Thyroid Hormone Optimization

Thyroid Hormone Optimization

$250 initial consultation

$275 initial lab testing fee.  Our phlebotomist will come to your home or office at your desired time and date.  Pacific Longevity defines concierge service.

Initial test includes:  CRP (measures inflammatory status and cardiovascular risk which is often increased in hypothyroidism), AM Cortisol (adrenal function - adrenal fatigue is common in hypothyroid patients), TSH (thyroid stimulating hormone), free t3, free t4, TPO (Hashimoto’s), vitamin D (vitally important in hypothyroidism), vitamin B12 (low B12 – fatigue, depression), CBC (screen for anemia and other blood disorders), CMP (complete metabolic profile), and Lipid Panel (LDL, bad cholesterol, often elevated).

Thyroid Hormone Optimization Program  – $195 monthly fee includes:

  • Concierge service with access to your physician 7 days a week regarding treatment, diet or exercise regimen
  • All subsequent office visits
  • All subsequent blood testing
  • All Medications Prescribed by Physician
  • All Shipping Charges
  • Ongoing nutritional and exercise advice

Pacific Longevity does not diagnose hypothyroidism based on TSH alone; nor do we treat your thyroid in isolation.  We understand that thyroid dysfunction impacts so many other systems and vice versa.  This is one of the reasons why so many people get their thyroid labs ‘fixed’, but continue to feel miserable.  We obtain a complete picture of your thyroid function, possible complications of poor thyroid function, and common disorders which may contribute to and worsen your symptoms. Our thorough panel also allows us to custom tailor a total wellness plan to put you on a path to vastly improved health and well-being.

In most cases, we combine Armour thyroid with another prescription medication that greatly aids in weight loss. Furthermore, hypothyroidism and the medications used to treat hypothyroidism can lead to insulin resistance, elevated blood sugar and the development of adult onset diabetes. Our unique combination of medications addresses these problems and actually lowers insulin resistance and the chances of developing adult onset diabetes.

Additionally, we almost always treat our patients with Armour thyroid/ dessicated thyroid extract.  Most physicians treat hypothyroid patients with Synthroid/ levothyroxine.  However, it has been shown in multiple studies that most patients prefer and respond better to Armour thyroid/ dessicated thyroid extract.

Synthroid is 100% t4; while Armour is 80% t4 and 20% t3.  T3 is the biologically active hormone, whereas T4 is mostly a pro-hormone to t3.  T4 is converted to t3 when thyroid hormone activity is called upon.  However, many people do not convert t4 to t3 efficiently; this leads to poor and even zero clinical response when many patients are treated with levothyroxine.  Click here to learn more about dessicated thyroid extract/Armour Thyroid.

Although desiccated thyroid extract is not widely used, this study showed that many patients preferred Armour thyroid to levothyroxine. This result was observed despite there being no differences in thyroid function blood test and psychometric test results; although use of desiccated thyroid extract was associated with more weight loss.

So, if you’ve been treated with Synthroid/levothyroxine and did not notice a significant clinical response, Armour thyroid may be the answer you’ve been seeking.  Ask your physician if he would be open to trying Armour with you.  However, be forewarned, many ‘traditional’ physicians will only treat with Synthroid.  Many have succumbed to the propaganda of the big pharmaceutical companies.  Armour thyroid is a natural substance, so it can’t be patented; you can probably fill in the blanks from there.

If your physician refuses to prescribe Armour thyroid, give us a call.  None have regretted that call as of yet.  Remember, Pacific Longevity does not simply test and prescribe.  We provide diet and exercise counseling, while treating you in a much more holistic manner than most traditional physicians. We will also create a customized supplement program for you. Unlike most other similar clinics, we don’t try to sell our patients expensive supplements in fancy bottles. Instead, I will send you links to where I get most of my supplements,

Please don’t hesitate to call or email us if you have any questions about our program. I look forward to meeting you.

Yours sincerely,
Richard Kim MD
Diplomate American Academy of Anti-aging and Regenerative Medicine


Signs and Symptoms of Hypothyroidism
The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone deficiency. But in general, any problems you have tend to develop slowly, often over a number of years.

