Understanding Your Thyroid

What is the thyroid?

The thyroid is a gland in the neck that is located in front of the windpipe and below the Adam's apple on the front of your neck. This gland produces two primary hormones, triiodothyronine and thyroxine. Once the thyroid hormone is activated to thyroxine, it regulates how body cells use energy. Generally speaking, the thyroid regulates metabolism, but its healthy functioning is crucial for overall health.

How does the thyroid impact in the body?

As with most systems of the body, when the thyroid isn't functioning optimally, many other systems don't function well either. Thyroid function impacts energy levels, adrenal gland function (which produces hormones that help deal with stress), sex hormone balance, and blood sugar regulation.

Hyperthyroidism occurs when the thyroid is overactive, giving the cells too much energy. When the thyroid is underactive, and cells aren't receiving enough energy, it is called hypothyroidism. 

Hypothyroidism is the most common thyroid imbalance, with about 5% of children over the age of 12 suffering from this problem. As the percentage increases with age, it is reported that up to 15% of individuals over the age of 65 suffer from hypothyroidism. Hypothyroidism is often detected in the family history, and certain medications can cause hypothyroidism. Because it is the most common, this post will discuss the under-functioning thyroid, how to test for it, and what to do with a hypothyroid diagnosis more deeply. 

What are the symptoms of hypothyroidism?

Because the thyroid impacts many systems of the body, the symptoms can be a combination of any of the following:

• Chronic fatigue

• Cold intolerance

• Constipation

• Foggy thinking

• Irregular heart rate

• Hoarseness

• Depression

• Muscle weakness or cramping

• Puffy eyes

• Weight gain

• Hair loss or hair thinning

• Infertility

Those diagnosed with hypothyroidism may also have lab abnormalities, including:

• High cholesterol

• Low sodium

• Anemia

• High homocysteine

Certain medical conditions may co-occur with hypothyroidism:

• Various cancers

• Carpal tunnel syndrome

• Infertility

• Type I diabetes

• Iodine deficiency

• Pituitary tumors

• Autoimmune diseases

How do you test for and diagnose thyroid disorders?

Noteworthy is that symptoms of hypothyroidism are nonspecific and can be found in many other disorders, which makes blood testing very important. Traditionally, hypothyroidism diagnosis and subsequent treatment were based on the TSH (thyroid-stimulating hormone) and the FT4 (free T4) blood tests. However, recent research indicates that obtaining a full thyroid panel by testing FT3 and RT3 along with TPO, TSH, and FT4 provides a more accurate picture and diagnosis. 

(Looking to dig a little deeper? Read the next paragraph.) 

Dr. Antonio Bianco, MD PhD Professor of Medicine at the University of Chicago and former president of the American Thyroid Association, has written a book called Rethinking Hypothyroidism. Throughout the book, he argues that we should rethink how we diagnose and treat hypothyroidism. He emphasizes the importance of using the FT3 (free T3) blood test to diagnose hypothyroidism accurately. Research has repeatedly shown that there is a significant percentage (15%) of patients that feel and function better using the active form of thyroid replacement seen in prescriptions like Armour thyroid, NP thyroid, and Cytomel, compared to the traditional usage of the inactive form of thyroid replacement Synthroid or levothyroxine. At a recent presentation, Dr. Bianco MD discussed the joint statement released by the American Thyroid Association, European Thyroid Association, and the British Thyroid Association indicating the equal effectiveness of the inactive (thyroxine) and active form (triiodothyronine). He also reviewed extensive studies, one of which included 11,000 individuals documenting the comparable safety profile of both the inactive and active forms of thyroid medication when appropriate doses were used.

For years, physicians have seen patients struggling with many of the symptoms associated with hypothyroidism, having multiple risk factors and related lab abnormalities. Yet, those patients were not treated for hypothyroidism as they had normal TSH and FT4. By rethinking the hypothyroid issue and considering the recent medical research, many patients could be more accurately diagnosed and appropriately treated for this condition when a full thyroid panel is obtained and correct doses of triiodothyronine are used when appropriate.

What can you do?

Correctly diagnosing hypothyroidism and finding the most effective medications require a knowledgeable and experienced provider. If you or someone you know suffers from some of the above-listed symptoms, have some of the risk factors or even associated lab abnormalities listed above and have been told the thyroid was "normal" based on FT4 and a TSH lab, I would suggest obtaining a full thyroid panel. 

Likewise, some patients respond better to the active form of thyroid medication (Armour thyroid, NP thyroid, and Cytomel) than the traditionally used inactive form (Synthroid or levothyroxine). Suppose someone is receiving an inactive form and still struggles with weight control, foggy thinking, or even high cholesterol. In that case, it might be worthwhile to discuss with their physician about considering a full thyroid panel and possibly switching the form of thyroid replacement. 

If you're interested in how Madsen Medical Integrative Medicine can help you achieve optimal health and longevity, please get in touch with us.