Thyroid 101: What is thyroid disease and how does it affect you?

The way in which each person reacts to their thyroid hormone levels is as unique as their own fingerprint. Treating thyroid hormone imbalance must be done with a thorough understanding of not only the thyroid hormones themselves, but also how they interact with all the other hormones in the body. One could say that your hormones work together closely like the instruments in a symphony orchestra. When one instrument is off, the entire symphony strikes a sour note. It is the same with your hormones. With this in mind, let’s take a look at specifically the thyroid hormones.

The thyroid is a butterfly-shaped gland located in the neck. It is the most important hormone when it comes to regulating a person’s metabolism. Metabolism refers to the chemical reactions that take place in one’s body enabling them to live. The thyroid plays a role in this by regulating the chemical reactions that produce energy in our body. Simply stated, the thyroid decides what our bodies do with the food that we eat. It can cause our food to be used for energy or, if our thyroid is underactive, we may tend to store the food as fat. This is why an underactive thyroid can lead to weight gain and feelings of lethargy.

However, one should keep in mind that the thyroid gland has an influence on almost every cell in your body. Hence, if your thyroid is sluggish the possible symptoms can vary greatly. Other than weight gain and low energy, common symptoms of low thyroid include:

  • Cold intolerance, predominantly in the hands and feet
  • Hair loss, including eyebrows
  • Brittle nails
  • Depression or anxiety
  • Decreased memory and foggy thinking
  • Inability to concentrate
  • Muscle and joint pain
  • Irregular menstrual periods
  • Constipation
  • Drooping eyelids and puffiness in the face
  • Dry eyes
  • Even carpal tunnel syndrome

In addition to regulating our metabolism and weight, thyroid hormone also aids in keeping the cardiovascular system working at its peak, stimulates growth hormone in children, as well as stimulates the cancer-fighting cells of your immune system. Clearly, it is important to keep your thyroid gland healthy and balanced.

The primary thyroid hormones are TSH, T4 and T3. The thyroid gland produces 10x more T4 than T3, but T3 plays a much more influential role in the way our bodies metabolize food. Although the thyroid produces mostly T4, it is converted to T3 primarily in your liver—or it should be which will be explained later. One may have problems converting T4 to T3 thus giving symptoms of low thyroid. TSH (thyroid stimulating hormone) is released when the brain senses low T3 or T4, thus stimulating their production.

Can one have a normal TSH and T4 but still suffer from low thyroid? Absolutely! This is why so many people are misdiagnosed. Consider this:

Having an “underactive thyroid” means that it is not producing enough of the active hormone, T3. To check for this, many physicians only check the TSH levels. If TSH is high, this means that your body is trying to produce more T4 so your body can convert it to T3. Unfortunately, this approach to diagnosing low thyroid (just checking TSH or T4) misses the mark in too many cases. As mentioned, T3 is the active form of the thyroid hormone. People often have low thyroid symptoms (because their T3 is low) even if their TSH is normal (because their T4 is normal even in the presence of low T3). The patient feels terrible because their doctor only checked their TSH and/or their T4. They were told their thyroid was normal because the TSH and T4 were normal when, in fact, it was the unchecked T3 that was too low. Thus, one may be low in T3 and experiencing symptoms while still having their TSH and T4 levels in the normal range.

There are two main reasons for this. First, as mentioned, the T4 may not adequately convert to T3. Secondly, T4 may be converted to something called “Reverse T3”. This is an inactive form of T3. It is still T3, but it is in an inactive form and essentially does nothing in your body. Thus, even if T3 levels appear to be normal, if too much of the total T3 is in the inactive form, then a patient feels the symptoms of low thyroid.

This may sound complicated but it doesn’t have to be. A comprehensive evaluation is necessary to determine an effective treatment plan. Roughly 20% of patients have symptoms of low thyroid, yet are told that their levels are normal. Again, this is because only their TSH and possibly their T4 were checked. When doctors evaluate a patient, they need to look at not only TSH and T4, but also T3 and Reverse T3.

A patient’s treatment plan should be individualized depending upon the problems that are found via the comprehensive testing. If T3 is too low, consider adding a combination T4/T3 preparation such as Armour Thyroid. Alternatively, a customized formula prepared by a compounding pharmacy may be provided to meet the patient’s specific needs. Treatment can also include targeting factors that influence the conversion of T4 to T3. One must have adequate levels of Vitamins A, D and E for a proper conversion to take place. Also, adequate levels of selenium, potassium, iodine, iron and zinc, along with enough protein increase the conversion of T4 to T3. Therefore, an adequate diet and possibly just adding certain supplements can go a long way in preventing low thyroid and its symptoms, which range from simply unpleasant to downright dangerous.

Also, remember that T3 plays in the hormonal symphony and one also needs proper levels of estrogen, testosterone, progesterone, insulin and cortisol.

A comprehensive approach to treating thyroid dysfunction is paramount. A physician must listen to the patient’s symptoms, make sure the appropriate tests are done and evaluated correctly, perform a proper physical examination, and obtain a medical history as well as a family history. All of this contributes to the proper diagnosis and treatment plan necessary to address these real problems, not the least of which are lethargy and weight gain, which, as we all know can lead to other serious health issues.

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