I'm curious about the requirement that California  residents must have a doctor's prescription when sending in the test kit.  I'm a CA resident and I've done home testing a few times with other labs and I never needed an order or Rx from my doctor.  

Why do these tests have that CA requirement?  I think that policy might need to be reviewed.

New York State, though, does prohibit home test kits, which really stinks, IMO.  I don't even think one can home test even with a doctor's OK.    I don't know how the state thinks that is protecting their residents.  I had to relay-mail my dad's www.grassrootshealth.net Vit D study test kit to him in NYS to get around this silly prohibition.

Nice informative blog

try Heart Health

I love the idea of at-home blood tests and your April 12 post on self-directed health.  Certainly, websites such as this one, Blood Sugar 101, Whole Health Source, Hyperlipid and Dr Eades blog make it easier to begin to take charge of one's own health (a prediabetes FBS brought me to this world and I am now low-carb and grain free as a result).

My first experience with a home test was via Grassroots Health's vitamin D test.  One of the things that made it simple and worth doing was all the information on Vitamin D at the usual blogs, including the Vitamin D Council.  I was able to start supplementing immediately once I saw my level.

But I find that things get more complicated when one tries to interpret the results of the various blood tests offered via TYP.

For example, I saw an ND who gave me an at home saliva test and an OGTT.  I knew I was prediabetic, but was told I was hypothyroid (very low cortisol), insulin resistant, hypoglycemic and that my serotonin, GABA, and dopamine were very low and nor-epinephrine was too high.  My hsCRP was below 3, but not .5.  Oh, yeah, and something about adrenal fatigue, which I'm not even sure exists.

I did not follow the advice of the ND because I found so much conflicting information.  My hope is that the Heart Scan Blog will offer much more information about how to interpret the results of the blood tests and what course of action is recommended given various results.

I thought that the only testosterone test that mattered was the "free" bio available testosterone level test, which is a saliva test? A man can have "normal" serum T level but none of it is being used which the "free" T test can show

...please where can I buy a unicorn?

New York State, though, does prohibit home test kits, which really stinks, IMO. I don't even think one can home test even with a doctor's OK. I don't know how the state thinks that is protecting their residents. I had to relay-mail my dad's www.grassrootshealth.net Vit D study test kit to him in NYS to get around this silly prohibition.

perhaps a disturbed circadian rhythm results in excess prolactin and that to hypothyroidism... thanks to our modern lighting keeping us up till late at night.

The temperature over the day actually tracks the cortisol level. The T3 is present in the blood, but is taken up by the cells only when cortisol is present. In the morning till 12:00 the cortisol is highest. Before sleeping it dips to its lowest waking value. It will dip further in the night. 2 hours before sleeping it will start to rise. I guess the temperature tracks the cortisol with a delay of a couple of hours. Providing the lowest temperature immediately at waking up.

There is a good temperature graph method by Dr.Rind to monitor thyroid function and also Adrenal function.
http://www.drrind.com/therapies/metabolic-temperature-graph

It seems that thyroid is responsible for defining the body temperature, while adrenal is responsible for varying the temperature as per requirement.

The test requires taking the temperature 3 times a day using an analogue meter (like the mercury thermometer). The temperature is taken at 3, 6, and 9 hours after waking, and then averaged. Remember to keep the thermometer in the mouth for around 10 minutes and don't do anything. Less will not be sufficient, and movement changes the temperature.

This test is done for at least 5 days. The average temp will define the thyroid function. If it is too low, it indicates thyroid problem. If the variation day to day is too much then it indicates a cortisol problem.

I am not sure what the average temperature should be but I think it should be at least 98.2F. The temperature variation has been recommended to be below .3F.
Mine varies 1F. I have a lot of adrenal insufficiency symptoms.

I am constantly astonished that population studies of common markers such as temperature and blood pressure have such low samples as in the hundreds.

My mother would take my temperature when I was young and might call our GP if it was over 100 F.

I had assumed (until recently) that decent statistically large databases, covering 000's of people, divided by gender, age, time of day, diseases etc., from which one might get some interesting were available.

Alas, there is only Broda Barnes, or studies with 190 in sample.

It is disturbing.

