HormonesPeter Attia on Subclinical Hypothyroidism: What Labs Actually Mean and When to Treat
In this clip from his Ask Me Anything podcast series, Peter Attia tackles one of the most commonly mismanaged conditions in clinical practice: subclinical hypothyroidism. He explains which thyroid labs he orders for every patient, why standard TSH reference ranges are often misapplied in older adults, and why free T3 and free T4 tests are least reliable precisely when clinicians need them most. Attia discusses why a mildly elevated TSH frequently resolves on its own without treatment, what to do when T4 therapy normalizes labs but the patient still feels unwell, how to thoughtfully incorporate T3, why medication timing matters enormously for absorption, and what third-party testing has revealed about popular thyroid-support supplements. The episode is aimed at both patients optimizing their healthspan and clinicians seeking a more nuanced, evidence-informed approach to thyroid management.
