The Pause

Issue #15 of 2025

Sponsored by the "Third Act " Optimizers

Thyroid Conversion Disorder

Your thyroid tests indicate you do not have typical hypothyroidism. They suggest a Thyroid Conversion Disorder. Now what?

“Doc, my doctor told me that my thyroid test is normal. Can you explain to me how my test is normal, but I have most of the symptoms of hypothyroidism?”

Most doctors look at just one test: the TSH reading.

Let me review the TSH test and its place in the HPT axis. You hear so much about the HPT axis regarding thyroid function or dysfunction.

THE HYPOTHALAMUS

The H stands for the hypothalamus. It’s your hormone thermostat. It sits in your brain and monitors hormone levels. When it sees a hormone lacking sufficient levels, it signals the body to produce more.

When the Hypothalamus detects that your body does not have enough T4 circulating within your body, it releases a hormone called the Thyroid-Releasing Hormone.

THYROID-RELEASING HORMONE (TRH)

TRH signals the pituitary gland to release Thyroid Stimulating Hormone.

THYROID-STIMULATING HORMONE (TSH)

TSH signals the thyroid gland to release T4.

A doctor determines whether you are hypothyroid by your TSH level. If your TSH levels are high, your pituitary gland works more than it should, telling your thyroid gland to release T4.

THYROXINE (T4)

Thyroxine (T4) is a tyrosine molecule, one of the amino acids that make protein, with four attached iodine molecules. It is a weak hormone. It is more of a prohormone, the precursor to the strong thyroid hormone. T3 is the active form of thyroid hormone, while T4 is generally inactive. Although T4 has some strength, T3 is seven to ten times more potent than T4.

TRIIODOTHYRONINE (T3)

Triiodothyronine (T3) is the active thyroid hormone.

Think of T3 as the supervisor of your body’s basal metabolic rate. Your basal metabolic rate is the calories your body needs to accomplish your basic life-sustaining functions.

If you don’t have enough T3, your cells’ metabolism fails, and that’s not good.

T4 ACTIVATION

Now that you know enough about the thyroid and tests, I’ll explain why your doctor says your thyroid is normal, but you know it’s not.

You think your thyroid is not normal because you are tired all the time, you are gaining weight, you have no tolerance to the cold, you are constipated, your skin is dry, you are losing hair, and you’ve lost the outer third of your eyebrows, correct?

“Correct, I have most of those symptoms. But my thyroid is normal?”

I always suggest five thyroid tests for my clients when they are testing their thyroid. Today I will explain the first three and return to the others in the following two courses.

We will look at: TSH, Free T4, and Free T3.

Your TSH is normal, but in the high portion of normal. This reading usually means your thyroid is sluggish, but I would never consider it sluggish on one reading. If your TSH test is at a high normal every time you test it, at least three times, then most thyroid doctors would diagnose your thyroid as sluggish.

Your Free T4 is in the upper 50% of normal, which is good. You want a T4 in the upper region of normal. Since T4 is plentiful, I now have to think twice before I call your thyroid sluggish.

Your Free T3 is in the lower 50% of normal. Viola! Now we have a good indication of why you have the symptoms of being hypothyroid, but your doctor says you're normal.

THYROID CONVERSION DISORDER

When you see a discrepancy in your Free T4 level and your Free T3 level, like in this case, where the T4 is plentiful but the Free T3 is not, there is a good chance your body is not converting your Free T4 into Free T3. This abnormality would explain why your doctor says you have “normal” thyroid tests, but you have the symptoms of hypothyroidism.

Thyroxine, T4, is converted into triiodothyronine (T3) by cleaving away one of the iodine molecules.

Two specialized enzymes, deiodinases 1 and 2, remove an iodine molecule from tyrosine to activate the hormone. So, what should you do?

ELEVATE DEIODINASE

“And how do I do that?”

Consume selenium—The body needs selenium to produce deiodinase. Selenium-rich foods include:

Brazil Nuts

• 1 nut can contain 68–91 mcg (or more!)
• 1–2 nuts a day may max out your daily needs.

