Is It My Thyroid?
There is an epidemic of thyroid disease which seems to be due to the increased exposure to toxins in our world and unhealthy lifestyles. The thyroid gland is the master regulator in the body so it is critically important for the thyroid to function properly. Every cell in the body has thyroid receptors, so thyroid dysfunction can cause a variety of symptoms.
Symptoms of thyroid problems can overlap with many other conditions. Common symptoms of low thyroid include: fatigue, forgetfulness, cold intolerance, constipation, dry skin, low mood, hair loss, and joint pain. Sound familiar? Many of my patients feel like they have a thyroid problem, but when their doctor tests their TSH (thyroid stimulating hormone) the result is “in range.”
The question becomes what does “in range” mean? The conventionally accepted range for TSH is 0.4- 4.5 mIU/LL. This interval likely includes many patients with thyroid dysfunction. The American College of Clinical Endocrinologists have defined a new reference range of 0.3-3.0 mIU/L, but the laboratories have not updated their reference intervals to reflect this and physicians continue to scan the results and say that the numbers are normal.
It is important to realize that the TSH test is only one piece of the thyroid evaluation. TSH is produced in the pituitary gland and it is part of the feedback loop that tells the thyroid gland to make more or less T4. T4 is the inactive form of the thyroid hormone. T4 must then be converted into T3 in order to bind the cell receptor and give the helpful thyroid effects. There is also another molecule called Reverse T3 which functions as metabolic brakes to regulate how much T4 gets converted to T3. It is a complex symphony which requires specific vitamins and minerals to move to the next step. This process can be disrupted by toxins, infections, stress, autoimmunity, inflammation, and liver dysfunction. The bottom line is that the TSH test only tells a very small piece of the story and other lab markers need to be evaluated as well.
Checking for antibodies against the thyroid is also very important. Many of my patients who feel like they have a thyroid issue, but still have normal function, actually have antibodies which their body has created against the thyroid gland. I screen all of my patients for thyroid antibodies. Autoimmunity creates thyroid antibodies which cause problems long before the thyroid stops functioning. If antibodies are present then we need to immediately work to settle the body down so that the thyroid gland does not get destroyed over time.
Many patients can be treated with lifestyle changes (healthy diet, stress management, proper sleep, exercise) and appropriate supplementation for support. Not all patients with thyroid issues require thyroid medication, especially if the other issues are addressed (leaky gut, toxins, nutrient deficiencies, etc). Therefore, addressing thyroid dysfunction requires a full evaluation.