Do you think you have a thyroid issue?
If you have found this blog, I suspect you are searching for answers. You probably haven't felt good in years.
You ask friends for their opinions. They each have their ideas, but no real solutions.
You might have read an article in a magazine, or on the internet, or maybe even on a Facebook post that discussed thyroid issues, and you thought "That is describing me exactly!"
You probably even went to see a doctor. You told him or her your complaints, they took a quick history, performed a simple physical exam, and then ordered some lab tests.
You might have even left hopeful, thinking that maybe this would be the time that someone finally figured out what was going on in your body.
Your hope was soon dashed, however, when you received a call from the doctor's office telling you that all of your labs were "normal."
The doctor probably offered a prescription for an antidepressant, or a sleep aid, or a pain medication, or some other type of prescription to treat one of your symptoms.
You might have even been prescribed a thyroid medication, but you were disappointed when you didn't really feel any better after taking it for awhile.
Even though you don't know what is going on, you know that something isn't right.
Perhaps you have even thought that this was your new "normal" and you would just have to learn to live with how you feel.
Unfortunately, that doctor could have been me until a few years ago.
Countless patients have come into my office over the years complaining of things such as unexplained fatigue, weight gain, depression, hair loss, mood swings, cold intolerance, headaches, dry skin, lack of libido, etc., or any combination of the above.
Doctors are taught in conventional training that if you want to assess the thyroid, just check a TSH level. If it is high, the patient has hypothyroidism. If it is low, the patient may have Grave's Disease or Hashimoto's Thyroiditis. If it is normal, then the patient does not have have thyroid disease.
Simple, little to no thinking involved.
Unfortunately, nothing is ever that simple, especially when dealing with the human body.
Doctors are aware of a vast array of other thyroid tests that are available, but most don't believe they are necessary.
To be honest, they may not know how to interpret the results or know what to do with them even if they did order them! I know I didn't until I learned a better way - the correct way.
The vast majority of patients with these symptoms will have TSH levels in the "normal" range. Doctors often don't know what to do with those patients, so they typically resort to prescribing medication for depression, or insomnia, or pain, or headaches, or even weight loss medication.
In other words, the downstream symptoms are treated instead of looking upstream to find the root cause of the problems.
Some experts estimate that up to 40% of the population has hypothyroidism. That's one out of every 3 people! Yet only a small fraction of them are diagnosed and even fewer are treated adequately.
What exactly is the purpose of this butterfly-shaped gland at the base of our neck? What does it do?
The answer is a lot, actually.
It influences almost all of the metabolic processes in the human body. That includes metabolism, growth, development, and body temperature.
It is essential for normal brain development in infants and children.
The hypothalamus secrets the hormone thyroid releasing hormone (TRH) which stimilates the pituitary gland to secrete thyroid stimulating hormone (TSH).
TSH then stimulates the thyroid gland to produce primarily T4 (and small amounts of T3).
The liver and muscles metabolize T4 into T3 (active thyroid hormone).
In the presence of inflammation, stress, nutrient deficiency, etc., higher amounts of reverse T3 (rT3) may be produced which works to block T3 activity in the body.
Symptoms of Hypothyroidism
This is an extremely compact list - the actual list of possible symptoms is MUCH longer. An extensive list can be found here. However, if you have several of the ones listed above, the chances of you having hypothyroidism is extremely high.
By the Way - It is important to understand that symptoms of hypothyroidism often overlap with other hormonal problems in the body.
Adrenal fatigue, peri-menopause, and menopause (andropause in men) often present with very similar symptoms to hypothyroidism.
It takes an experienced practitioner who can perform a thorough history, physical, and some targeted laboratory tests to distinguish what exactly is going on.
It may even be a combination of several conditions!
Prior to the 1970s, hypothyroidism was a purely clinical diagnosis - doctors made the diagnosis after taking a thorough history and performing a physical exam.
After the TSH lab test was developed, it became the gold standard in diagnosing hypothyroidism.
Many doctors have now stopped looking for symptoms or clinical signs of the disease and almost solely depend on the lab for the diagnosis.
Unfortunately, this misses the vast majority of patients that are suffering from the condition!
The purpose of the lab tests should only be to confirm what the provider has already found after talking to and examining the patient.
As a wise old doctor told me when I was in medical school, "If you listen to the patient long enough, they will tell you what is wrong with them."
By the way - some experts suggest that the normal range for TSH should be lowered to 0.4-2.5. This is because when the reference ranges were established for the TSH, the highly sensitive TSH test was not available, and the reference populations included people with various degrees of thyroid disease such as Hashimoto's. The National Academy of Clinical Biochemistry indicates that over 95% of normal individuals have a TSH level below 2.5.
If you have many of the symptoms listed above and you have lab tests that confirm your suspicions, you can officially be diagnosed with hypothyroidism.
I discuss treatment options in my blog here.
Now It's your turn...
Do you think you have hypothyroidism?
Have you had problems getting a definitive diagnosis?
Anything in this article that you learned?
Leave your comments below.
Dr. Whelchel is a family physician who specializes in functional medicine, especially hormone optimization. He has over 20 years experience in private practice managing patients with various medical issues. His passion is helping patients reach their full potential of wellness and quality of life. He grew up in the Texas Panhandle where he currently lives. He is married and has 3 awesome children.