Beyond "your labs look normal".
Full thyroid panels, medication dosed for how you actually feel, and real attention to Hashimoto's and underlying causes — not just a TSH number that gets waved off as fine.
How thyroid disorders are treated here
Complete Testing
TSH, Free T3, Free T4, and antibody testing — not just TSH alone.
Dosed for How You Feel
Optimal medication dosing, including T3/T4 combination therapy when appropriate.
Hashimoto's Care
Care for the full range of Hashimoto's effects — fatigue, hair loss, weight changes, and mood — not just the lab number, plus antibody and nodule monitoring.
Root-Cause Support
Medical acupuncture, nutritional optimization (selenium, zinc, iodine), and addressing stress, gut health, and inflammation.
Common thyroid conditions we treat
Thyroid disease covers several distinct conditions, and getting the right one identified — rather than treating every abnormal TSH the same way — is the first step to actually feeling better.
Hypothyroidism
An underactive thyroid that doesn't make enough hormone, causing fatigue, weight gain, cold intolerance, hair thinning, constipation, and brain fog. The most common thyroid disorder we see.
Hyperthyroidism
An overactive thyroid producing too much hormone, causing rapid heartbeat, anxiety, unintended weight loss, heat intolerance, and tremor. Graves' disease is the most common cause.
Hashimoto's Thyroiditis
An autoimmune condition where the immune system attacks the thyroid, gradually causing hypothyroidism. The leading cause of underactive thyroid in the U.S., often missed if only TSH is checked.
Nodules & Goiter
Lumps or overall enlargement of the thyroid gland, usually benign but requiring monitoring — and sometimes ultrasound or biopsy — to rule out concerning changes.
How we test your thyroid
A TSH-only test is where most thyroid problems get missed. TSH is a pituitary signal, not a direct measurement of the thyroid hormone your cells actually use — so it can look "normal" while you still feel far from it. We run a fuller panel so problems don't hide behind one number:
- TSH (Thyroid-Stimulating Hormone): the pituitary's signal to the thyroid — useful as a starting point, but not the whole story
- Free T4: the storage form of thyroid hormone circulating in your blood, ready to convert to the active form
- Free T3: the active hormone your cells actually use — often skipped by labs that only run TSH and T4
- Reverse T3: an inactive form that can build up under stress or illness and block T3 from working, even with normal TSH
- TPO and thyroglobulin antibodies: markers of autoimmune activity that confirm or rule out Hashimoto's or Graves'
- Thyroid ultrasound: ordered when a nodule or goiter is felt on exam, to characterize its size and features
You don't have to just live with "normal" labs.
Most new patients are seen within a week, in person or via telemedicine.
Thyroid medication options, compared
There's no single "right" thyroid medication for everyone — the best option depends on your labs, your symptoms, and how your body converts hormone. We discuss these options together rather than defaulting to whatever's cheapest to prescribe.
Levothyroxine (Synthroid)
Synthetic T4, the standard first-line treatment. Works well for most patients whose bodies convert T4 to T3 efficiently on their own.
Liothyronine (Cytomel)
Synthetic T3, sometimes added in small doses alongside T4 for patients who still feel fatigued despite a normal TSH on T4 alone.
Combination T3/T4 Therapy
A T4 medication paired with a T3 medication, dosed individually — an option when T4-only treatment leaves symptoms unresolved.
Natural Desiccated Thyroid
Armour Thyroid and NP Thyroid, derived from pig thyroid gland, naturally contain both T4 and T3. Some patients feel better on NDT than synthetic T4 alone, though the T3:T4 ratio is fixed rather than individually adjustable.
Whichever medication you start on, dosing is adjusted based on repeat labs and, just as importantly, how you actually feel — fatigue, weight, mood, and hair and skin changes all factor into whether a dose is truly optimized, not just "in range."
Related services that support thyroid health
Chronic Disease Management
Thyroid disorders often travel with other chronic conditions — we manage them together, not in isolation.
Learn moreWeight Management
An underactive thyroid can make weight loss feel impossible even with real effort — we address both together.
Learn moreWomen's Health
Thyroid disorders are far more common in women, and can affect periods, fertility, and menopause symptoms.
Learn moreThyroid care questions
What thyroid tests do you run?
Full thyroid panels, not just TSH — TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies (TPO and thyroglobulin), to get the complete picture rather than one number that can miss real problems.
Why do I still have symptoms if my TSH is "normal"?
We optimize thyroid levels based on how you feel, not just lab ranges. You might have low T3, high Reverse T3, or thyroid antibodies that aren't being addressed by TSH alone — treatment is adjusted until you feel better, not just until a number looks fine.
What's the difference between T3 and T4 medication?
T4 (Synthroid/levothyroxine) is a storage hormone that converts to T3, the active hormone. Some patients on T4-only medication still feel tired because they don't convert well — adding T3 or switching to combination therapy often helps.
Is Armour Thyroid better than Synthroid?
Neither is universally "better" — they work well for different people. Synthroid (levothyroxine) is pure T4 and lets us adjust your dose precisely; Armour Thyroid is natural desiccated thyroid with a fixed T4:T3 ratio, and some patients who don't feel well on T4 alone do better on it. We help you weigh the options based on your labs and symptoms rather than assuming one is right for everyone.
Do you treat Hashimoto's thyroiditis?
Yes. Hashimoto's causes far more than a high TSH — it can bring fatigue, hair loss, weight gain, brain fog, dry skin, and mood changes. We optimize your thyroid hormone levels and treat that full range of symptoms and complications, while monitoring your antibody trends and any thyroid nodules over time — rather than fixating on a single number.
How long until I feel better after starting thyroid medication?
Most patients notice initial improvement within 2–4 weeks, though it can take 6–8 weeks for a dose to fully take effect and show accurately on repeat labs. Getting to your truly optimal dose is often a gradual process of small adjustments, not a single prescription.
Can you help if my current thyroid medication isn't working?
Yes. We run comprehensive testing to identify why treatment isn't working — poor T4-to-T3 conversion, nutritional deficiencies, undiagnosed Hashimoto's, or the wrong dose — and offer synthetic T4, T3, combination therapy, and natural desiccated thyroid as options.
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