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Thyroid Labs: Looking At More Than Just The Surface

red test tube with a note of the result from thyroid testĀ Did you know that an underactive thyroid, i.e. hypothyroidism, affects approximately 200 million people across the globe? Millions remain undiagnosed for many years. For a long time, these people have no idea why they gain weight and suffer from issues like anxiety, depression, fatigue, hair loss, brain fog, and a plethora of digestive problems. Their thyroid labs come back saying their thyroid function is fine when in fact, it is not.

A thyroid that does not work correctly could lead to a multitude of symptoms. Usually, in the case of conventional medicine, the thyroid labs only focus on testing the level of your thyroid-stimulating hormone (TSH). If the TSH levels are not within the normal range, then the doctor will advise you to take a synthetic thyroid hormone to address the issue. On the other hand, if the thyroid labs show normal levels of TSH, then you may receive a healthy prognosis. But this may not necessarily be the case.

Hormones that Play a Role in Thyroid Function

The pituitary glands produce the hormone TSH. It controls thyroxine (T4) and triiodothyronine (T3) production in the thyroid gland. TSH attaches to the hormone receptors that are found on cells inside the thyroid gland. This triggers the gland to release thyroid hormones. T4 and T3 are hormones that play essential roles with regards to muscle control, bone health, brain development, heart, digestion, and metabolic rate.

Once your T4 and T3 hormone levels reach a certain limit, they send a negative feedback loop to the pituitary to stop producing TSH. Hypothyroidism happens when the thyroid gland is underactive and the TSH levels are high. The thyroid gland may also enlarge and cause a condition known as a goiter. The most common symptoms associated with this condition are weight gain, fatigue, and sensitivity to cold.

Hyperthyroidism happens when your thyroid gland is overactive and the TSH levels are too low. The common symptoms associated with hyperthyroidism include heart palpitations, anxiety attacks, weight loss for inexplicable reasons, and constantly feeling too hot. You may have a slightly larger thyroid as well. It is also possible to have central hypothyroidism from a low TSH. You will need to check with your physician what type of hypo or hyperthyroidism you have regarding your TSH level.

Thyroid Labs Testing According to Conventional Medicine

Your thyroid labs can show normal while something is wrong. The issue starts with the reference used as normal by the particular lab doing the testing. A laboratory looks at the statistical average of all the TSH lab results and uses this as a reference. This means different labs may have different lab references as to what is considered normal.

But here is the thing. People who undergo thyroid labs may also have other health issues. So when their labs are included to generate the lab reference and marked as the normal range, it does not factor the other health issues of these people.Ā  Now, when your thyroid labs are compared, with this 'normal range', it has essentially ignored the fact that maybe, the range is incorrect in the first place.

Functional Thyroid Labs Testing and What it Means

Although the functional approach also looks at your TSH, it also encourages a broader range of tests that narrow down the root cause of the problem.

Thyroid Stimulating Hormone (TSH) Test

image of hormones circulating in thyroid glandYour pituitary gland in the brain sends chemical messengers to your thyroid to indicate it should release TSH. Research indicates thyroid labs between 2.5 and 3.5 mlU/L as normal. However, this range increases your risk of death due to heart attack or stroke by 69%. In other words, normal can kill you.

Instead of looking at the reference range, you should look at the optimal range, in other words, what your thyroid labs should look like for you to function optimally.

Total Thyroxine (T4) Test

For the most part, your T4 hormones tend towards metabolic inactivity. It becomes active when converted to T3. A full T4 test gives you a total of both the bound and unbound forms of this hormone. Unbound T4, i.e. when no longer bound to a protein carrier, becomes T3. This test thus gives you an indication of your T4 count and T3 uptake.

Free Thyroxine (T4) Test

The free T4 test gives an indication of the free form of T4 in your body. If suffering from hypothyroidism, levels may be low, although it could show as normal during the earlier stages of the condition.

Total Triiodothyronine (T3) Test

This test gives you an idea of the total amount of this metabolically active thyroid hormone. In other words, it shows to what extent your body converts T4 to T3. This test is aimed at showing whether your thyroid is overactive, or underactive.

Free Triiodothyronine (T3) Test

This test measures the usable form of this hormone. Having lower T3 levels is relatively common but increases your chances of a heart attack.

The conventional synthetic T4 medication may not properly allow your body to convert T4 into T3, although other possibilities also exist as to why this is the case.

Reverse Triiodothyronine (T3) Test

Reverse T3 is an unusable form of the T3 hormone. Your levels of this hormone may be relatively high due to chronic stress and the accompanying high cortisol levels. T4 gets turned to reverse T3 if there is too much T3.

