Are you one of the millions of people who are walking around with too little thyroid hormone but have been told “your thyroid levels are normal?”
Statistics vary wildly, but it is estimated that:
- from 12M to 60M people have thyroid problems that lead to symptoms and
- 60% of those who suffer from thyroid dysfunction are unaware of it.
Does this describe you?
Low energy, suffering from brain fog, easily get out of breath, extra weight won’t budge, your hair is thinning, have extremely dry skin, sleep poorly or wake up exhausted, suffer joint pain, constipation, cold all the time.
Do these symptoms sound normal? Sadly, with so many people suffering from these and other symptoms of malfunctioning thyroid, they are normal, or, what the norm is for a group of people. They do not represent healthy nor what people should have to live with.
Commonly we assume that this is what happens as we age, things start to go wrong. Or a doctor gave you the old stand-by blood test to measure TSH levels and based on this number alone reported back, “Your thyroid levels are normal.” What is implied is “You’re fine” even when you know you aren’t.
Diagnosing thyroid health from TSH numbers alone is like trying to figure out why you can’t lose weight by only looking at what you eat. Sure food is going to play in to it but there are many other things to consider.
Let’s do the science quickly so you understand the potential problems with common testing and diagnosis.
First of all, a TSH test measures pituitary hormone. The pituitary gland produces TSH — thyroid stimulating hormone — which in effect yells to the thyroid to wake up and give the body some T4, tyroxine. T4 is not the active hormone of metabolism, good sleep, and feeling great, T4 must be converted into T3 for that. (Rather than go into all the science about T4’s uses suffice to say it has some but our problems mostly arise when we don’t convert enough of it to T3).
Take away — Using TSH levels alone to determine if the thyroid hormone is getting where it needs to go gives us only half of the information we need.
Then there are the reference ranges, aka, the range of blood levels within which someone should feel good and be healthy. The original range was determined long ago and was updated on new findings but not all docs follow the newer ones. If your doc is using the old set of numbers you’ll see these on your blood work report 0.5 – 5.0. The updated range is 0.3 – 3.0. We are looking for optimal health and that is usually found at the midpoint of any high/low measurement. Optimal TSH, according to Dr. Rind, a holistic thyroid expert based in Washington DC, is 1.3 – 1.8, lower than the mid-range of the most commonly used ranges. Using the conventional ranges, you could be a 3 or a 5 and be considered healthy yet that much off the mid mark could mean you feel awful.
What do those numbers mean anyway? When your number is higher than what the range calls normal it means your pituitary is pumping out quite a bit of TSH. Again, TSH is thyroid stimulating hormone not a thyroid hormone. This means the thyroid is not making enough T4. (More TSH–not enough T4). Then you have biochemical individuality, body type, weight, age, and so on, and you soon see that using so small a range is whack-a-doodle. That said, if you are not symptomatic and fall within those ranges then all is well. It’s the people who feel poorly who fall within those ranges that have the problem. And as you read at the top of the article it’s quite common.
Normal is a moving target. Let me repeat, you can have the “right” number and still feel awful. Why? One problem arises when T4 doesn’t get converted to T3. T3 is the active thyroid hormone. T4 to T3 conversion is hampered by any number of things including nutritional deficiencies, high cortisol, low vitamin D, toxins, heavy metals, illness, and other things.
Another potential problem is autoimmune thyroid diseases. Hashimoto’s causes hypothyroidism that can swing into hyper and is the most common. Graves leads to hyperthyroid states.
In addition to those the adrenal system supports thyroid function. If your adrenals are taxed or compromised your thyroid condition will be harder to fix.
You can see why your family physician might not be the best person to help you if you think you have a thyroid problem. There is so much to know. Diagnosis is only one part of the issue, prescribing is another.
If you feel you have a thyroid problem and have been dismissed as normal it’s time to look for a new doc or get educated then go back and ask for new tests. Present your practitioner with the latest science. Here is a great book that will break it all down for you in an easy to understand way. Thyroid Healthy, Lose Weight, Look Beautiful and Live The Life You Imagine by Suzy Cohen. She’s a former pharmacist turned holistic health advocate and she’s made the thyroid her area of focus after having suffered through all of the symptoms and being told she was fine.
Here are the tests to ask for to get the big picture on your thyroid’s condition:
Ultrasound — often used to rule out cancer — a thyroid ultrasound is safe, no radiation, no prep, and can detect enlargement, inflammation, or cancer.
The way to tell if you have Hashimoto’s or Graves is to test for thyroid antibodies. These are ATA, thyroglobulin antibody and TPO, thyroid peroxidase antibody.
In addition to the TSH you should ask for Free T4, Free T3, Reverse T3. rT3 is an important number. The more you have of the reverse form of T3 the less T3 that can get into the cells.
One measure of thyroid health that is downplayed in importance in the western medical world but is seen as valuable with the thyroid docs is the Free T3 to rT3 ratio. According to Suzy Cohen the suggested level is greater than 2. It evaluates tissue levels of these hormones and gives another piece of the puzzle when determining where you are and what it will take to get you better.
Don’t settle for normal as a diagnosis when you feel like crap. Thyroid problems are not the only cause of those symptoms I mentioned but it’s a great place to start looking and frequently brings immediate relief with treatment.