The Thyroid Tests Your Doctor Isn’t Running with Dr. Eric Osansky #045

February 04, 2026•7 min read

Summary

Your Thyroid Labs Are “Normal” — But Are They Optimal?

Picture this. You’re exhausted. You can’t get yourself going in the morning. You’re reaching for coffee, reaching for sugar, gaining weight you can’t explain. Maybe you’re getting sick more often than usual. Something just feels off. So you go to your doctor. Maybe your friend, your sister, or your mom told you to get your thyroid checked. And you do. The labs come back. And your doctor says:

“Everything’s normal.”

But nothing feels normal. And you walk out wondering if you’re imagining it.

You’re not.

In this episode, I sit down with Dr. Eric Osansky — a chiropractor, clinical nutritionist, and certified functional medicine practitioner who was personally diagnosed with Graves’ disease and reversed it using a natural treatment approach — to break down exactly what’s happening with thyroid testing and why so many women are falling through the cracks.

Here’s what I learned that blew my mind: there are at least six to eight different thyroid markers that can be tested. Your TSH (which is actually a pituitary hormone, not even a thyroid hormone), Free T4, Free T3, Reverse T3, and multiple types of thyroid antibodies — TPO antibodies, thyroglobulin antibodies, thyroid stimulating immunoglobulins, and more. But most doctors? They’re running one, maybe two of those. Usually just TSH and sometimes T4. That’s it.

And here’s where it gets even more frustrating. Even when those tests are run, your doctor is comparing your results against a lab reference range that’s extremely broad. For TSH, most labs consider anything up to 4.5 or even 5.0 as “normal.” But Dr. Eric and most functional medicine practitioners consider the optimal range to be between 1.0 and 1.5. So if your TSH comes back at 4.0, your doctor might say you’re fine — but you could absolutely be experiencing symptoms of an underperforming thyroid. Same goes for Free T3. The optimal range is around 3.0 to 3.5 in the US, but if you’re sitting at 2.3 and your doctor sees it’s technically within range, they’ll likely tell you everything looks great. Meanwhile, you feel like you’re running on empty.

One of the most important things we discussed is that T4 — the hormone the thyroid produces the most of — is actually inactive. It has to be converted into T3, the active form, before your body can use it. And a lot of women have problems with that conversion process. Their T4 looks fine, but their T3 is low. If your doctor isn’t testing T3 (and most aren’t), you’d never know. That’s also why Synthroid — which is synthetic T4 — doesn’t work for everyone. If you can’t convert T4 into T3 efficiently, giving you more T4 isn’t going to help.

We also talked about something that doesn’t get nearly enough attention: the autoimmune component. Hashimoto’s thyroiditis is the most common autoimmune condition, period. Not just the most common autoimmune thyroid condition — the most common autoimmune condition. And yet most conventional doctors don’t test for the antibodies that would identify it. They give you thyroid hormone replacement and never address the fact that your immune system is attacking your thyroid gland. The immune system is completely ignored.

Dr. Eric brought up the connection between gluten and Hashimoto’s, which is a conversation I think every woman needs to hear. There’s a concept called molecular mimicry where the structure of gluten may be similar enough to thyroid tissue that the immune system gets confused and attacks the thyroid. The research on this specific mechanism is still being studied, but what’s not debatable is that gluten increases intestinal permeability (leaky gut) — and a leaky gut is one of the three pillars of the autoimmune triad: a genetic predisposition, an environmental trigger, and increased gut permeability. Dr. Eric recommends every one of his patients eliminate gluten while healing, at minimum.

We wrapped up talking about the supplements that have the most evidence behind them for thyroid support. Selenium came up first — specifically 200 micrograms of selenomethionine — and Dr. Eric noted there’s strong research showing it can help lower TPO antibodies and even support Graves’ disease and thyroid eye disease. He personally eats Brazil nuts, but during active healing, he recommends the supplement form because the selenium content in Brazil nuts is wildly variable — anywhere from 20 to 80 micrograms per nut. Vitamin D was next (he likes levels at 50 or above on a 25-hydroxy vitamin D test), and omega-3 fatty acids rounded out the top three.

We also touched on a hot topic right now: the FDA’s ongoing push to restrict natural desiccated thyroid medications like Armor and NP Thyroid. Dr. Eric’s perspective? This has been going on for years, and the argument that the dosing isn’t consistent from batch to batch is being used as a reason to push people toward synthetic options. His take — and I agree — is that patients deserve choices. Some people do great on Synthroid, and that’s wonderful. But so many people don’t, and they deserve the option to try desiccated thyroid that includes T4, T3, and other thyroid hormones like T1 and T2.

Bottom line: if you’ve been told your thyroid is “fine” and you don’t feel fine, you’re not crazy. You might just need someone who’s willing to run the right tests, look at the right ranges, and actually address the root cause instead of just handing you a prescription.

Your body isn’t broken. It’s just been ignored. And that changes now.

Where to Listen:

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The information provided during this podcast is for educational purposes only. The speaker may be a licensed medical professional and may present case studies of actual patients or refer to patients' treatment during the program. Please be reminded that the Scope of Practice for Holistic Nutrition Professionals prevents us from diagnosing, preventing, treating, curing, prescribing, managing, or healing disease. Holistic Nutrition Professionals are not licensed in any state and work with clients, not patients.

Chapters

00:00 Introduction to Thyroid Health

03:13 Understanding Thyroid Lab Tests

06:18 The Importance of Comprehensive Testing

10:52 Autoimmunity and Thyroid Conditions

13:23 Dietary Triggers: Gluten and Hashimoto’s

16:30 First Steps After Abnormal Lab Results

19:28 Medication vs. Lifestyle Changes

21:58 Optimal vs. Normal Ranges in Testing

25:00 Supplements for Thyroid Health

29:51 The Future of Natural Thyroid Medications

🔥 Resources/Links Mentioned:

Connect with Dr. Eric Osansky and get on his newsletter list here.

Listen to Dr. Eric Osansky's podcast, Save My Thyroid here.

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