Words You Don’t Hear At Your Doctor’s Office: Thyroid Panel
Naturopathic Doctors (ND's) and Medical Doctors (MD's) have an incredible opportunity to work side by side. This series is focusing on the different perspective Naturopaths may have and highlighting the importance in different areas of practice. Enjoy!
You’ve probably heard your doctor mention your thyroid before in some capacity, so the title of this article isn’t exactly true. But likely you’ve heard it in the context of the lab value TSH (Thyroid Stimulating Hormone). TSH is a hormone released from the brain influencing your thyroid, however this is only a small reflection of what is going on with your thyroid. Why aren’t they talking about the other – arguably- more informative thyroid hormones? Find out why.
What Is the Thyroid and What Does It Do?
The thyroid is a butterfly-shaped gland located just in front of your trachea (throat). It essentially acts as the body’s thermostat for every single cell.
When the thyroid is over-producing thyroid hormone (hypERthyroidism), metabolism increases causing symptoms like feeling hot, restless/agitated and heart palpitations. You can also experience very light menstrual cycles or diarrhea. Imagine someone setting your thermostat just a couple of degrees higher so everything is working in overdrive.
The more common situation is when the thyroid is under-functioning (hypOthyroidism). Conversely, this turns your thermostat down. This causes symptoms like low energy, constipation, feeling cold all the time, hair loss, weight gain (metabolism slows), and heavy periods. More common, right?
This was slightly simplified since it isn’t always the actual thyroid gland itself that isn’t functioning properly. For proper conversion of inactive to active thyroid hormone, you need a host of vitamins and minerals. If your nutrient profile is inadequate, the thyroid can seem as if it is under-functioning.
What am I getting tested for at the Doctor’s?
When you go to see your MD, either you request checking your thyroid or they suggest it based on your symptoms. The only hormone they can check at first is Thyroid Stimulating Hormone (TSH). This value reflects how much your brain is telling your thyroid to produce thyroid hormone. If it’s high, the brain is saying “produce more thyroid hormone, our metabolism is too low!” and that would indicate an under-functioning thyroid. HOWEVER, the ‘normal’ range of TSH is substantial (0.5-4). The only way MD's can test for other thyroid hormones (which I’ll touch on in a minute) is if TSH is outside of that normal range. Why is this a problem?
The range for TSH is huge. At either end of that ‘normal’ spectrum (0.5 or 4), people typically feel like garbage. Each ND is different, but I look for anything outside of 1-2.5 because I find that is where the optimal levels are for people actually feeling good (not just not feeling terrible).
TSH can be perfectly normal and the other thyroid hormones are not. The thyroid hormones our actual thyroid produces are T3 and T4. T4 is not very biologically active. T3 is the more biologically active hormones which has a larger influence on your metabolism, but it is found in less quantity. T4 gets converted to T3 in your liver and other cells in your body. In order to do that, nutrients like Selenium and Zinc are needed as well as fat-soluble vitamins (A, D & E) for healthy cellular sensitivity. Your liver also has to be in good working order to covert T4 to T3.
That is why it is so important to get a full thyroid panel (TSH, T, T3, rT3, anti-TPO, anti-TG) when investigating thyroid conditions based on symptoms. NDs can order this in Ontario for around $100. There are other important values like anti-TPO and anti-TG reflecting autoimmune activity (Grave’s or Hashimoto’s), which could be a whole other article, so I’ll spare you.
Be your own health advocate! If you know something isn’t right, talk with your MD or ND about it. You typically know your own body better than anyone else.
Fun fact: If you are on medication for hypothyroidism (Synthroid/Levothyroxine/Eltroxin) and not feeling 100%, it is so important to get your full thyroid panel checked. Those medications are giving you T4, so if you are having a conversion issue to the active T3, the medication isn’t doing much for you.