At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain, or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more obvious signs and symptoms. Hypothyroidism signs and symptom may include:

  • Extreme difficulty losing weight
  • Fatigue
  • Increased sensitivity to cold
  • Constipation
  • Dry skin
  • Unexplained weight gain
  • Puffy face
  • Hoarseness
  • Muscle weakness
  • Elevated blood cholesterol level
  • Muscle aches, tenderness and stiffness
  • Pain, stiffness or swelling in your joints
  • Heavier than normal or irregular menstrual periods
  • Thinning hair
  • Slowed heart rate
  • Depression
  • Impaired memory

When hypothyroidism isn’t treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid gland to release more hormones may lead to an enlarged thyroid (goiter). In addition, you may become more forgetful, your thought processes may slow, or you may feel depressed.

Advanced hypothyroidism, known as myxedema, is rare, but when it occurs it can be life-threatening. Signs and symptoms include low blood pressure, decreased breathing, decreased body temperature, unresponsiveness and even coma. In extreme cases, myxedema can be fatal.


In discussing the paradigm shifts, Dr. Wiersinga took a critical look at the use of levothyroxine (T4) only treatment . He pointed out that there are a number of studies that show that levothyroxine treatment is associated with a number of negatives for patients, including:

  • increased psychological distress
  • impaired well-being
  • decreased health-related quality of life
  • impairments in cognitive psychomotor speed, attention, learning and memory
  • increased prevalence of anxiety
  • poorer psychological function, working memory and motor learning

In particular, according to Dr. Wiersinga, “Impaired psychological well-being, depression or anxiety are observed in 5–10% of hypothyroid patients receiving levothyroxine, despite normal TSH levels.”

Dr. Wiersinga also reports on an interesting Scottish study that found that the risks of heart problems, arrythmias and bone density issues increased in patients with suppressed TSH levels (less than .03), and in patients with high TSH levels (above 4.0) but there was no increased risk associated with “low” TSH levels (.04 to .4).

Dr. Wiersinga presented research that demonstrates that “normal TSH levels consequently do not guarantee euthyroidism in all tissues that are targets of thyroid hormone.” Simply put: levothyroxine-only treatment may not be the optimal treatment for patients with hypothyroidism. Instead, some addition of t3 may help normalize thyroid function in all tissues.


If you’re not familiar with desiccated thyroid/Armour Thyroid, here’s a quick rundown. Desiccated (dried) thyroid is a thyroid hormone replacement drug, prepared from the thyroid gland from pigs — also known as “porcine thyroid.” Some of the brand names including Armour Thyroid, Nature-throid, and Westhroid. Desiccated thyroid is a prescription drug, and it’s regulated by the FDA. It has been on the market and safely used for more than 100 years. Until synthetic thyroxine (also known generically as levothyroxine, with brand names including Synthroid, Levoxyl, and Levothroid) was introduced in the 50s, desiccated thyroid was the only thyroid hormone replacement medication.

When synthetic thyroxine was introduced, there was a great deal of hoopla about how modern it was, compared to “old-fashioned” desiccated thyroid — and many doctors switched patients over to the synthetic medication, and never looked back. Meanwhile, synthetic thyroid — namely Synthroid — became a hugely profitable mainstay for the various drug companies that have owned the rights to Synthroid over the years, which have included Boots, BASF, and now, Abbott Labs.

All along, Synthroid has been sponsor of medical meetings, golf outings, symposia, research grants, and speakers’ fees, and is the chief provider of lunches at medical offices, patient literature, pens, pads, mugs, and other freebies, giveaways, and marketing items for decades.

We now have several generations of doctors who have been trained to believe that synthetic thyroxine — and specifically Synthroid — is the only thyroid replacement medication available or worth using. They simply don’t know anything else. They don’t know that treating and managing patients with hypothyroidism using desiccated thyroid is not especially difficult, because they’ve never done it, and all they’ve heard is negative things — mainly from sales representatives for synthetic drugs. They hear ridiculous rumors on a regular basis — spread by drug reps for competitive levothyroxine drugs — that desiccated thyroid is going off the market. And they believe those rumors and.

