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THRB and Thyroid Hormone Resistance: What Your Genotype Means for Energy, Metabolism, and Reproductive Health

The thyroid gland produces hormones that regulate metabolism, energy, body temperature, cholesterol levels, and reproductive function. The THRB gene encodes thyroid hormone receptor beta, a protein that lets cells sense and respond to thyroid hormones. Certain variations in THRB can reduce cellular sensitivity to thyroid hormone, a condition sometimes called thyroid hormone resistance. This can cause symptoms that look like hypothyroidism even when blood thyroid hormone levels appear normal.

How this matters for health

  • Reduced receptor function can lead to persistent fatigue, difficulty losing weight, cold intolerance, elevated cholesterol, and irregular menstrual cycles.
  • Effects are often subtle and variable. Some people with a risk variant may have few symptoms, while others may notice more pronounced metabolic or reproductive challenges.
  • Genetics is one part of the picture. Diet, nutrient status, environmental exposures, and underlying medical conditions also influence thyroid function and overall health.

Practical steps to support thyroid health

Whether or not you carry a THRB variant, the following measures support healthy thyroid hormone action at the cellular level and support metabolic and reproductive wellness.

  • Eat a balanced diet rich in thyroid-supporting nutrients:
    • Vitamin A: liver in small amounts, sweet potato, carrots, spinach.
    • Zinc: oysters, beef, pumpkin seeds, lentils.
    • Iodine: iodized salt, seaweed (use cautiously if you have thyroid disease), dairy.
    • Selenium: Brazil nuts (1–2 per day), seafood, eggs.
    • Iron: red meat, poultry, legumes, and vitamin C with plant sources to aid absorption.
  • Maintain vitamin D sufficiency through safe sun exposure, diet, or supplements as needed.
  • Consider myo-inositol and melatonin only under clinical guidance if you have menstrual irregularities or fertility concerns; these supplements have been used adjunctively in some hormonal conditions.
  • Limit high intakes of goitrogenic foods when raw (e.g., cruciferous vegetables like broccoli, cauliflower, kale) and minimize excessive soy intake; cooking reduces goitrogenic activity.
  • Reduce exposure to endocrine-disrupting chemicals where possible: avoid unnecessary plastics with BPA, choose cleaner personal care products, and minimize airborne and household toxins.
  • Support overall metabolic health with regular physical activity, moderate carbohydrate intake tailored to needs, adequate sleep, and stress management.

Recommended tests and monitoring

  • Standard blood tests: TSH, free T4, free T3, reverse T3 when clinically indicated.
  • Autoimmune screen if symptoms suggest autoimmune thyroid disease: anti-TPO and anti-thyroglobulin antibodies.
  • Check nutrient status: vitamin D, ferritin/iron studies, selenium status when appropriate, zinc levels if deficiency suspected.
  • Comprehensive metabolic panel and lipid profile if you experience unexplained high cholesterol or metabolic symptoms.
  • Reproductive evaluation if you have persistent menstrual irregularities or fertility challenges.

Genetic Interpretation: THRB rs28933408

2 effect alleles — TT

You carry two copies of the T effect allele at rs28933408. This genotype is associated with thyroid hormone resistance, which means your cells may not respond as well to thyroid hormones even when blood hormone levels look normal.

Potential features you may notice:

  • Persistent fatigue and low energy
  • Difficulty managing weight or unexplained weight gain
  • Cold intolerance
  • Irregular menstrual cycles or fertility challenges
  • Elevated cholesterol despite normal thyroid labs

Actionable suggestions:

  • Share this genetic information with your healthcare provider and consider more detailed thyroid assessment if symptoms persist despite normal standard labs.
  • Monitor TSH, free T4, free T3, and consider reverse T3 and receptor function evaluation if available clinically.
  • Prioritize the nutrient and lifestyle steps above: ensure adequate vitamin A, zinc, iodine, selenium, iron, and vitamin D.
  • Limit excessive soy and uncooked goitrogenic vegetables and reduce exposure to endocrine-disrupting chemicals.
  • Work with a clinician experienced in complex thyroid cases, especially for reproductive planning or persistent metabolic issues.
1 effect allele — GT

You carry one copy of the T effect allele at rs28933408. This genotype suggests a predisposition to reduced thyroid hormone sensitivity. Symptoms, when present, can resemble hypothyroidism despite normal blood tests.

Potential features:

  • Fatigue and decreased energy
  • Weight gain that is hard to lose
  • Cold sensitivity and menstrual irregularities
  • Possible fertility challenges

Actionable suggestions:

  • Discuss targeted monitoring with your healthcare provider. Consider periodic checks of TSH, free T4, free T3, and nutrient status.
  • Adopt the dietary and lifestyle measures above to support receptor function and overall hormonal balance.
  • If symptoms are disproportionate to blood results, request a more individualized evaluation rather than relying on standard screening alone.
  • Consider fertility-focused labs and counseling if planning pregnancy and you have menstrual irregularities.
0 effect alleles — GG

You carry two copies of the common non-effect G allele at rs28933408. This genotype indicates that THRB receptor function is expected to be typical, and you are not at increased genetic risk from this variant for thyroid hormone resistance.

What this means for you:

  • Cells should generally respond normally to thyroid hormones.
  • Standard thyroid screening is appropriate if symptoms occur, and routine nutrient and lifestyle measures remain valuable for overall thyroid health.

Actionable suggestions:

  • Continue regular health maintenance: balanced diet, exercise, vitamin D sufficiency, and monitoring if symptoms arise.
  • If you develop symptoms suggestive of thyroid dysfunction, pursue standard thyroid testing and discuss additional evaluation with your provider as needed.

How to use this information

  • Treat this genetic result as one piece of your health puzzle. It can guide conversations with your clinician, especially if you have symptoms that do not match routine thyroid tests.
  • Personalized care is important. Work with your healthcare provider to interpret labs, consider nutrient testing, and build a plan that fits your symptoms, reproductive goals, and overall health.
  • Consider tracking symptoms, menstrual cycles, weight trends, and labs over time to share objective information with your clinician.

PlexusDx does not provide medical advice. This information is educational and intended to help you understand how variants in THRB may influence thyroid hormone response. Always consult your healthcare provider before starting or stopping medications, supplements, or making significant changes to your diet or health routine.