Many people suffer with thyroid disorders. It is more common in women by the age of 40, but it can also happen to men as well as younger children. I have a patient who is only 10 years old and suffers with Hashimoto’s disease of the thyroid. If you suffer with a thyroid disorder you can experience many symptoms such as:
- Headaches
- Weight gain
- Weight loss
- Joint and muscle pain
- Fatigue or low energy
- Cold hands and feet
- Depression
- Constipation
- Overly sensitive to cold weather
- Poor circulation and numbness in hands and feet
- Muscle cramps while at rest
- Catches colds and other viral/bacterial problems easily and has difficulty recovering
- Wounds heal slowly
- Require excessive amount of sleep to function properly
- Chronic digestive problems (hypochlorhydria)
- Itchy dry skin
- Dry or brittle hair and nails
- Hair falls out easily
- Edema, especially facial (myxedema)
- Loss of outside portion of eyebrows
Have you been to your doctor where he performed a blood test and they told you everything looked normal. Or maybe it was abnormal and now they have you on Synthroid, Levothyroxine or methimazole and told you that you have hypothyroidism or hyperthyroidism. Your doctor will run a few blood panels one of them being a basic thyroid panel consisting of TSH or thyroid stimulating hormone and T4. If your blood work came back normal but you experience any of the symptoms above and have tried everything to try to find answers such as low calorie diets, vitamins, diet change etc with little hope, then you may still have a thyroid condition. Even though your basic blood work came back normal. To explain this I will explain how a lab will determine what normal is. Did you know that every lab has a different range of what normal is. The way it is determined is that every few years the lab will gather all of the information from testing in a single year and based on patients who have no symptoms they will develop a range for what normal is for each test. Most labs will say a normal TSH should be between 1 and 4. However there is a range that has been reported which is called an optimal range. This is a range where the patient should be functioning at its best. For the TSH that range is between 2-3. Anything out of this range there is a possibility the thyroid my not be working as well as you thought. The other problem is that when they test TSH they are really testing your pituitary gland of the brain and not the function of the thyroid. The thyroid produces, T3, T4, Free T3, Free T4, rT3, TPO and TG. If the doctor is not checking these hormones as well as TSH they really are not doing you any favors. The TSH can be normal but the other hormones can be out of range and you will never know unless the doctor checks these as well. Why do they not do this, there are several reasons one being insurance probably wont cover it and secondly the doctor may have very little knowledge of the actual biochemistry of the thyroid system. Some doctors will test T4 with a basic lab. However this hormone is not the strongest of the hormones or the most produced. T4 is produced by the thyroid but it is converted into the stronger hormone of T3 in the Liver. T3 is the most important hormone to determine if your thyroid hormones are at the proper levels.
Another important hormone to test are TPO antibodies and TG antibodies. These hormones are produced when your immune system becomes hyper active and will destroy the thyroid or its hormones. There are many reasons why this happens. It may be due to stress, infections, Fungal infections, digestion issues or even a diet of healthy foods.
My point here is you need to ask your doctor a few questions. Why did my thyroid suddenly stop working and what was the cause. Why am I still having these symptoms and why is my medicine not working even though the labs are normal or why are my medications not working even though we increase the dosage. The answer to these questions is your doctor is trained to treat your symptoms. If the blood work shows it is out of range, they will give you medicine to get them back in range. If you have headaches or joint pain you will be prescribed anti-inflammatories. If you are fatigued they will probably prescribe Adderall. Many of these medications will either exacerbate the symptoms or your thyroid problems or develop new symptoms and need more medicine to treat those problems. How do you want to live your life. Do you want to be well known at the pharmacy and be on first name basis or do you want to enjoy your life and live symptom free.
Dr. Michael Schulman
