The best way to diagnose hypothyroidism is not with a blood test. When thyroid levels get low, the appropriately trained clinician will discern this by doing an extensive history and physical exam. One of my medical school instructors called this the MAN scan. These are rarely done anymore as younger physicians hack their way through medicine depending on technology to replace the physical interface required to practice good medicine.
Once I started noticing the dramatic before/after changes with my protocols, I started documenting this for two reasons. One, was to keep myself honest. My philosophy is that if you’re not getting better, I should not be getting paid. I often refused payment for this reason. Secondly, I wanted to have objective evidence validating or invalidating the efficacy of my treatment protocols. Detractors can spit ad hominems, however, at the end of the day it’s about what you can prove using objective measures. No need to argue whether you’re an apple tree. Grow apples.
The old endocrinology literature teaches us the physical manifestations of hypothyroidism. After studying these books, I started looking for the body’s signals that thyroid levels were inadequate. This book compiles pictures of those physical manifestations along with brief physiologic editorials. For beginners, this is an easy way to quickly learn how to make the physical diagnosis of hypothyroidism. For seasoned clinicians, this is a great “Show and tell” to validate to patients that, although their thyroid blood tests are interpreted as “normal”, their body is saying something different. The book Hypothyroidism Type 2 by Mark Starr M.D. is a great companion to this book.