Protocol
TSH 2.5-4.5 with symptoms - the decision tree most clinics skip.
Medically reviewed byDr. Priya Rao, MD
OB-GYN, Women's Health Lead - updated April 2026How we review
Best fit
We screen eligibility before any prescription enters the conversation. Decline is treated as an outcome, not a failure.
Contraindications
These are hard stops. We route into a different protocol or refer out, rather than working around a contraindication.
Execution
Each phase has explicit entry criteria, actions, and exit conditions. The plan moves on data and tolerance, not a calendar.
Phase 01
Weeks 0-2
TSH alone is not a diagnosis. Run the full panel, document symptoms, and screen the obvious imitators.
Phase 02
Weeks 3-10
Most members feel meaningfully better when ferritin, sleep, and stress are corrected before any thyroid medication is touched.
Phase 03
Weeks 11-20
Re-measure the panel and decide whether levothyroxine is justified by ATA-style criteria or the original drivers were upstream.
Stack components
Prescription
Provider-selected and state-dependent.
Labs
Supplements
Coaching
Expected outcomes
Risk picture
Monitoring cadence
Labs and availability
Common questions
Evidence
Trials, regulatory guidance, and peer-reviewed evidence the protocol is anchored against.
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Take the assessment and we’ll route you into labs, a foundational stack, coaching, or provider review based on what you answer.
