Do You Have a Thyroid Condition?
/January is thyroid awareness month!
Thyroid disease affects one in five women and one in ten men, yet 50 percent of people with thyroid disease go undiagnosed. Many who are diagnosed become treated inadequately with medications such as Synthroid®
I was one of these individuals who was undiagnosed. It was even missed by my integrative health practitioners! A year into my functional medicine training, I put together a history of my labs to see if I could find patterns and trends. One astonishing pattern I found was continuous suboptimally low or clinically low thyroid markers. After a miscarriage, I brought this up to my gynecologist and her response to me was “I don’t know what any of these markers mean. We only run TSH to determine someone’s Thyroid health.” At that moment, I took a deep breath as I was furious that a physician wasn’t giving women the comprehensive care they need. Nor did she know how. After that appointment, I vowed to start my own practice to give women the comprehensive, heart felt care they were not only needing, but desiring.
What does the thyroid do?
The thyroid gland is a small butterfly shaped gland that rests just below the center of the neck. It regulates everything metabolic in the body. When I say metabolic, I don’t just mean weight gain or loss. I mean the cellular energy that makes you go swiftly each day. It’s what makes you maintain your life! What a huge task by such a small gland!
It impacts the digestive system, mood and emotions, mental clarity, skin health, immune function, how well our body's utilize cholesterol. It even helps to synthesize other hormones like progesterone, which are needed for fertility, and cortisol, which is needed for immune function and stable blood sugar.
When the thyroid is working properly we feel energized and happy! When the thyroid is working suboptimally, we may feel sluggish, depressed, and experience constipation, dry skin, feeling cold, infertility - just to name a few!
Many times (such as myself), folks are undiagnosed with hypothyroidism because of a couple factors:
Only TSH lab marker is run during blood work
Because the lab test results land in the reference range, the doctor says “they’re normal/fine!”
However, there are some big factors that are overlooked!
How Your Thyroid Gland Functions
TSH is a brain hormone NOT a thyroid hormone. The brain tells the thyroid to make more or less thyroid hormone by increasing or decreasing TSH. By running TSH alone, we are not actually seeing what’s going on with the thyroid.
What bloodwork markers do we need to look at to understand the thyroid? Thyroid hormones! There are 3 main hormones we want to be looking at:
T4: T4 (about 93 percent) is the inactive form of your thyroid hormone that, if everything works as designed, your body will convert into T3.
T3: About 7 percent of your thyroid hormone is T3, the “active” hormone. While we want enough T3, we also need enough T4 to be able to convert to T3.
Reverse T3: T3 hormone is like the gas peddle, but Reverse T3 is like the brake. It forces the body to slow metabolism… often due to high levels of stress.
Additionally, we want to look at thyroid antibodies. Thyroid antibodies include Thyroid Peroxidase antibody and Thyroglobulin antibodies. When there’s a presence of antibodies, it can indicate that the body is attacking the thyroid gland (mistaking it for a stranger danger substance) and reducing it’s ability to make T4 and T3. In Functional Medicine, we very much want to know if there are antibodies being produced against the thyroid. If there are, then our primary focus will not be on the thyroid gland itself, but it will be on balancing and regulating the immune system so it stops attacking the thyroid gland.
What about those reference ranges?
The last thing to address here is whether “normal” labs always mean normal or optimal thyroid function. The conventional lab ranges are, in many cases, based on a sample of people that have received those tests, and then they simply make a bell curve of the results. Anyone who is in the middle of that bell curve is deemed as being normal. As a result, these ranges are based on what the average values are in a population, rather than what the optimal values are.
Additionally, the conventional reference range for TSH is quite large, typically being .5 - 4.5. This means that if you go to your doctor and your TSH is 4, they’re going to tell you that you have a normal functioning thyroid gland. However, studies have shown that a normal TSH was more like 0.5 to maybe 2 or 2.5. Anything above 2 - 2.5 should be further investigated for hypothyroid dynamics.
Labs to Run: A Full Thyroid Panel
To receive a comprehensive look at your thyroid these are the lab markers you’ll want to run
TSH: Thyroid Stimulating Hormone
Brain hormone that tells the thyroid to make more or less thyroid hormone
Total & Free T4: Thyroxine
Weak thyroid hormone. T4 can be converted to T3 or Reverse T3
Total & Free T3: Triiodothyronine
Active thyroid hormone. It competes with Reverse T3
Reverse T3:
Blocks the action of T3
Anti-TPO Ab: Anti Thyroid Peroxidase Antibody
Antibodies that destroy the creation of T4 thyroid hormone
Anti-Tg Ab: Anti Thyroglobulin Antibodies
Antibodies that interfere with the creation of T4 thyroid hormone
There is so much you can do to support your thyroid! One of the big life factors is reducing stress and/or changing your perception of life situations. Another area that’s easy to control is the foods you eat! Of course, you’ll want to ensure you’re removing processed foods as much as possible, eliminate gluten immediately as it directly impacts the thyroid and eliminating any other food sensitivities or allergies you may have. There are also specific nutrients and foods the thyroid needs to function optimally.
Nutrients and Foods that Support the Thyroid
· Iodine: Found in sea vegetables such as kelp! Needed to make T4
· Tyrosine: Amino acid found in meats, eggs, fish & small amounts in plant foods like nuts & seeds. Needed to make T4
· Zinc: Oysters, lamb, beef, pumpkin seeds, chickpeas. Needed to convert T4 to T3
· Selenium: Brazil nuts, Salmon, Turkey, Cottage cheese, Chicken. Needed to convert T4 to T3
· Iron: fish, chicken, eggs, seafood, cheese, or plain yogurt, beef and organ meats such as liver. Needed to convert T4 to T3
Your Thyroid Isn’t Broken
Thyroid dysfunction is often NOT due to the thyroid being broken. It’s often a symptom of something deeper going on within the body. You’ll want to explore your stress load, toxicity, nutrient status, your gut health, and your liver health to name a few.
If you want a comprehensive lab panel done, please find a provider that’s open to running this for you or reach out to me.
*Sources:
Labcorp. (2021). Thyroid panel. Retrieved from https://www.labcorp.com/help/patient-test-info/thyroid-panel
Optimal lab ranges obtained from OptimalDx software and Healthmatters.io
Chris Kresser. Why Your Normal Thyroid Lab Results May Not be Normal
School of Applied Functional Medicine. Adrenal and Thyroid Myths and Truths.
https://draxe.com/nutrition/tyrosine-benefits/ , foods high in zinc, foods high in selenium