Five Ways Conventional Thyroid Testing Fails Millions
January is Thyroid Awareness Month. As someone diagnosed with hypothyroidism who takes daily thyroid hormones, this topic is especially close to my heart. As a health practitioner it is an even more poignant topic, due to the modern epidemic in thyroid dis-ease that is now estimated to affect one in five women, and one in eight men. In fact, current estimates indicate that up to 60 million Americans likely suffer from thyroid disease--many going undiagnosed. Synthroid (or synthetic thyroid hormone T4) is currently the number one prescribed medication in the United States!
It is not uncommon to have someone come in listing more than five clear signs of hypothyroidism (under-functioning thyroid) only to have them tell me that their doctor recently tested their thyroid hormone levels and found them “normal”. At this point I take a deep breath and try to explain to them why their conventional medical doctor is most likely using woefully inadequate testing methods, and even worse, how this may negatively impact their health for many years to come.
The thyroid is a small butterfly-shaped gland resting in the anterior throat with a powerful effect on nearly every system in your body. From body temperature regulation, to sex hormone interaction and regulation, to metabolism (fat burning to fat storage) efficiency, to cellular energy production: we are only at the tip of the iceberg when it comes to understanding just how critical this “tiny but mighty” gland is to our overall health. While this topic is a large one that deserves entire books and hours of lecture, I would like to share the following five critical points with our patient population:
There are four thyroid hormones required to properly assess thyroid health. Your conventional medical doctor will in all likelihood test one: TSH or Thyroid Stimulating Hormone, which is actually secreted by the pituitary gland and not the thyroid. When you schedule your next doctor visit and they or you would like to get your thyroid tested, please request the following hormone panel: TSH, Free T3, Free T4 and Reverse T3. Unfortunately, many insurance companies will not cover anything other than TSH, so know that it is worth every penny to pay out of pocket for the “extras”.
In the United States, the majority of hypothyroid cases are due to a condition called autoimmune thyroiditis or Hashimoto’s Disease. This is an autoimmune illness in which the immune system attacks the thyroid tissue. (For more information about this disease, an excellent book is The Root Cause by Izabella Wentz.) Conventional doctors almost never test for this illness, because for them the treatment is the same regardless of cause: supplement with thyroid hormones based on test results. You can insist on having two basic antibodies, TPOAb and TgAb, added to your thyroid blood panel to rule out Hashimoto’s. If you have elevated antibodies, you have an autoimmune condition and need to work on healing your immune system, not just supporting the thyroid. FYI, for a long time thyroid hormone levels are normal while antibodies steadily rise. This makes testing for antibodies even more important.
If you are having symptoms of hypo or hyperthyroidism (you can easily search symptom lists online), insist on both a physical exam and an ultrasound in addition to lab testing. Sometimes test results are considered within normal range, yet the thyroid may contain palpable nodules or signs of swelling visible in an ultrasound indicative of early stage disease. At this stage, you can restore normal thyroid function with the help of an educated health practitioner.
Be aware that the lab ranges conventional doctors use to identify normal or abnormal thyroid function are much broader than those used by functional medicine practitioners who are targeting optimal rather than normal ranges. As an example, most conventional doctors consider TSH blood levels between 0.5 and 4.5 to be the normal range; in functional medicine an optimal range of 0.5 to 1.5 and definitely less than 2.0 is considered ideal. If you are feeling lousy yet are told your thyroid is normal, take your same test results to a functional medicine practitioner or natural doctor and they are likely to respond very differently than your doctor.
Finally, most conventional doctors will be quick to prescribe Synthroid (or levothyroxine), a synthetic form of T4, should your test results come back showing sub par levels of hormone. Be aware that T4 is the inactive “storage” form of thyroid hormone which is converted to T3, the active form producing the results. For a variety of reasons including nutritional deficiencies, high levels of stress, and genetics, many people do not convert T4 to T3 effectively. For this reason many people do better on forms of thyroid medication that combine T4 and T3, including Naturethroid, Westhroid, and Armour. It is even possible to combine Synthroid with a pure form of T3 called Cytomel. It can take patience and several months to come up with the right medication and dosage for optimal effect in reducing or eliminating symptoms in unique you. Run from a doctor who is not willing to work closely with you in the beginning to find that magic formula.
Some of the most common symptoms of hypothyroidism include: fatigue and low energy, unexplained weight gain, hair loss, muscle cramping and aching, hoarse voice, low sex drive, menstrual cramps, high cholesterol, loss of outer edge of eyebrows, fluid retention or swollen feet, low blood pressure, and excessive earwax. Infertility (difficulty conceiving) and frequent miscarriage can both be connected to an under-functioning thyroid. An extensive clinical examination and history is extremely important. If you suspect you have thyroid illness, you need to take action as soon as possible, but also need to be careful to find the right doctor to work with you.
Most importantly, be your own advocate: do the research and know the right questions to ask. Your symptoms are NOT in your head! Finally: come in for some regular acupuncture! I have found acupuncture to be a powerful support for regulating thyroid-related symptoms. If your thyroid symptoms are early stage they are often possible to resolve without medication, and regular acupuncture while you are treating with supplemental care can be invaluable.
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