In the 1980s and 1990s, however, Armour started to make a resurgence, as interest in natural medicine was on the rise, and as patients who weren’t feeling well on synthetic thyroid medication became more empowered and knowledgeable. Patients learned that there were options — among them, desiccated thyroid like Armour, and by then, brands including Nature-throid and Westhroid.

Yes, desiccated thyroid drugs have had a resurgence — but let’s be clear: several million prescriptions a year are written for desiccated thyroid, compared to more than 30 million prescriptions a year for levothyroxine. But frustrated patients who don’t feel well, coming to sites like this one, reading my books and those of some innovative practitioners, and talking to other patients, are learning that they have options besides Synthroid/levothyroxine — and namely that some patients feel better on desiccated thyroid medication.

Over at the Endocrine Today blog, endocrinologist and osteopath Thomas Repas, DO, FACP, FACE, CDE, has done a three-part article on “Desiccated thyroid in the management of hypothyroidism,” from his perspective as an endocrinologist.

It’s an interesting analysis, because it will give you a pretty clear idea of how most endocrinologists view desiccated thyroid drugs like Armour, and why they are so frequently opposed — often adamantly — to use of these drugs. (This is in comparison to holistic, integrative MDs, who often prefer use of desiccated thyroid, because they find it works better for some — or even most — of their patients.)

Dr. Repas starts out by saying that he, like his peers in endocrinology, doesn’t use desiccated thyroid, because “I believe that desiccated thyroid is antiquated therapy and should no longer be used.”

He also claims that endocrinologists don’t use Armour because of an “unacceptable level of variability batch to batch, often resulting in unacceptable variation in thyroid-stimulating hormone.” Noting that levothyroxine also has variability from brand to brand, he states, “if we consider slight variation between various levothyroxine products to be clinically important, then the much larger variation within desiccated thyroid preparations is unacceptable.”

In Part III, Dr. Repas climbs high up in his ivory tower to declare that while most people would not dream of “directing a cardiologist how to perform cardiopulmonary resuscitation during a cardiac arrest…otherwise reasonable people have no hesitation trying to ‘teach’ me about the thyroid.” He then argues that the desire to be listened to, interest in natural approaches are driving the interest in natural desiccated thyroid.

Dr. Repas says his opposition to desiccated thyroid is based in science, but he fails to mention that there are no double-blind, peer-reviewed, double-blind studies that compare levothyroxine to desiccated thyroid in terms of effectiveness at resolving patient symptoms. So while he claims to rely on science, the fact is, the science doesn’t exist to bolster his arguments that levothyroxine is superior to desiccated thyroid in resolving symptoms.

In fact, Dr. Repas himself admits, in the comments section of Part I:

For the record, my greatest concern with desiccated thyroid (or levothyroxine or T3) is when they prescribed in a manner that results in long-term exogenous hyperthyroidism. If a patient is not hyperthyroid and they are doing better on one product vs. another, it is very hard to argue against that.

He also concludes Part III with a truly ambiguous comment:

Finally, last week I saw a woman who had been on desiccated thyroid for decades. I explained that we now prefer levothyroxine instead of desiccated thyroid. I also quickly pointed out that her thyroid-stimulating hormone has been perfect, between 0.7 mIU/L and 1.0 mIU/L over the last several years. She had no symptoms; it was difficult for me to argue with success. After discussing and asking her what she wanted to do, she left my office still on desiccated thyroid.

It is not difficult to maintain patients on desiccated thyroid without overdosing them into hyperthyroidism. If that is his greatest concern, why would he not be willing to try desiccated thyroid in patients who don’t feel well on levothyroxine. He is, after all, a trained endocrinologist with expertise at titrating doses, and keeping a patient “euthyroid” — in the normal range — should be simple. Especially when he sees, as he mentions, that some patients are maintained perfectly on desiccated thyroid, for decades.

