Many people feel unwell with a TSH of 4.0 to 5.0, even though its technically normal. Optimal thyroid function involves: TSH is between 0.52.5 mIU/L (some doctors and patients prefer a level below 2.0) Free T4 is in the upper half of the reference range Free T3 is in the upper half of the reference range Low or absent symptoms of hypothyroidism, such as fatigue, hair thinning, constipation, cold intolerance, or depression In autoimmune thyroid disease (Hashimotos), its also helpful to monitor thyroid peroxidase (TPO) antibodies and support the immune system with selenium, vitamin D, and lifestyle changes to reduce inflammation
Patients with mild to severe hepatic impairment, those using concurrent OATP1B1 inhibitors, or those who cant tolerate the 100 mg dosage are advised to use eluxadoline 75 mg twice daily (61)
And if you dont have the morning sunlight, youre going to have your mornings full of suboptimal energy metabolism that is initiating that vicious cycle of aging
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Postgrad Med 2010;122:1627
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