hub

Thyroid & Endocrinology

Evidence-based protocols for hypothyroidism, AIT, insulin resistance, and endocrine dysfunctions

The thyroid gland is the master metabolic regulator. This hub aggregates articles on clinical protocols for hypothyroidism, autoimmune thyroiditis, insulin resistance, adrenal dysfunction, and other endocrine disorders. Each article cites peer-reviewed sources (Lancet, NEJM, JAMA, Endocrine Reviews) with direct PubMed links.

12 articles

Low-dose naltrexone (LDN) in Hashimoto thyroiditis: mechanism, dosing, protocol

Naltrexone at 1.5–4.5 mg/day (10 times lower than addiction-medicine dosing) ceases to act primarily as an antagonist and becomes an immunomodulator. Short nocturnal blockade of μ-opioid receptors produces a rebound increase in endogenous endorphins, TLR4 blockade on microglia, and a Th17 / Treg shift toward tolerance. In Hashimoto thyroiditis, LDN is a third-line candidate when TPO antibodies remain elevated despite an adequate L-T4 dose and corrected selenium and vitamin D deficiencies. I review the mechanism, titration protocol, expected time to effect, and settings where LDN should not be used.

12 min Read →

T4 → T3 Conversion: Where Deiodinase Fails and What Functional Hypothyroidism Is

Thyroxine (T4) is a prohormone; the active hormonal form is triiodothyronine (T3). The D1/D2 deiodinase enzyme in the liver, kidneys, intestine, and brain is responsible for T4 → T3 conversion. If the enzyme is not properly assembled from selenium, iron, and zinc, the tablet remains in the bloodstream while tissues remain without a signal. Every third patient on an L-thyroxine dose that is adequate by TSH continues to feel unwell: fatigue, dry skin, hair loss, weight gain, brain fog. This is functional hypothyroidism: a state in which TSH is normal, fT4 is normal, but tissue T3 is not. I review four mechanisms of impaired conversion, markers, target ranges, and a holistic restoration protocol.

12 min Read →

Hyperprolactinemia and Dopamine: Why It Is Not About a Pituitary Tumor

When labs show elevated prolactin, women are often sent for pituitary MRI under the assumption of a prolactinoma. But in the vast majority of cases, this is not about a tumor — it is about dysregulation of dopaminergic control. Understanding this changes both diagnostics and treatment approach.

11 min Read →

OCPs and Thyroid: Why "Levothyroxine Just in Case" Is Iatrogenesis

L-thyroxine + OCPs to a young woman "just in case" — this is not treatment, it is intervention into the endocrine axis without diagnosis. Let us examine how ethinyl estradiol distorts thyroid labs and why the standard "elevated TSH → give thyroxine" approach often contradicts current clinical guidelines.

9 min Read →

Iodine and Thyroid: 5-Step Protocol for Proper Use

Iodine is essential raw material for thyroid hormones, but 80% of cases of its inefficacy or harm are not about dose — they are about systemic context. When selenium and iron are missing, iodine does not heal — it fuels inflammation. Here is the five-stage model: from cellular uptake to T4→T3 conversion.

10 min Read →

Why You Are Not Losing Weight: The Reverse T3 Trap and Survival Mode

When you aggressively cut calories, fast, and live in stress, the body does not turn on fat burning — it turns on survival mode. First water leaves and it seems to work. Then reverse T3 rises, active T3 falls, mitochondria slow, you feel cold, swollen, foggy. And weight stalls or creeps up. Here is how to escape this trap.

11 min Read →

Cortisol and Adrenal Health: Why 'Adrenal Fatigue' Isn't a Diagnosis but a Real Problem

The term "adrenal fatigue" dominates integrative medicine discussions, yet it has never been recognized as a legitimate medical diagnosis. The real issue — HPA axis dysregulation — is well-documented in peer-reviewed literature and has measurable biomarkers, distinct phases, and evidence-based treatment protocols.

14 min Read →

Testosterone in Men Over 40: When TRT Is Truly Necessary

After age 40, testosterone declines by 1-2% annually. But age-related decline is not always benign. We examine when TRT is genuinely warranted, which labs are essential, and how to optimize testosterone naturally before committing to lifelong therapy.

14 min Read →

Menopause Without Suffering: Bioidentical vs Synthetic Hormones

Menopause affects every woman. But hot flashes, insomnia, anxiety, and bone loss are not inevitable. We examine the difference between bioidentical and synthetic hormone therapy, reinterpret the WHI study, and outline a personalized approach to menopausal hormone therapy.

13 min Read →

PCOS: Why "Just Take Birth Control" Is Not Enough

In 70% of women with PCOS, the root cause is insulin resistance, not a hormonal imbalance. Standard birth control prescriptions mask symptoms without addressing the underlying mechanism. We examine the pathophysiology, proper diagnosis, and a comprehensive treatment protocol.

13 min Read →

Pregnenolone: 'Mother of All Hormones' for Burnout and Chronic Fatigue

Pregnenolone — the precursor to every steroid hormone in the body — occupies a unique position at the intersection of endocrinology and neuroscience. During chronic stress and burnout, its levels decline among the first, triggering a cascade of hormonal disruption.

11 min Read →

Hypothyroidism and Natural Desiccated Thyroid (NDT): Why Levothyroxine Isn't the Only Option

Labs are normal but symptoms persist? 15-20% of patients on levothyroxine continue to suffer from fatigue, weight gain, and brain fog. The problem isn't the patient — it's the approach.

12 min Read →

Need a personal consultation?

Dr. Pereligyn offers in-person and online consultations.

Book a consultation