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Have you been to the doctor and have been told your thyroid is fine after getting a thyroid test?
Yet you have a lot of the symptoms of low thyroid!
This maybe because your doctor is only testing TSH, which is Thyroid Stimulating Hormone, and this is only testing one aspect of thyroid function.
This article will give you all the information that you need to assess your thyroid function, and what to do if your TSH levels come back “normal”.
Also if you are looking for a complete thyroid test, we can organize that, without a doctor’s referral and it can be done anywhere in Australia.
Many people can have the symptoms of low thyroid function, yet when they go to their doctor they are told everything is “fine”.
While this could mean that your symptoms are caused by something else like adrenal dysfunction, depression, nutrient deficiencies or an imbalance in your sex hormones …. it could still be an issue with thyroid function as you have not had a complete thyroid test.
Do you experience these symptoms?
Worse than being told that everything is “normal”, is being told that you are overweight because you eat too much of the wrong foods, or that they are just getting old! Often anti-depressants are offered to make you feel better.
It is important to make sure that your thyroid is functioning optimally, because every cell in your body has a receptor for thyroid hormone (Vitamin D is the only other hormone to have a receptor on every cell).
This means that if your thyroid is not fully functioning it will have health consequences that will affect you in so many ways, this makes proper diagnosis important for your health.
The TSH thyroid test being accurate to diagnose low thyroid function, this is probably one of the biggest myths, especially when it comes to testing your hormones.
Due to Medicare restrictions doctors can only test TSH levels when doing a thyroid test in Australia, and only if problems show up with the TSH test do they do more advanced thyroid testing to check T4 and T3 levels
One of the reasons that TSH is such a poor indicator of low thyroid function is that the reference range for TSH is around 0.4 to 4.5 but the optimal range is between 0.5 and 2.0.
This reference range is an average of the population, which includes people who are sick, people who may not be sick but are far from healthy, and people who are healthy.
You don’t want your thyroid results compared to sick people, ideally a thyroid test reference range would only include healthy people with no thyroid problems.
The ideal range for TSH is between 0.5 and 2.0, so anything above 2.0 indicates that your thyroid is not functioning optimally. You can get a test from your doctor and be told everything is fine (despite your symptoms), even though your TSH is not in that optimal range.
There is a lot of very good research showing that ideal thyroid levels should be below 2. For example an Italian study showed that women with a TSH between 2.5 and 5.0 had a miscarriage rate 70% higher than women with a TSH below 2.
TSH above 2.5 also correlates with increased Homocysteine and CRP both inflammatory markers and associated with many chronic health problems, especially cardiovascular disease.
Testing for TSH, T3 and T4 is the next step and it is much better than just testing for TSH alone but it is not the full story and I will explain why.
About 94% of the thyroid hormone that is produced in the thyroid gland is T4 but the thyroid hormone that is active in every single cell in your body is T3, so T4 has to be converted into T3.
For some people this conversion from T4 to T3 does not work very well due to inflammation, adrenal stress, other sex hormones, nutrient deficiencies, digestion and liver function.
Many people have other health conditions that are affecting their thyroid function, especially the conversion of T4 to T3 and the delivery of T3 to your cells.
It’s important to address the underlying cause of any health issue so even if your thyroid levels are out of balance then simply taking medication is not the best long term solution (it maybe part of the solution)
You need to address the underlying cause to prevent thyroid function from getting worse as you get older. The main drug given to treat low thyroid conditions is Thyroxine which is basically T4 but if you have an issue with converting T4 to T3 you will still have low thyroid symptoms, but your blood tests will probably come back in the “ok” range.
Another test that is not routinely done is to test for reverse T3, this is an inactive form of T3 produced by the liver and it is normal to have some reverse T3.
But problems arise when your T3 levels are low and your reverse T3 levels are high.
Not only does this mean that you have the inactive form of T3 in circulation, and most likely low levels of the active T3 thyroid hormone ….. but the pituitary gland that governs the release of TSH to make more thyroid hormones will think everything’s fine, so you could have normal levels of TSH.
High reverse T3 levels are a way of slowing down your body when it is under stress.
So when you see high reverse T3 you need to assess why.
This can be caused by gut infections, lack of sleep, high stress life, chronic injuries or other chronic health problems. So when you see high reverse T3 on a thyroid test, this does not mean you have a thyroid problem, but there are other areas of your health or lifestyle that are affecting your thyroid.
A large majority of low thyroid conditions in the Western world are caused by an autoimmune condition called Hashimoto’s while in developing countries Iodine deficiency is the primary cause.
To test for an autoimmune thyroid condition you need to test thyroid antibodies, but this is not routinely done. Even if someone has a thyroid condition the antibodies are not normally tested as it does not change the doctor’s treatment plan, which is to give Thyroxine.
The way to test to see if you have Hashimoto’s is by doing a thyroid antibodies test and the two things they test for are thyroid peroxidase (TPO) and anti-thyroid globulin (TG).
It is important to know whether your low thyroid is caused by an autoimmune condition or not, because that will help understand the underlying cause of your thyroid issue.
Research shows that gut function and in particular intestinal permeability is one of the leading causes behind autoimmune conditions and in particular Hashimoto’s. Treat gut function and you can often improve thyroid function.
Especially leaky gut, and gluten, which is one of the major causes behind leaky gut due to the release of a chemical called Zonulin in the intestines in response to eating foods such as wheat. A high percentage of people who have Hashimoto’s also have either Celiac disease or gluten intolerance.
As I said earlier in developing countries low Iodine is a common cause of thyroid conditions.
While low Iodine can be the cause of low thyroid in Australia, I would not recommend supplementing Iodine until you have a urine test to determine your Iodine levels, and whether you are deficient or not.
In fact supplementing with Iodine if you have Hashimoto’s can make your condition worse, and often lead to an increase in your thyroid antibodies, which leads to further destruction of the thyroid gland.
If you are low in Iodine it is important to start with a low dose supplement and slowly build up the dose if you have Hashimoto’s, also to reduce the negative impact that excess Iodine may have, I would also recommend supplementing with Selenium at the dose of 200 mcg a day.
In fact supplementing with Selenium at this 200 mcg a day dose has been shown to help with Hashimoto thyroid whether you are taking Iodine or not.
I recommend everybody gets a extensive thyroid test, especially when you are young and healthy if you have a family history of low thyroid, so that you know what “normal” is for you.
If you have been struggling with a variety of health issues for years but have always been told that “everything’s fine” as your TSH levels are ok, then you should also get a full thyroid test, to assess if low thyroid function is the cause of your health issues.
Getting tested is one thing but it is also important to get the results interpreted by a practitioner who is experienced in understanding the results, and who treats in a holistic way.
I offer consultations and the Extensive Thyroid Test Australia wide, other test options to consider are the DUTCH hormone test to assess adrenal function and sex hormone levels.
Other tests to consider are the nutrients that are essential for thyroid function. This includes Vitamin D, B12, folate, Zinc, selenium, tyrosine, iron studies and of course Iodine.
Michael is head consultant at Planet Naturopath - Functional Medicine and Nutrition Solutions.
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