Every week people arrive at my clinic wondering if their thyroid is okay. They’ve often had their conventional doctor check their thyroid, and are told that everything is fine. However, they aren’t convinced. They feel tired, cold, achy, and gain weight easily. They have headaches, depression or constipation, all symptoms that may reflect low thyroid function. Experience has taught me that evaluating the thyroid is complex. Low thyroid function can be caused by the immune system itself and by the dysfunction of other hormone glands in the body. It can be also affected by stress, toxins, and nutritional deficiencies. Evaluation of the thyroid is so much more than just running one test.
The thyroid gland is a small gland in the front of the neck that produces the hormone that sets the metabolic rate of every cell in the body. These hormones tell your body how fast to burn calories, influence stomach acid production, determines moisture levels in the skin and so much more. The thyroid gland is also the most common site of autoimmune disease in the body. The immune system can sometimes attacks the thyroid gland and interferes with its ability to provide the hormones needed for normal tissue function and repair. I had a patient who had gained 47 pounds in one year, despite good diet and regular exercise. Her doctor insisted that her thyroid was functioning properly, according to the one test, the TSH level, that he can run. We ran further tests which showed that she did indeed have antibodies to her own thyroid that were blocking her thyroid from making the hormones she needed to burn calories normally. Once that deficiency was corrected, she had to work hard to lose weight, but it was possible for her to do so.
Another patient came to the clinic already taking thyroid replacement medication but reported feeling as tired and achy as she had when she was first diagnosed as hypothyroid years ago. Again, her TSH test was normal. We dug a little deeper and ran a reverse T3 test. This test determines if her thyroid hormone was being converted to active T3 or a dud version called reverse T3. Elevations of reverse T3 are important if you are sick and need to conserve energy and rest. However, there are other conditions that can trigger this downstream activation of reverse T3. High stress levels, low iron levels, and chronic inflammatory states can all drive up reverse T3 and make you feel unnecessarily tired. In this case, the patient had experienced chronic stress and had an elevated reverse T3. We changed her thyroid medication slightly and gave her additional natural medicines to balance all her thyroid hormones, thus giving her back the vitality she was missing.
Naturopathic physicians prefer a full panel of thyroid hormones to accurately diagnose thyroid problems. This panel includes the relatively stable pituitary hormone TSH, free T4 (inactive thyroid hormone), free T3 (active thyroid hormone), reverse T3 and a thyroid antibody called TPO. Often we are able to unveil issues in the complex dance of the thyroid hormones, which can then be treated in a variety of ways, both holistic and pharmaceutical.