Yellowfin Tuna (cooked)

• ~92 mcg per 3 oz serving
• Also, a great source of lean protein and omega-3s.

Halibut (cooked)

• ~47 mcg per 3 oz

Sardines (canned in oil, drained)

• ~45 mcg per 3 oz

Sunflower Seeds

• ~19 mcg per 1 oz (about ¼ cup)
• Great for sprinkling on salads.

All of the foods above are Meso-Menu-compliant, selenium-rich foods.

Short-term fasting—A study found that short-term fasting, such as 16/8 intermittent fasting, OMAD (One Meal a Day), or alternate-day fasting (not eating one day and eating normally the next day), can increase deiodinase.

Tauroursodeoxycholic acid (TUDCA) or 4-phenyl butyric acid (4-PBA)—These chemical chaperones can increase deiodinase and intracellular T3 production. You'll learn more about these supplements in a future course.

ELEVATE SELENIUM

Selenium is essential for thyroid hormone production. It also protects against oxidative damage, is an antioxidant, and boosts immunity by fighting infection.

Researchers found that we need about 200 mcg of selenium daily.

Most people consume selenium from grains and nuts. However, these foods are not weight loss foods, so if you are still working your way to your ideal, happy, healthy, bottom weight, you may need to supplement.

SELENIUM DEFICIENCY

Selenium deficiencies are usually associated with digestive disorders. Most deficiencies are due to our inability to absorb selenium efficiently. Selenium deficiency occurs in celiac disease, Crohn’s disease, and leaky gut. Any chronic inflammatory condition of the intestines will reduce selenium absorption.

SELENIUM SUPPLEMENTATION BENEFITS

• Selenium supports thyroid hormone production.
• Selenium protects the thyroid from overexposure to iodine.
• Selenium is necessary to convert T4 to T3. The enzyme that severs an iodine from T4 and converts T4 to its active form, T3.
• Selenium also helps with the uptake of T3 into the cell.

T3 RESISTANCE

Let me explain how selenium helps with T3 uptake.

Insulin resistance causes modern-day Type 2 Diabetes, but a lack of insulin does not. Insulin resistance means the cells’ entrance doors remain closed in the presence of insulin. When you are resistant to insulin, the doctor will prescribe more insulin. She hopes to open more cellular doors.

Selenium works like insulin. It will open more entrance doors so more T3 can enter the cells.

HOW TO INCREASE SELENIUM LEVELS

There are three primary ways to increase your selenium levels.

1. Supplement with 200 mcg a day.

​SELENIUM 200 MCG​

Always consult with your healthcare practitioner before beginning any supplement.

2. Eat one Brazil nut a day.

A Brazil nut contains 68–96 micrograms (mcg) of selenium. The recommended daily allowance is 55–75 mcg for adults. But…There are 872 Kcal in a cup of Brazil Nuts. You can see that weight loss could be affected if you overeat Brazil nuts.

Supplementation may be the best choice during Phase One of HOPE because of the calories associated with Brazil nuts. Once you have obtained your ideal, bottom, happy, ideal weight, Brazil Nuts are the easiest way to ensure healthy selenium levels.

Here is an Amazon Link to purchase Organic Brazil Nuts.

​RAW BRAZIL NUTS ON AMAZON​

3. Eat foods high in selenium.

The best sources of selenium are the foods in the infographic below.

​SELENIUM RICH FOODS INFOGRAPHIC​

SUMMARY

As always, I would prefer that you consume selenium-rich foods. If you cannot, then add a selenium supplement. Elevating selenium levels is the next step we take to optimize thyroids.

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Stay tuned! Watch for next week's Thyroid Optimization Newsletter, where I share another tool to make looking and feeling great easier.

But first, another success pre- and post

👇

Yes, I help young women transform their bodies, too! Marissa wanted to get in shape for her wedding, so our mission was accomplished.

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🚀 Doc Mac

Your coach in The Pause and beyond.
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THIS WEEK'S US-IE

We had an enjoyable weekend with friends. Yesterday, we ended it with a couple of our children and three grandchildren barbecuing around the pool. Vicky couldn't be happier.

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