Thyroid Health TSH T4 Tracker

TSH and what it actually measures

TSH — thyroid-stimulating hormone — is secreted by the pituitary gland and tells the thyroid how much hormone to produce. When thyroid hormone levels are low, TSH rises (the pituitary pushes harder). When thyroid hormone levels are high, TSH falls (the pituitary backs off). This inverse relationship makes TSH a sensitive indirect measure of thyroid function — a TSH above the upper limit of normal suggests hypothyroidism; a TSH below normal suggests hyperthyroidism.

Standard laboratory reference ranges for TSH run approximately 0.4–4.0 mIU/L, though some guidelines use slightly different ranges and some endocrinologists use narrower targets for specific patient populations. Enter your TSH from your most recent blood draw — values can remain valid for three to six months between draws if your condition is stable. The tracker will categorize your value against the standard range.

Free T4 and Free T3 — why both matter

Free T4 (thyroxine, normal approximately 0.8–1.8 ng/dL) is the primary thyroid hormone produced directly by the thyroid gland. Most of it is converted to the active form Free T3 (triiodothyronine, normal approximately 2.3–4.2 pg/mL) in peripheral tissues. For most people on levothyroxine (T4 therapy), Free T4 and TSH are the primary monitoring values. Free T3 is particularly relevant for people who feel symptomatic despite normal TSH and T4, or those who are investigating whether combination T4/T3 therapy might be appropriate.

The tracker accepts Free T3 as an optional input. If your provider does not routinely test Free T3, leave it at the default or skip it. If you have had the test, entering it gives a more complete picture of your thyroid hormone metabolism and can reveal whether T4-to-T3 conversion may be suboptimal — a factor relevant for some people who do not feel well on T4 therapy alone.

Levothyroxine dose and medication adherence

The Levothyroxine Dose field accepts 0–300 mcg in 25 mcg increments, covering the typical dosing range. Levothyroxine has specific absorption requirements: it should be taken on an empty stomach, typically 30–60 minutes before food, and separated from calcium, iron, and certain other supplements by at least four hours. Adherence and timing both matter.

The Medication Adherence field captures whether all doses were taken today, one was missed, two or more were missed, or none were taken. Missed levothyroxine doses do not produce immediate symptoms — the half-life is about a week — but consistent misses over weeks reduce thyroid hormone levels enough to produce symptomatic hypothyroidism even if you were previously well-controlled. Logging adherence against your symptom and energy inputs reveals whether any drifts correlate.

Symptoms and the labs-versus-experience gap

The Active Symptoms field — None through 5+ symptoms — counts how many classic thyroid symptoms you are experiencing. Hypothyroid symptoms include fatigue, cold intolerance, weight gain, constipation, dry skin, brain fog, and hair thinning. Hyperthyroid symptoms include anxiety, heart palpitations, weight loss, heat intolerance, and sweating. Energy Level (from Crashed through Peak energy) adds a functional measure alongside the symptom count.

When your TSH and T4 are in range but you are logging 4+ active symptoms and an Energy Level of Low or Crashed consistently, that pattern is worth documenting and discussing explicitly with your endocrinologist. Thyroid symptoms that persist despite normal standard thyroid panel values sometimes respond to dose adjustments to the lower end of the TSH range, combination therapy, or investigation of other contributing conditions like adrenal or nutrient deficiencies.

Weight change and the thyroid connection

The Weight field and Weight Change over the past month capture a symptom dimension with particular practical importance for thyroid conditions. Unexplained weight gain alongside elevated TSH is one of the most common presentations prompting hypothyroidism evaluation; unintentional weight loss alongside suppressed TSH is a key concern in hyperthyroidism and thyroid cancer treatment.

The tracker displays current weight and tags the change category — stable, gained 2–5 lbs, gained 5–10 lbs, gained 10+ lbs, or the corresponding loss categories. Over months, this creates a weight trend alongside your dose and TSH values that can help distinguish between thyroid-driven weight changes and other factors. A gradual 8 lb gain over six months that correlates with a TSH rising from 1.5 to 3.8 is informative in a way that a single weigh-in never is. Save your lab values and symptom log free — bring a months-long picture to your endocrinologist instead of reconstructing it from memory. Track 6 months of labs + symptoms + dose to bring real-world response data to your endocrinologist → Track 6 months of labs + symptoms + dose to bring real-world response data to your endocrinologist →

Important: this is a self-tracking tool, not medical advice

This tracker is a self-monitoring tool, not a diagnostic device. The information you enter and the scores it produces are for personal awareness and for sharing with your clinician — they are not a substitute for professional medical evaluation, diagnosis, or treatment. Do not change medication, dose, or treatment plan based on this tool. If you experience symptoms that concern you, contact your clinician; for emergencies in the US, call 911 or your local emergency number. Mental health crisis support in the US is available 24/7 by calling or texting 988.

Thyroid Health TSH T4 Tracker vs. the alternatives

How to use it

1. Enter your most recent TSH in mIU/L, Free T4 in ng/dL, and Free T3 in pg/mL from lab results — these update when you get new blood work.
2. Log your Levothyroxine Dose in mcg and select Medication Adherence for today.
3. Select Energy Level from the five-tier dropdown and enter Current Weight and Weight Change category for the month.
4. Choose Active Symptoms count and update Last Lab Work status to reflect how recent your most recent blood draw was.
5. Review your Thyroid Health Score and the breakdown of lab versus functional inputs — note any discrepancy between your numbers and your symptoms for the next provider conversation.

Who it's for

• Person newly diagnosed with hypothyroidism starting levothyroxine — Logs energy level, symptom count, and weight weekly during the dose titration period, bringing the trend to show their endocrinologist whether TSH normalization is producing symptomatic improvement.
• Someone on stable levothyroxine therapy who still feels symptomatic — Logs Energy Level, Active Symptoms, and TSH values over three months to document a consistent labs-normal-but-symptomatic pattern for a discussion with their endocrinologist about dose optimization or combination therapy.
• Person post-thyroid cancer on suppressive levothyroxine therapy — Tracks weight, energy, and heart rate alongside TSH in the suppressed range, monitoring for signs of iatrogenic hyperthyroidism at follow-up appointments.
• Individual with Hashimoto's thyroiditis — Logs TSH and symptom count across multiple months to observe the antibody-driven fluctuation pattern in Hashimoto's, helping their provider see whether thyroid function is stable or declining.

Key terms

TSH (thyroid-stimulating hormone)

A pituitary hormone that regulates thyroid hormone production. Elevated in hypothyroidism; suppressed in hyperthyroidism. The primary screening and monitoring test for thyroid conditions.

Free T4 (thyroxine)

The main thyroid hormone produced by the thyroid gland. The unbound (free) fraction is metabolically active. Most is converted to the active T3 form in peripheral tissues.

Free T3 (triiodothyronine)

The active thyroid hormone. Converted from T4 primarily in the liver and kidneys. Relevant in cases of normal TSH with persistent symptoms.

Hashimoto's thyroiditis

An autoimmune condition in which the immune system attacks the thyroid gland, gradually reducing its function. The most common cause of hypothyroidism in developed countries.

Sources & further reading

• American Thyroid Association — Patient Information
• AACE — Thyroid Disorders
• NIDDK — Hypothyroidism
• Endocrine Society — Hyperthyroidism
• PubMed — 2014 ATA guidelines for hypothyroidism treatment