paid for the test at a cash rate through discount testing companies. 

The Carlton Clinic evaluates the free-T3 test in addition to the standard thyroid tests in your evaluation.  Dr. Snouffer will be glad to work with you to get this test and all tests you need for your anti aging or other consultation as economically as possible.  We then use this information, in combination with your history, symptoms and records from your regular physicians to integrate a more complete picture of your thyroid health and (if warranted) the need and efficacy of replacement.

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The Carlton Clinic
1713 Hamric Drive East, Suite B
Oxford, Alabama  36203