Thyroid
Disorders Your thyroid affects everything.

Comprehensive thyroid evaluation and ongoing management for hypothyroidism, hyperthyroidism, and thyroid nodules including regular lab monitoring and medication management tailored to your levels and how you feel.

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More Than a TSH Thyroid Management That Accounts for You

Thyroid disorders are among the most common endocrine conditions in primary care and one of the most frequently undertreated when physicians treat a lab value rather than a patient. At Superior Health Medical & Wellness, Dr. Akers evaluates thyroid function comprehensively, interprets results in the context of your symptoms, and adjusts treatment based on how you actually feel, not just where your TSH falls within a reference range.

Whether you have been told your thyroid is normal but continue to experience fatigue, weight gain, hair loss, and cognitive fog, have known hypothyroidism that is not adequately managed, or have newly developed hyperthyroid symptoms, Dr. Akers provides thorough thyroid evaluation and individualized ongoing management.

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Thyroid Disorders at Superior Health
Thyroid Disorders What We Manage

Thyroid management at Superior Health is thorough and individualized. Dr. Akers evaluates the full thyroid picture rather than relying on a single TSH value.

Hypothyroidism involves inadequate thyroid hormone production, producing fatigue, weight gain, cold intolerance, constipation, dry skin, hair loss, depression, and cognitive slowing. Dr. Akers diagnoses hypothyroidism using TSH, free T4, and free T3 when clinically indicated, and manages it with levothyroxine optimized to your symptom response.
Hashimoto thyroiditis is an autoimmune condition and the most common cause of hypothyroidism. Thyroid peroxidase antibodies confirm the autoimmune etiology. Dr. Akers evaluates for Hashimoto when hypothyroidism is present and monitors antibody levels as part of ongoing thyroid management.
Hyperthyroidism produces weight loss despite increased appetite, heat intolerance, palpitations, tremor, anxiety, and insomnia. Dr. Akers evaluates using TSH, free T4, and T3, identifies the cause, and manages symptoms while coordinating definitive treatment with endocrinology when indicated.
Many patients taking levothyroxine have normal TSH levels but continue to experience hypothyroid symptoms. Dr. Akers evaluates whether T3 levels are adequate in addition to TSH and adjusts levothyroxine doses based on the full clinical picture rather than just a TSH within a wide normal range.
Subclinical hypothyroidism and subclinical hyperthyroidism represent early or partial thyroid dysfunction. Dr. Akers evaluates whether treatment is appropriate based on symptoms, degree of TSH abnormality, cardiovascular risk, bone density concerns, and reproductive goals.
Thyroid nodules are found in up to 50 percent of adults on imaging. Dr. Akers evaluates thyroid nodules using risk stratification based on size, ultrasound characteristics, and clinical factors, and coordinates specialist referral for biopsy when indicated.
Patients with a history of treated thyroid cancer require ongoing surveillance including thyroglobulin monitoring, periodic neck ultrasound, and TSH-suppressive levothyroxine therapy. Dr. Akers coordinates ongoing surveillance in collaboration with the endocrinologist or oncologist.
Thyroid function changes significantly during pregnancy, with increased hormone demands and shifts in normal reference ranges. Dr. Akers monitors thyroid function carefully during pregnancy and adjusts levothyroxine dose to maintain TSH within pregnancy-specific targets.
Both hypothyroidism and hyperthyroidism significantly affect cardiovascular health. Hypothyroidism raises LDL and increases cardiovascular risk. Hyperthyroidism increases heart rate and raises arrhythmia risk. Dr. Akers manages thyroid function with cardiovascular implications in view.
TSH and free T4 should be checked six to eight weeks after any levothyroxine dose change and then annually once stable. Dr. Akers establishes a personalized monitoring schedule and adjusts therapy promptly when labs indicate the need for a dose change.
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Why It Matters Why Thyroid Management Needs to Go Deeper
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01 TSH Alone Does Not Tell the Full Story

A TSH within the normal range does not mean your thyroid function is optimal for you. The reference range is broad and based on population distributions. Many patients with TSH values in the upper half of normal experience significant hypothyroid symptoms. Dr. Akers evaluates free T4 and free T3 alongside TSH.

