It's estimated that as many as 25 million Americans have a thyroid problem, and half of them have no idea that they do. Hypothyroidism, or an under-active thyroid, accounts for 90% of all thyroid imbalances.
The thyroid, a butterfly-shaped gland in the center of your neck, is the master gland of metabolism. How well your thyroid is functioning is inter-related with every system in your body. If your thyroid is not running optimally, then neither are you.
Here are 10 signs that you could have an underactive thyroid:
1. Fatigue after sleeping 8 to 10 hours a night or needing to take a nap daily.
2. Weight gain or the inability to lose weight.
3. Mood issues such as mood swings, anxiety or depression.
4. Hormone imbalances such as PMS, irregular periods, infertility and low sex drive.
5. Muscle pain, joint pain, carpal tunnel syndrome, or tendonitis.
6. Cold hands and feet, feeling cold when others are not, or having a body temperature consistently below 98.5.
7. Dry or cracking skin, brittle nails and excessive hair loss.
9. Mind issues such as brain fog, poor concentration or poor memory.
10. Neck swelling, snoring or hoarse voice.
How does you thyroid gland work?
Thyroid hormone production is regulated by a feedback loop between the hypothalamus, pituitary gland and the thyroid gland. Hypothalamic thyrotropin-releasing hormone (TRH) stimulates pituitary thyrotropin (TSH) synthesis and secretion.
In turn, TSH stimulates production and release of T4 and T3 from the thyroid gland. When enough T4 is produced, it signals to TRH and TSH that there is enough thyroid hormone in circulation and not to produce more.
About 85% of the hormone produced by our thyroid gland is T4, which is an inactive form of the hormone. After T4 is made, a small amount of it is converted into T3, which is the active form of thyroid hormone.
To complicate matters, T3 also gets converted into either Free T3 (FT3) or Reverse T3 (RT3). It's the Free T3 that really matters in all of this, since it's the only hormone that can attach to a receptor and cause your metabolism to rise, keep you warm, keep your bowels moving, mind working, and other hormones in check. The role of Reverse T3 is not well known, however, I do see it elevated in persons under extreme stress and those who have mercury toxicity.
And finally, Hashimoto’s thyroiditis, an autoimmune disease, is the most common form of hypothyroidism and its numbers are rising annually. An autoimmune disease is one in which your body turns on itself and begins to attack a certain organ or tissue believing its foreign.
I routinely screen all of my patients for autoimmune thyroid disease by ordering Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb).
Why is hypothyroidism so under diagnosed in the USA?
Many symptoms of thyroid imbalance are vague and most doctors spend only a few minutes talking with patients to sort out the cause of their complaint.
Most conventional doctors use only one or two tests (TSH and T4) to screen for problems. They are not checking FT3, RT3 or thyroid antibodies.
Most conventional doctors use the ‘normal’ lab reference range as their guide only. Rather than listening to their patients symptoms, they use ‘optimal’ lab values and temperature as their guide.
Which lab tests are best to determine if you have a thyroid problem?
I check the below panel on each of my patients. Make sure your doctor does the same for you.
- Free T4
- Free T3
- Reverse T3
- Thyroid Peroxidase Antibodies (TPOAb)
- Thyroglobulin Antibodies (TgAb)
What are the ‘optimal’ lab values for thyroid tests?
In my practice, I have found that the below are the ranges in which my patients (and myself) thrive. I listen to my patients as well and take how they are feeling into account.
- TSH 1-2 UIU/ML or lower (Armour or compounded T3 can artificially suppress TSH)
- FT4 >1.1 NG/DL
- FT3 > 3.2 PG/ML
- RT3 less than a 10:1 ratio RT3:FT3
- TPO – <9 IU/ML or negative
- TgAb - < 4 IU/ML or negative
What are 10 things you can do to improve your thyroid function?
1. Make sure you are taking a high quality multivitamin with Iodine, Zinc, Selenium, Iron, Vitamin D and B vitamins.
2. Take a tyrosine and iodine supplement to help with the FT4 to FT3 conversion.
3. Go gluten-free! If you have Hashimoto’s, try going completely grain and legume free.
4. Deal with your stress and support your adrenal glands. The adrenal glands and thyroid work hand and hand. I recommend restorative yoga and adaptogenic herbs, which support the adrenal glands in coping with stress.
5. Get 8 to 10 hours of sleep a night.
6. Have a biological dentist safely remove any amalgam fillings you may have.
7. Watch your intake of cruciferous vegetables. There is a bit of a debate surrounding this.
8. Get fluoride, bromide and chlorine out of your diet and environment.
9. Heal your gut. A properly functioning digestive system (gut) is critical to good health. To learn more, click here.
10. Find a functional medicine doctor in your area and have them run the above laboratory test and work with you to find our root cause of the thyroid imbalance.