Hypothyroidism is a common condition and many patients with the symptoms of low thyroid, test normal for TSH, the marker used to screen for hypothyroidism. TSH (thyroid stimulating hormone) is secreted by the pituitary gland in the brain. It is common for a family doctor to not test the levels of actual thyroid, which is T4 and T3. Lack of thorough blood work compounded with the fact that the symptoms of a low functioning thyroid are common to other conditions, results in missed diagnoses of patients who need to be treated with thyroid hormone.
HYPERthyroidism, resulting from an overactive thyroid is more easily detected through TSH and the patient’s symptoms are specific to hyperthyroidism. Symptoms include insomnia, anxiety, fast heart rate, diarrhea and bulging pupils.
Hashimoto’s Thyroiditis, an autioimmune disease of the thyroid has been increasing in prevalence, especially among women, and is largely undiagnosed and undertreated. Patients with Hashimoto’s will present with alternating hyperthyroidism and hypothyroidism. The long term chronic presentation is hypothyroidism and diagnosed patients will be prescribed T4. Patients with an underactive thyroid (HYPOthyroidism) and Hashmoto’s have similar chronic symptoms that are common for many other health conditions such as chronic fatigue syndrome, Fibromyalgia, Depression, and obesity. These patients get missed for the proper diagnoses due to lack of comprehensive blood work. Therefore, their symptoms get treated, without finding out that the cause may be due to thyroid disease.
The thyroid gland produces T4 which is largely inactive. This hormone is transported to the nucleus of every cell in the body. Here it is converted to T3. This transportation process into the nucleus and the actual conversion to T3 depends on the presence of ATP (cellular energy), trace minerals, and Iodine. Many patients have poor cellular energy and deficient trace minerals due to long standing malnourisment. In addition, the presence of heavy metals and leaky gut creates an autoimmune process in the body which can lead to Hashimoto’s disease. (antibodies against the thyroid).
The symptoms of Hashimoto’s and Hypothyroidism include chronic fatigue, depression, thinning hair, inability to lose weight, high cholesterol, low sex drive, irregular periods, joint and muscle aches. By looking at this list, one can see how Hashimoto’s and subclinical hypothyroidism get missed without the proper blood work.
Typically the physician that regularly sees their patients test for TSH and not the thyroid markers which are T4 and T3. TSH (thyroid stimulating hormone) is secreted by the pituitary gland when it detects low levels of T3 INSIDE THE HYPOTHALAMUS. Therefore, when TSH is elevated the patient is low on thyroid hormone. In these cases the patient will be prescribed T4. However, measuring TSH without looking at T4 and T3 is an inaccurate measure for the systemeic levels of thyroid. This is because the hypothalamus lacks a regulatory protein that is present everywhere else. This results in hypothalamic levels of T3 which is higher than anywhere else in the body. Therefore, patients who have under-active thyroid glands often have normal TSH on blood work, so the doctor does not prescribe thyroid hormone. The increasing amount of undiagnosed patients who deseperately need T4/T3 is attributed to ordering the wrong blood tests. These patients are commonly misdiagnosed with another condition such as depression and chronic fatigue and must live with the chronic symptoms of hypothyroidism.
When TSH levels are elevated on a blood test, the conventional treatment is Synthroid which is T4, the inactive hormone. Recall that the inactive T4 is converted to the active T3, and that this conversion is dependent on certain nutrients and cellular energy. Unfortunately, this conversion process is assumed to be working in all patients, therefore, even with the proper diagnosis of Hypothyroidism or Hashimoto’s the prescribed T4 is ineffective. Many patients also need to be prescribed T3, otherwise their symptoms of hypothyroidism persist despit being on T4.
The answer to this is simple. Request a full thyroid panel and get support for the conversion of T4 to T3, and in some a prescription for T3 will be necessary.
Jane Hendricks NMD
Garden Of Health, llc
7272 E. Indian School Rd. suite 540
Scottsdale, AZ 85251