- Exhaustion may persist despite normal TSH if full thyroid tests are not done
- Normal B12 levels can still cause symptoms if below optimal levels around 800
- Low ferritin under 50 can cause hair loss even if haemoglobin appears normal
Have you ever walked out of a clinic with a file full of "normal" reports yet felt anything but normal? On paper, everything looks fine. But in real life, you are exhausted. You struggle to focus. Your hair is thinning. Your mood feels off. The scale keeps moving up. Sleep does not feel restful.
When this happens repeatedly, you begin to question yourself. Maybe it is just stress. Maybe it is hormones. Maybe this is simply what getting older feels like.
According to Cleo Tetzloff, a doctor based in California, USA, this experience is far more common than we think. In a recent Instagram post, she shared ten signs your body may be asking for help - even when your lab reports are "within range" and your doctor says you are fine.
Here is what she explained:
1. Exhausted but Thyroid Is "Normal"
Your TSH may be 3.5, and the lab marks it as within range. But Dr Tetzloff notes that optimal levels are closer to 1.0-2.0. Often, only TSH is checked, while Free T3, Free T4, Reverse T3 and thyroid antibodies are not tested, leaving the full picture incomplete.
2. Brain Fog but B12 Is "Fine"
Your B12 level might be 280 - technically normal. However, some countries treat anything under 500 as deficient. Dr Tetzloff prefers levels closer to 800. Low B12 can contribute to fatigue, memory issues and poor concentration. "You're not crazy. You're depleted," she says.
3. Hair Falling but "Not Anaemic"
Your haemoglobin may look normal, so you are told you are not anaemic. But if your ferritin level is 18, it indicates low iron stores. Dr Tetzloff says ferritin should be above 50 for thyroid support and above 70 to help reduce hair loss. Ferritin often gets overlooked if haemoglobin appears fine.
4. Low Mood but Vitamin D Is "Sufficient"
Your vitamin D level might be 28 and labelled sufficient. But she says optimal levels for mood, immunity and hormone balance are between 50-80. Low vitamin D can be linked to anxiety and depression. "You're not broken. You're deficient," she says.
5. Gaining Weight but Blood Sugar Is "Normal"
A fasting glucose level of 96 may be considered normal, but optimal levels may be closer to 75-85. Fasting insulin is rarely tested, she notes. Insulin resistance can develop quietly for years before glucose levels rise. By that time, weight gain and inflammation are already underway.
6. Can't Sleep but Cortisol Was "Fine"
Cortisol is often tested only once, typically at 8 am. This does not reveal daily fluctuations. A four-point cortisol test may show afternoon crashes and night-time spikes, which explain daytime fatigue and feeling wired at night.
7. Hormones "Normal for Your Age"
If you are in your late 30s or 40s and feel unwell, you may be told it is simply age-related. Oestrogen drops, progesterone lowers, testosterone fluctuates and cycles change. But Dr Tetzloff questions why feeling terrible should be accepted as normal.
8. Inflammation Never Properly Checked
Deeper markers of inflammation are often missed. Tests such as hs-CRP, homocysteine or fasting insulin are not typically ordered. A basic blood panel may only rule out major disease. It shows that you are not in immediate danger, but it does not reveal whether low-grade inflammation is slowly building - something that can affect energy, weight, mood and long-term health.
9. Gut Issues Brushed Aside
You may feel bloated after meals, experience constipation on some days and the opposite on others. Foods you once tolerated may now upset your stomach. Anxiety may even appear unexpectedly. But instead of deeper tests such as stool analysis or SIBO evaluation, you may simply be advised to "eat more fibre". The root cause remains unexplored, and the discomfort continues.
10. No One Connected the Dots
Dr Tetzloff explains that borderline B12, slightly elevated TSH, low ferritin, low vitamin D and rising insulin can collectively explain why you feel unwell. But because each marker is viewed in isolation, the overall pattern is missed.
Dr Tetzloff writes, “The system was never designed to help you thrive. It was designed to keep you alive.”
Her caption adds practical steps:
- Stop accepting “normal.” Ask about optimal.
- Find someone who connects thyroid, gut, hormones, blood sugar and nervous system together.
- Ask for proper testing:
- Full thyroid panel
- Fasting insulin
- Ferritin, B12, Vitamin D
- 4-point cortisol
- Inflammatory markers like hs-CRP and homocysteine
- A mapped hormone panel
- Gut health testing
Dr Tetzloff's point is not to reject doctors. It is to look deeper when symptoms continue. If you feel unwell but are told you are fine, it may be worth asking better questions. Your body sends signals early. You deserve to understand them.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
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