As you’ll see in the three articles, there are a number of comments left by patients who are enraged by Dr. Repas’ article, and understandably so. On the one hand, Dr. Repas is trying to explain why he doesn’t believe in Armour Thyroid, calling use of it unscientific, and claiming that fans of it are engaging in magical thinking. But without real science to support his claims, and negating the factual experience of hundreds and thousands of thyroid patients, he is showing that he is engaged in magical thinking. After all, where is the evidence that TSH detects all thyroid problems (especially when after six years, they are still arguing over what that normal TSH range is, leaving millions of patients in a non-diagnosis/non-treatment limbo!) and that levothyroxine resolves all thyroid symptoms.

At the same time, Dr. Repas also admits, from a practical standpoint, that his primary concern is overdosing a patient to hyperthyroidism on any thyroid drug — not just desiccated thyroid. And he also admits that if a patient can be properly managed on desiccated thyroid — and “properly managed” in his view means maintaining a TSH level in an optimal range — then he doesn’t see a reason to “argue with success.”

So he won’t start new patients on desiccated thyroid — even if they ask. If an existing patient who is on levothyroxine but not feeling well asks to switch to desiccated thyroid, he won’t do it. But if a patient is already on it and doing well, he won’t “argue with success” and will continue to prescribe the desiccated thyroid for him or her? Where is the “science” in that approach?

In some ways, let’s admit it — Dr. Repas is more open-minded than some endocrinologists. There are some who simply will not have as patients anyone on a T3 drug or desiccated thyroid. They will refuse to see — or fire — patients who don’t follow their direction. But Dr. Repas is also fairly representative of the narrow-minded perspective that we see amongst endocrinologists in general. Their primary concern is the “TSH normal range” — and their treatment goal is to get patients into the normal range. Symptom resolution appears to be irrelevant, and takes a back seat to numbers management.

Are you a thyroid patient who wants to try Armour? You’ll probably need to leave your endocrinologist behind, and find an integrative MD or holistic practitioner who really understands thyroid issues and is versed in use of desiccated thyroid.


 Find out what Dr. Oz has to say about thyroid and other hormones


While approximately 59-million people in the US suffer from thyroid issues—the great majority aren’t even aware they have a problem. However, when the thyroid (the butterfly-shaped gland in the neck) is dysfunctional, it can cause an array of health issues-including weight gain, depression, sexual dysfunction, depression, heart disease, and extreme fatigue. Bioidentical hormone replacement therapy could be the solution you need!

It’s vital to determine if you have any of the following common symptoms that might indicate a thyroid condition…
1.) Fatigue
Feeling exhausted when you wake up, feeling as if 8 or 10 hours of sleep a night is insufficient or being unable to function all day without a nap can all be signs of thyroid problems. (With hyperthyroidism, you may also have night time insomnia that leaves you exhausted during the day).

Fatigue image
2.) Weight Changes
If you’ve tried every low-fat, low-carb, low-calorie diet with little weight loss success; you might have hypothyroidism. The same goes for hyperthyroidism and the inability to gain weight while eating way more than usual.
Weight gain image
3.) Muscle & Joint Pain
Unexplained aches and pains in the muscles and joints (following no period of physical exertion) can be symptomatic of a thyroid condition.
Joint pain image
4.) Swollen Neck
Swelling in the neck or a visibly enlarged thyroid that leads to neck pain and a gravelly voice can indicate thyroid disease.
Neck pain image
5.) Hair & Skin Changes
The hair and skin often show the first signs of thyroid problems—including symptoms such as dry hair; hair loss; and dry, thin, or scaly skin.
Hair loss image
6.) Constipation
Painful bowel movements or long-term constipation can signify hypothyroidism.
Constipation image
7.) Menstrual Abnormalities
Oftentimes thyroid issues will lead to heavy, irregular, or painful periods in the case of hypothyroidism—while shorter, lighter or unsteady menstruation can indicate hyperthyroidism.
Menstrual image
8.) Depression
Depression or anxiety disorders (i.e., panic attacks) can indicate thyroid disease.
Depression image

9.) Carpal Tunnel
Weakness or tingling in the arms, wrists, hands, and legs is a sign of carpal tunnel syndrome which is a common sign of an undiagnosed thyroid condition.

Carpal Tunnel image
10.) Family History
If you have a family history of troublesome glands or “goiter” you may expect thyroid problems down the road.