#373 – Thyroid function and hypothyroidism: why current diagnosis and treatment fall short for many, and how new approaches are transforming care | Antonio Bianco, M.D., Ph.D.

In this episode of The Drive podcast, Peter Attia interviews Dr. Antonio Bianco, an expert in thyroid physiology and metabolism, about the biology of thyroid hormone production, conversion, and action. They discuss how diodinase enzymes regulate thyroid hormone activity, the limitations of using TSH as a marker, combination therapies (T3 and T4), the role of genetics and tissue sensitivity, the effects of hypothyroidism on energy and mood, the relationship between thyroid hormones and mitochondrial efficiency, cardiovascular health, and why some patients feel unwell despite normal thyroid labs. They also touch on future research and treatment approaches, and the importance of understanding thyroid physiology for effective treatment.