02 Thyroid Affects Everything

The thyroid regulates metabolic rate, body temperature, heart rate, mood, cognition, skin and hair quality, bowel function, fertility, and bone density. When thyroid function is even mildly inadequate, virtually every system in the body is affected.

03 Optimization Requires Personalization

Optimal thyroid management varies from patient to patient. Some patients do best with TSH in the lower half of normal. Others with persistent symptoms on T4 alone improve with the addition of small amounts of T3. Dr. Akers adjusts management to your individual response.

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Understanding Thyroid Function How the Thyroid Regulates Your Metabolism

The thyroid produces T4 and T3. T4 is the primary secretory product and is converted to the more metabolically active T3 in peripheral tissues. TSH from the pituitary drives thyroid hormone production. When thyroid output is low, TSH rises to stimulate more production.

Conversion of T4 to T3 in peripheral tissues can be impaired by chronic illness, caloric restriction, and certain medications, producing low T3 levels and hypothyroid symptoms despite normal T4 and TSH. This is one reason some patients with normal thyroid labs continue to feel hypothyroid.

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Thyroid Medication Management Getting Your Thyroid Medication Right

Levothyroxine should be taken consistently at the same time each day, ideally in the morning 30 to 60 minutes before eating, away from calcium, iron, and certain other medications that interfere with absorption. Dose requirements change with weight changes, pregnancy, aging, and certain medications.

For patients who continue to experience symptoms despite optimal levothyroxine dosing and normal TSH, a trial of combination T4/T3 therapy may be appropriate. Dr. Akers discusses this option openly with patients who are persistently symptomatic.

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Frequently Asked Questions Thyroid Disorders
Questions Answered
Common hypothyroid symptoms include fatigue, weight gain, cold intolerance, constipation, dry skin, hair loss or thinning, brain fog, depression, and slow heart rate. Symptoms develop gradually and are often attributed to other causes before the thyroid connection is made.
Hyperthyroid symptoms include unexplained weight loss despite increased appetite, heat intolerance, excessive sweating, palpitations, rapid heartbeat, tremor, anxiety, insomnia, and diarrhea.
TSH is produced by the pituitary and regulates thyroid hormone production. It is the most sensitive screening test for thyroid dysfunction. However, TSH alone does not provide a complete picture of thyroid status, particularly in patients with persistent symptoms.
Yes. TSH can be within the reference range while free T4 or free T3 are suboptimal, particularly in patients with impaired T4 to T3 conversion, Hashimoto thyroiditis with fluctuating function, or TSH that is normal by population standards but too high for optimal function in an individual patient.
Hashimoto thyroiditis is an autoimmune condition in which the immune system attacks the thyroid, gradually reducing its function. It is the most common cause of hypothyroidism. TPO antibodies are elevated in most patients.
Hypothyroidism is treated with levothyroxine, a synthetic form of T4. Dose is titrated to normalize TSH and relieve symptoms. Some patients benefit from the addition of small doses of liothyronine when T4 alone is insufficient.
Fasting is not required for TSH testing. However, levothyroxine should not be taken on the morning of a thyroid blood draw, as it temporarily elevates T4 and can produce a falsely low TSH reading.
Thyroid nodules are extremely common and most are benign. They can be caused by iodine deficiency, chronic thyroid inflammation, cysts, or thyroid cancer, which accounts for approximately 5 to 10 percent of thyroid nodules.
Most thyroid nodules are benign and require only periodic monitoring. Risk factors for malignancy include size above 1 centimeter, certain ultrasound features, rapid growth, and family history of thyroid cancer. Dr. Akers evaluates nodules using risk stratification guidelines.
Once hypothyroid management is established and stable, annual TSH monitoring is typically sufficient. New dose changes require rechecking labs in six to eight weeks.
Severe iodine deficiency impairs thyroid hormone production but is uncommon in iodine-sufficient countries. Selenium is important for T4 to T3 conversion. For most people, diet has modest effects on thyroid function compared to the underlying disease process.
Calcium supplements, antacids, iron supplements, and certain other medications interfere with levothyroxine absorption when taken simultaneously. Levothyroxine should be taken at least one to two hours before or four to six hours after these medications.