Thyroid Antibodies Test

High thyroid antibodies levels indicate that your thyroid is being attacked by your immune system. Most autoimmune disorders are associated with low thyroid function. Hashimotoā€™s disease is one such example. Two thyroid antibodies tests indicate your thyroid peroxidase and thyroglobulin levels.

Additional Tests

Besides these various thyroid labs, other relevant tests look at your immune system, other hormones in your body, and your microbiome. Taking a holistic view of what goes on with your body makes determining the steps needed to gain optimal health so much easier.

How Thyroid Function Impacts Your Body

image representing the inflammation of thyroid glandYour thyroid gland is an important endocrine component, and, as such, is dependent on the adrenal function which is governed by the Hypothalamic-Pituitary-Adrenal (HPA) axis and your bodyā€™s NeuroEndoMetabolic (NEM) stress response. The latter, an entirely automatic response to stresses of any kind, sees your body producing higher quantities of stress hormones like cortisol to deal with a stressful situation.

Stressful situations, besides a rise in cortisol production, also sees the decrease in other hormone production and either a decrease in or the stopping of body functions not considered necessary for immediate life support.

Long-term stress may have serious consequences because these body functions may work at sub-par levels due to your body having to deal with a continuous NEM response. The result is often Adrenal Fatigue and its many diverse symptoms. Impaired thyroid function is one such symptom, although Adrenal Fatigue may not be the only cause of this. Proper thyroid and adrenal function are, however, linked.

Adrenal Fatigue and Thyroid Labs

Adrenal fatigue is often overlooked as a source of secondary or sub-clinical thyroid dysfunction. The problem with Adrenal Fatigue is that it creates a condition of multiple organ resistance. This includes your thyroid gland. Your thyroid labs, when tested, may show a normal or high TSH count, normal or low T3 and free T3 count, and a normal or low T4 and free T4 count.

Conventional medicine would typically recommend thyroid replacement therapy, leaving you feeling better for a while. Unfortunately, the symptoms rend to return. To combat this, dosage may increase but this has the disadvantage of putting your body into overdrive because of a raised metabolic rate.

Any existing adrenal issues may increase and trigger an adrenal crash that worsens your symptoms and may leave you incapacitated.

Functional medicine recognizes the importance of optimal adrenal function in addressing both thyroid and hormonal issues.

Addressing the Issue

Compromised adrenal function results from stress. Identifying, and dealing with, your stressors may be your first port of call. Of course, the correct diet may also help. This means steering clear of foods and drinks high in sugar and foods that disrupt your hormonal imbalance while including healthy fats and organic protein into your diet. The Adrenal Fatigue diet would be of great benefit.

Many people with hypothyroidism have an iodine deficiency. Your thyroid needs iodine to produce thyroid hormones but your body cannot make its own. If suffering from hypothyroidism, you could include more iodine in your diet or consider an iodine supplement.

Glandulars are another possibility. Natural compounds made from animal glands derived from cows or sheep, deliver cell extracts to the same glands in the human body. For example, adrenal glandulars may have anti-inflammatory properties while thyroid glandulars containing thyroid hormones, which may help address hypothyroidism.

Do keep in mind that, although you should support your adrenals if you have thyroid issues, you should avoid any stimulants as they may overtax your adrenals and cause an adrenal crash, especially if in the latter stages of Adrenal Fatigue. It would only make matters worse than they already are. Adrenal support should be nurturing and gentle and aimed at allowing for normal adrenal hormone production. This, in turn, would support thyroid function.

In Closing

word thyroid problem as represented in a white tableThe first step towards finding out whether you have thyroid issues is doing some thyroid labs. Remember, conventional medicine does not ordinarily do the broad range of thyroid labs like they do in functional medicine. You may have thyroid issues but you may be told that your STH range is normal. At the same time, synthetic thyroid medications may, while making you feel better for a while, not deal with the issue in the long run, leaving you to deal with the symptoms once more.

The broader range of thyroid labs considered in functional medicine gives you a much more accurate idea of what, exactly, is going on with your thyroid. At the same time, the methods used to address the issue are more holistic and designed to deal with multiple issues and causes.

Now that you know more about thyroid hormones, thyroid issues, and thyroid labs, donā€™t you think you should know more about how your endocrine system works and how it can function at an optimal level? Our various pages address these and the other associated health issues. Please feel free to browse through them and ask questions if you are unsure of something. We will address any issue as soon as possible.

Ā© Copyright 2021 Michael Lam, M.D. All Rights Reserved.


Dr. Lam's Key Question

Thyroid labs indicate thyroid function. However, do keep in mind that compromised thyroid function may mean compromised adrenal function. So, although thyroid labs are not used to determine adrenal health, they do give a good indication of whether something may be wrong there as well.

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