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Hypothyroidism – Appropriate testing required

Dr. Meghna Thacker / Hypothyroidism  / Hypothyroidism – Appropriate testing required

Hypothyroidism – Appropriate testing required

The thyroid gland is a butterfly-shaped organ that is located in the neck below the Adam’s apple. It produces the thyroid hormones that regulate the body’s metabolism. Its functioning affects about every organ in the body. Thus if it is under functioning then everything in the body slows down, causing symptoms such as fatigue, weight gain, dry skin, constipation, depression, brain fogginess or difficulty concentrating, sleep problems, hair loss, feeling cold or cold intolerance and menstrual irregularities.

The two main thyroid hormones are T4 and T3. The T4 is considered a pro hormone while T3 is 300 % more biologically active compared to T4. Our bodies convert T4 to T3 through the deiodination process. This T3 is utilized by the cells to produce energy. TSH is the Thyroid stimulating hormone and produced by the pituitary gland, which is the master gland of the body. Low levels of T3 and T4 signal the release of TSH thus increasing its levels on lab results. While high levels of T3 and T4 stop the release of TSH thus decreasing its levels on lab results. TSH is considered the standard screening test for thyroid. But over the years in my practice I have found it to be an unreliable test. There could be a patient complaining of a list of hypothyroid symptoms but based on the TSH test result, they are sent away saying everything came back fine and your thyroid is working optimally.

 I usually order a complete thyroid panel which includes TSH, T3, FT3, T4, FT4, Anti-thyroglobulin and Thyroid Peroxidase Antibodies. Let me explain the reason behind ordering all these tests. The T3 hormone is bound to a protein while FT3 is freely circulating in the blood, similarly for the T4 and FT4. Sometimes the T4 levels test out fine but T3 levels are low. One probable reason could be that the body is not being able to make the conversion from T4 to T3. Zinc is one of the mineral that is required for this process. From a thyroid treatment standpoint this helps because if a patient is treated with Synthoid or Levothyroxine, it provides them the T4 hormone alone. If the person is unable to convert this over to T3 which is the biologically active hormone, then their physician would know based on the levels of T3 tested that they may need to adjust their treatment and probably add a medication that provides the T3 hormone also.

There are times when all the above tests come back within normal ranges but one or both of the Thyroid antibody tests are elevated.  This condition is referred to as Hashimoto’s Thyroiditis. In this case a patient maybe complaining of symptoms of hypothyroidism but they are usually sent away by their doctors saying that everything came back fine since they were not tested for these antibodies. A person may have these antibody levels elevated for up to 10 years and struggle with signs and symptoms before they are actually diagnosed with Hypothyroidism based purely on numbers. Naturopathic medicine can immensely help a patient diagnosed with Hashimoto’s Thyroiditis.

Keep a look out for my future articles where I will address the naturopathic approach to treating Hypothyroidism and Hashimoto’s Thyroiditis.

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