Despite routine thyroid testing, many people with a thyroid condition go undiagnosed. Typical symptoms of hypothyroidism include fatigue, weight gain, low mood, hair loss, feeling cold, low energy, swelling or water retention, joint pain, brain fog, memory loss, infertility and irregular periods. The most common blood test performed to look at thyroid function is the thyroid stimulating hormone (TSH). However, the range of “normal” is quite wide and it is possible to have a normal TSH yet have low thyroid.
In 2012, a review detailing how hypothyroidism can be missed with conventional testing was published in the Journal of Restorative Medicine. Over 200 references were used to compile the paper by Dr. Kent Holtorf and alternative strategies for diagnosis are provided.
The level of brain thyroid hormone (T3) can be different than the cellular level of thyroid hormone. When TSH is measured in the blood, it is a reflection of the brain T3 level and not the tissue (cellular) levels which are responsible for metabolism. There is no direct test to evaluate the tissue T3 levels, but looking at a variety of other blood markers can help the difficult to diagnose cases become recognized. Reverse T3 is an unusable form of T3 that the body makes when it perceives that it is under stress and it will be made in excess of actual free T3. In Dr. Holtorf’s journal article, it is suggested that if the free T3 to rT3 ratio is less than 0.2, it is highly indicative of low tissue thyroid levels and the presence of hypothyroidism. To further confirm tissue levels, another blood test, SHBG can be performed as it tends to be low with low tissue T3.
So, how do we clearly determine thyroid health? The first part is looking at symptoms and determining if there is a clear pattern involving hypothyroid attributes as mentioned above. Secondly, a comprehensive thyroid evaluation by blood at the correct time of day will confirm. This panel includes TSH, Free T3 and Free T4, reverse T3, SHBG and the two types of anti-thyroid antibodies that are the cause of hypothyroidism 50% of the time. With all of this information, a definitive diagnosis can be made and the correct type of treatment prescribed. Treatment for hypothyroidism usually involves minerals, herbs, prescription thyroid hormone(s), diet and digestion support and correction of iron levels, hormone balancing and stress management both lifestyle and treatment. Please contact our clinic for more information.
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