It’s Important to Get Answers to These 3 Questions About Your Thyroid
By Gia McCloskey-Jurevich, Nurse Practitioner at Omnia Health in Denver, Colorado
What is hypothyroidism and what can we do about it? Let’s discuss three things to consider when your thyroid labs are normal but you still have hypothyroid symptoms. Let’s explore thyroid issues with a functional medicine approach.
Symptoms of hypothyroidism are vast and can be confused with other health issues.
Hypothyroidism symptoms include:
When a patient reports these symptoms most doctors will check the thyroid gland by looking at a TSH or thyroid-stimulating hormone level. While this is an important first step, it is only one small piece of a very complex situation.
Thyroid-Stimulating Hormones (TSH)
Thyroid-stimulating hormones (TSH) is produced by the pituitary gland which monitors how much thyroid hormones, mostly T3 and T4, are circulating throughout the body. If the thyroid is underactive, the thyroid hormones will be low so the TSH will rise in an attempt to “stimulate” the thyroid into producing more hormones.
According to most labs, the normal range is from 0.5 mIU/L to 4.5 mIU/L (mIU/L is a measurement that means: milli-international units per litre). Hence, a TSH above 4.5 mIU/L means that a person has hypothyroidism and is generally given a prescription for thyroid hormone replacement, usually in the form of T4. In theory, the TSH will decrease over a couple of weeks as the amount of T4 rises.
This hypothyroidism solution works for some…
For some people, this works very well, and they feel better once they are on the appropriate dose of medication. However, many people continue to struggle. Some report feeling better for a short time but then their symptoms eventually return. And with our active Denver lifestyles, who wants to keep dealing with fatigue, weight gain, and brain fog?
When patients call Omnia Health with the above symptoms and tell us they have had their thyroid checked and it was normal, I ask three questions:
1. What was your TSH level?
2. Did your doctor check your T4 and T3 levels?
3. Have you ever had your thyroid antibodies checked?
A Deeper Dive Into Thyroid-Stimulating Hormones (TSH)
Optimal vs. Normal Lab Ranges
In functional medicine, we talk about optimal vs. normal lab ranges. Although the normal range of TSH is up to 4.5 mIU/L, I have found that most people feel best with a TSH between 0.5 and 2.5 mIU/L.
So simply increasing the thyroid hormone dose to get the TSH into those ranges can make a significant difference in how a person feels.
Adding More T3 to Your Prescription
Next, we look at the actual levels of T4 and T3. Your T4 needs to be converted to T3 which is the most active form of thyroid hormone. If T3 is low, a person will most likely experience hypothyroid symptoms even with a normal TSH and T4. There are several factors that can contribute to poor conversion of T4 to T3 including stress, gut dysbiosis, certain medications, lack of specific nutrients, and inflammation.
A simple solution to address symptoms is to add in a prescription of T3. A functional medicine practitioner won’t stop there but will look at the other factors that might be contributing.
Two Main Antibodies That Lead to Hypothyroidism
Finally, let’s talk about thyroid antibodies and answer the question – “What is an antibody?” Antibodies are proteins that our immune system produces that circulate our body and attack foreign substances such as viruses and bacteria. Unfortunately, our immune system can become faulty and produce antibodies against our own body.
There are two main antibodies that can lead to hypothyroidism, Thyroid peroxidase (TPOAb), and Thryoglobin antibodies (TGAb). Thyroid antibodies attack the thyroid tissue eventually leading to hypothyroidism, due to the destruction of the thyroid gland. If a person tests positive for either type of thyroid antibodies, they are diagnosed with Hashimoto’s thyroiditis, an autoimmune disease.
“It is estimated that around 90% of hypothyroidism is Hashimoto’s.”
It is estimated that around 90% of hypothyroidism is Hashimoto’s. Many doctors don’t test for these antibodies because it doesn’t change their treatment approach. Thyroid antibodies can be present for many years before TSH is affected yet their presence often leads to symptoms of hypothyroidism.
Functional medicine addresses auto-immune diseases by looking into the root cause. As functional medicine practitioners, we ask; “Why is the body attacking itself?” Autoimmune diseases stem from a complex web of lifestyle, environmental, and genetic factors. These include diet, stress, insomnia, medications, chronic infections, toxins, and gut infections, to name a few.
As you can see, addressing hypothyroidism is so much more than simply checking a TSH and prescribing thyroid hormone replacement.
If you are struggling with hypothyroid symptoms and are told your labs are normal, consider setting up a consultation with Omnia Health.
We offer a Complimentary 15-Min. Phone Consultation. There’s no obligation, it’s easy to set up and it might give you the peace of mind you’ve been searching for. Most of our patients are from the Denver, Colorado area but we can certainly help answer questions from anywhere.
Health Issues We Treat With a Functional Medicine Approach:
“When I was a kid, my mom worked for a Chinese medicine doctor who treated patients with acupuncture and herbs. Growing up, I got a lot of exposure to medicine approaches that are beyond the conventional, traditional approach…”
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Antibodies & Hypothyroidism
There are two main antibodies that can lead to hypothyroidism, Thyroid peroxidase (TPOAb), and Thryoglobin antibodies (TGAb). Thyroid antibodies attack the thyroid tissue eventually leading to hypothyroidism, due to the destruction of the thyroid gland.
“What is an antibody?”
Antibodies are proteins that our immune system produces that circulate our body and attack foreign substances such as viruses and bacteria. Unfortunately, our immune system can become faulty and produce antibodies against our own body.