Dr. Davis,
I'm a big fan. It's refreshing for me to find people with a deeper understanding than me. Would you treat the hypothetical patient in your post with the normal TSH but low T3 with iodine supplementation before prescribing T3, or jump right to med therapy?
It boggles my mind that a good chunk of hypothyroidism is simple iodine deficiency, but that truth is hidden from all but those who vigilantly try to seek it out.

Something that affects temperature in women: the time of the month.

alot of low t3 is just leptin resistance.  Fix the leptin resistance with no sugars and starches, plenty of green veges, fish and a bit of lean meat, and the thyroid starts converting t4 back into t3 and not reverse t3.  I actually believe the t3 supplementation is like giving insulin to a T2DM- it just kills them quicker!

How do you suggest to measure the oral basal body temperature?  30 years ago the suggestion was to use the axillary temp.  Now with the ear digital thermometers that would seem to be easier and more accurate.   We used 97.2 axillary, you suggest 97.3 orally, no problem but how do you suggest to measure

totally agree with @anonymous - supplementing T3 is an extremely crude and potentially harmful (long term) measure. leptin and physical activity plays a huge role in the conversion of T4 to T3. also iodine, selenium and zinc status. listen to the last podcast by byron richards covering all of these correlations in his "thyroid health class" episode (mp3): http://www.wellnessresources.com/audio/podcast_112410.mp3

Thanks, Daniel. It is always worth trying iodine first; crudely estimated, about 30% of people will respond just to iodine. If that doesn't work, then a T3 preparation or a combination T4/T3 preparation is worth considering.


Hi, Lori--Yes, indeed. A big effect. I advocate measuring it during the first 7 days after menstrual bleeding starts, the time when temperature is lowest.

Anonymous--I actually have plenty of slender people (e.g., BMI <23), therefore presumably with normal leptin levels, who still display the low-T3 effect. I believe there is more to this issue.

what actually constitutes a low T3?
Is it below the range the lab considers normal, with in the range, but at bottom 10% or the 40 to 50 % level of the range?

Hi Dr Davis
I have read several articles and studies that link lower T3 levels to calori restriction diets and to slower aging.
Wouldn't T3 supplementation accelerate aging process?

Hi Dr Davis
sigh!  You are right on most things including about butter being insulinogenic (but I still eat it anyway) but you have not grasped the basic idea yet.

BMI is such a crude tool.  It does not account for how much is fat and how much is muscle.  Very skinny people are highly leptin resistant (think the osteoporotic grandmother who also has IHD - most from the generation above us are skinny).  That is why BMI in critical care units is inversely related to mortality.  Lean and very muscular people are unlikely to be leptin resistant, though they may have a BMI of 26.  People with low BMI, or marathon runners with stress fractures are more likely to be leptin resistant.  People with BMIs of over 26 are usually  quite leptin resistant though there may be some exceptions to that rule.  We are all leptin/insulin resistant because this is how we age, but most of us are ageing too quickly.  
Byron Richards, despite being a dreaded naturopath (and recommending wheat!), understands this connection very well:
  
http://www.byronrichards.com/index.php/thyroid_leptin/entry/obesity_causes_thyroid_problems/

PS  my child is now off her t4! - we followed a modified rosedale.  Thyroid supplementation, testosterone supplementation, growth hormone treatment and insulin for  T2 do not treat the underlying cause, and will accelerate the ageing process and cause sarcopenia, whether you are fat or skinny.

I have found this website helpful regarding thyroid www.thyroidbook.com

I am hypothyroid and on T4 T3 combination therapy.  In 2010, I followed Michael Pollan's "Food Rules" less the whole grains: I was weight stable.  However, starting this year (and still following the organic, whole food approach) I also embarked on strict carb restriction.  I lost about 16 pounds and then I hit a plateau.  I also got a tooth abscess and malaise.  My annual thyroid tests showed a TSH of <1, but a T4 at the bottom of the range and a hypothyroid T3.  My T4 T3 have been revised upwards and I am staying with carbohydrate restriction.

Perhaps this suggests that hypothyroid patients need to be cautioned when embarking on carbohydrate restriction. Or, perhaps I am a one-off.  Also, are (under-treated) hypothyroid people susceptible to carb diets as such diets may effectively reduce the extent of their thyroid deficiency?