Is Your Thyroid To Blame?
Hypothyroidism: Is a Sluggish Thyroid Affecting your Weight and Energy?
by Dr. Laura Riley Jones, Naturopathic Doctor
Hypothyroidism is the result of inadequate cellular thyroid hormone production to meet the needs of the tissues in the body. The most common symptoms of Hypothyroidism include fatigue, weight gain, depression, constipation, cold extremities, muscle aches, headaches, decreased libido, weakness, cold intolerance, water retention, premenstrual syndrome (PMS) and dry skin. Though controversial amongst medical practitioners, the diagnosis of Hypothyroidism is often missed by standard thyroid testing which typically looks solely at Thyroid Stimulating Hormone (TSH) levels.
Known as the most sensitive marker of peripheral tissue thyroid levels, it is often assumed that a normal TSH is a clear indication that a patient’s tissue thyroid levels are adequate (symptoms are not due to Hypothyroidism). A closer look at thyroid physiology demonstrates that the widely held belief that the TSH is an accurate marker of the body’s overall thyroid status is clearly erroneous. Most Endocrinology texts clearly state that the diagnosis of Hypothyroidism should be made based on clinical symptoms and lab values should be used to only support, not dictate this diagnosis.
TSH is synthesized and secreted by your pituitary gland. It acts as a mes¬sen¬ger sent to knock on the door of the thyroid. It’s purpose is to tell the thyroid to produce more or less T4, the inactive thyroid hormone. T4 is sent out to the peripheral tissues where, in a healthy individual, it is converted to active, working thyroid hormone. This active form of thyroid hormone is called T3.
In a patient with Hypothyroidism, the thyroid gland becomes diseased or fails to produce enough T4. As a result, the TSH knocks and knocks on the door, and theoretically, the TSH lab will show a high number. Or, if the thyroid gland overproduces thyroid hormones (called hyperthyroid), the TSH lab will theoretically go low to show that the TSH signal to slow down thyroid hormone production is not working adequately.
It has been my experience, that to clearly rule out the diagnosis of Hypothyroidism in a patient with multiple corresponding symptoms, a full thyroid panel must be ordered. This includes a TSH, Free T3, Free T4, Reverse T3 and at times, T3 uptake. It is important to understand that many patients experience Hypothyroid related symptoms even though their TSH and Free T4 levels look perfect. Unfortunately, their bodies may have a problem converting inactive thyroid hormone, T4, to active thyroid hormone, T3. If only the TSH was examined on laboratory study, then the diagnosis could be missed as T4 levels (not T3 levels) dictate TSH. For this reason, it is important to take symptoms into consideration at all times, recognizing that “normal” TSH, T4 and T3 levels as indicated by laboratories may not be “normal” for every individual. Not all of us fit into the one size fits all approach to thyroid hormone levels. This is why so many patients are walking around with symptoms related to poor thyroid health, not being treated with the appropriate medical care.
A well-rounded approach to both thyroid diagnosis and Hypothyroidism treatment is critical. Often times, thyroid hormone replacement therapy is a necessary part of treatment for Hypothyroidism. Of course, an appropriate exercise routine and a proper diet has the power to make a profound positive impact on thyroid function. A Naturopathic approach to thyroid disease involves both of the above, along with the potential addition of hormone replacement, and/or clinically studied mineral or herbal medicine recommendations to support healthy thyroid function.
Dr. Riley-Jones can be reached at at (603) 369-4626 or visit her online at http://www.naturalmedicinenh.com