Symptoms & Diagnosis

Is Your Hypothyroidism Diagnosed Properly?

Original article by Michael Teplitsky, MD

Author Michael Teplitsky, MD Published July 25, 2026 Read 4 min 791 words

About half of the hypothyroid patients who came to see me had their own doctors. They had the symptoms of low thyroid. Their regular doctor checked a blood test called TSH. Sometimes also another blood test called free T4. When the test(s) came back normal, the doctor said that the patient is OK, that her symptoms were not real. Sometimes he offered tranquilizers or antidepressants.

I am not talking about just one or two people, but about many hundreds. Many thousands, even millions had this experience. They have hypothyroid symptoms but are not being treated because their blood tests are “normal.”

That’s because the current “correct” approach to diagnosing hypothyroidism is not to look at the symptoms, but only on this blood test called TSH.

This is not only silly, but also completely wrong.

Let’s briefly discuss hormones. TSH stands for Thyroid Stimulating Hormone. It is not a thyroid hormone. It is produced by the part of the brain called the pituitary gland.

Thyroid gland produces hormones T4 and T3. When we talk about thyroid hormones we mean T3 and T4. Out of the two, it’s the T3 that is the most active. Ideally there should be just the right amount of the thyroid hormones so they can do their job.

TSH stimulates the thyroid gland, makes it work harder to produce more T4 and T3. If the levels of T3 and T4 are low, the body makes more TSH to push the thyroid into making more. If there are enough T3 and T4, the body does not make a lot of TSH, so the level will usually be low.

To put it another way, TSH is usually high when thyroid is low. TSH is usually low when thyroid is normal or high. I say usually because it’s not always the case. It’s like saying that it’s usually warm in the summer. But of course, there are exceptions, and some summer days may be cool or even cold.

There are also exceptions in cases of hypothyroidism, when a person has the disease but her TSH is not high. It’s either “normal” or even low. In most labs “normal range” for TSH is 0.27 to 4.2

If your TSH is below 4.2, you are normal. If it’s higher than 4.2 then you have hypothyroidism, especially if you have a few symptoms.

According to the medical establishment, you cannot have hypothyroidism if your TSH is “normal” no matter what your symptoms are.

This method works for tens of millions of people who are being diagnosed with hypothyroidism. Unfortunately, there are tens of millions of people for whom this method does not work. They also have hypothyroidism, but their TSH is “normal”.

Why do patients with this “hidden” hypothyroidism look for help from holistic doctors? Because we are different.

We don’t pay that much attention to the TSH. We follow one simple rule – treat the patient, not the blood test.

Let’s suppose you see a kid with fever, red, painful throat, lymph nodes in the neck, etc., you take a throat culture and send it to a lab. And what do you do next? Do you wait a couple of days for the culture results before starting the treatment? Of course not.

Based on the kid’s symptoms and your observations, you start treating him or her with antibiotics for what you presume is a throat infection. You treat the patient, not test results.

Doctors have been treating hypothyroidism since 1800s. They didn’t do blood tests back then. There was no such thing as TSH. If the patients had the symptoms and signs of hypothyroidism, that’s what the doctors treated them for, usually very successfully.

And another thing. We talk about high and low TSH and say that TSH should not be higher than 4.2 I have another lecture where I explain how doctors come up with these numbers. I also have a free report that explains how “normal” ranges are determined.

It turns out that normal TSH is really less than 1.5-2.0. So people with hypothyroid symptoms and TSH of 3.0 or 4.0 (normal, according to most labs) are not really normal. That’s why we treat such people for hypothyroidism and achieve good results.

If you have hypothyroid symptoms, get a full blood test panel, not just TSH. If you doctor refuses to do it, which is often the case, find another doctor. A holistic doctor like me.

You can also go on my web site and book a free 20 min phone consultation so I can help you figure out what to do next.

FAQ from The Metabolic Journal Editors

These questions are based on this article and related Dr. Teplitsky articles.

What symptoms does Dr. Teplitsky connect with low thyroid?

His articles emphasize fatigue, weight gain, feeling colder than others, constipation, hair loss, depression, brain fog, and a long list of less obvious symptoms.

Why can diagnosis be difficult?

Many symptoms overlap with other conditions, and Dr. Teplitsky argues that a narrow lab interpretation can miss some patients who still need a careful thyroid evaluation.

How can I book an appointment with Dr. Teplitsky?

Call Dr. Teplitsky’s office at 718-769-0997 to book an appointment or ask about availability.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making changes to your health regimen.