Tips for a Healthier You: Get a Full Thyroid Panel
Have you been having unexplained symptoms, or been told that your thyroid is normal, even though you don’t feel right? Getting a complete picture of your thyroid health may help you find the answers you are looking for.
Get a Full Thyroid Panel
The thyroid is a butterfly-shaped gland at the base of the neck that holds the keys to human metabolism. When the thyroid is not working well, the symptoms can include fatigue, weight gain, dry skin, dry hair, hair falling out, constipation, depression, and brain fog. I frequently have patients come into my office with those symptoms (and more) who have suspected that their thyroid is under-functioning, but they have been told that their thyroid labs are “normal” and the symptoms are due to diet, depression, aging, and so on. Upon closer inspection, though, it turns out that their symptoms are not, in fact, normal.
When I finished residency, I, like most physicians, had had about two hours of instruction on thyroid disease. Fortunately, some astute patients had done their homework, and they both taught me some more advanced understanding of thyroid and then encouraged me to do my own research, which I did to the tune of literally hundreds of hours of studying and listening to lectures.
What I learned prepared me for patients like “Emma” who walked into my office and said, “My hair has all fallen out.” I looked closely at her and realized that she was right. Not all of her hair had fallen out, but it was incredibly thin, you could see her scalp everywhere on her head, and she had a few wispy strands here and there.
In the two hours of instruction in medical school and residency training, physicians are taught a very simple model: a brain hormone called Thyroid Stimulating Hormone (TSH) tells the thyroid how hard to work. When the thyroid fails, the brain speaks more loudly and the TSH level goes up. This is called hypothyroidism, or a lack of thyroid hormone and its function in the body. If thyroid function is too strong, the TSH goes down; this is called hyperthyroidism, or too much thyroid function.
What isn’t taught, unfortunately, is that this method of looking only at TSH (which is not even a thyroid hormone), is not a foolproof method of evaluating for thyroid disease; it only identifies disease some of the time. Emma did, in fact, have a normal TSH level (though just barely) but also had incredibly low thyroid hormones (Thyroid 4 and Thyroid 3) and auto-antibodies against her thyroid which is called Hashimoto’s Disease and makes the TSH level even less reliable.
If we took the TSH out of the picture, it was easy to tell that she was suffering from thyroid disease. We changed her diet, took out gluten, added a few dietary supplements, started her on a natural thyroid medication called desiccated thyroid, and over the next year she improved dramatically. Her energy rose, her mood was better, she weaned off her antidepressant, and yes, her hair once again grew back to be nice and thick. If we had only looked at the TSH level, we would have missed the opportunity to make a tremendous difference in how she was feeling and how she lived her life.
Most patients in my practice who have thyroid disease know this already, either because they’ve done their own research or they’ve talked with me about thyroid physiology over the years. If you have thyroid disease and are on medication already and are not part of our practice, this is relevant to you as well.
Recently, a patient came to talk with me about chronic pain issues and the Mind-Body Medicine work that we do, which he had been working on and is relevant to him for a variety of reasons. In the intake process, I noticed that he was taking a high dose of levothyroxine, the standard thyroid medication that 99% of patients with thyroid disease take. Despite the high dose, though, he still had a variety of symptoms of hypothyroidism, including feeling tired, feeling cold all the time, and having incredibly dry, itchy skin.
He agreed to let me order a full thyroid panel of labs for him, not just a TSH level. The TSH turned out to be mildly elevated, which is when most physicians have learned that in that situation, they should raise the levothyroxine dose to bring the TSH level down. But when we looked at the additional thyroid labs, though, we also saw that his Thyroid 4 level (the main thyroid storage hormone) was high—not low, as would be expected from looking through textbooks. Furthermore, his Thyroid 3 (active thyroid hormone) level was low—again, not the expected finding. His Reverse T3 (inactive thyroid hormone) level was high; that skewed ratio of high Reverse T3 to low Thyroid 3 frequently brings on thyroid symptoms even if the TSH does not reflect that. Lastly, he also had Hashimoto’s Disease which, again, makes the TSH level less reliable.
He and I made the decision to gradually switch him over from the high-dose levothyroxine to a more standard dose of desiccated thyroid, and his symptoms are gradually improving; he’s feeling warmer, his skin is less dry, and, importantly, his symptoms of chronic pain are improving as well.
So, whether you’re suspecting thyroid disease but have been told everything is “normal” or you have thyroid disease and aren’t feeling well on levothyroxine, feel free to reach out this year to get a fuller picture of what’s going on with your thyroid hormones. Textbook medicine works sometimes, but you are not a textbook; you’re you. Medically, you need what you need, not what works for anyone else. Don’t let the sclerotic medical system keep you from feeling your absolute best in 2023.
For more information, check out Dr. Stracks’s posts about thyroid function, thyroid labs, and holistic thyroid treatment options.
Don’t settle for complacency. You deserve answers when it comes to your health. To get your thyroid fully checked out and get Dr. Stracks’s insights about your thyroid health, please contact us through our website or by calling us at 312-489-8890. Your healing journey begins now.