Thyroid Health
The thyroid is a gland that sits in the upper neck and whose main job is to produce thyroid hormone, primarily what are referred to as T4 and T3. Thyroid hormone then goes into each cell of the body and helps set the metabolic rate. The metabolic rate is how much each cell produces. Having too little thyroid hormone is referred to as hypothyroidism and causes symptoms of having too little energy Too much thyroid hormone is referred to as hyperthyroidism and causes symptoms of cells trying to produce too much energy. Hypothyroidism is by far the more common of the two and tends to affect women more than men, with up to 20% of all women developing hypothyrodism.
Symptoms of hypothyroidism include:
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The thyroid is involved in how we metabolize food, how we store and use energy, how we think, talk, sleep, and more! So it makes sense that when the thyroid isn’t functioning, life can seem entirely off-kilter. As is true for hormones in general, but perhaps thyroid in particular, lab testing is not an exact science. People sometimes (quite often) have normal thyroid labs but display signs of thyroid deficiency. Therefore, both labs and symptoms need to be considered.
The primary screening lab test for thyroid dysfunction is a thyroid test that measures a hormone in the blood called Thyroid Stimulating Hormone (TSH). This hormone is secreted by the pituitary gland in the brain and turns on the secretion of the thyroid hormones from the thyroid gland itself. In optimal conditions, the T3 and T4 hormones give feedback to the brain and keep the TSH low. Hypothyroidism is displayed through labs when TSH is high – indicative of too little circulating T3 and T4 hormones and the brain sending increased messages to the thyroid gland for more thyroid hormone production. There are many cases, however, where the TSH is not elevated and yet the thyroid hormones are inefficient at the cellular level. Patients will often times feel better when some dose of thyroid hormone is prescribed.
This then leads us to the next primary issue in thyroid health. There are two primary forms of thyroid hormone on the market, tablets containing only T4 vs tablets containing both T4 and T3. Synthroid (brand name), or levothyroxine (generic), is a thyroid hormone tablet containing T4 only, and is the most commonly prescribed thyroid replacement. The theory is that T4 converts to T3 so it is unnecessary to include T3 in the tablet. Unfortunately, many bodies seem to be inefficient at this process. It therefore often proves very beneficial for the patient to prescribe a tablet, such as Armour or Nature-Throid, that contains both T4 and T3. Both Armour and Nature-Throid are bio-identical to what the body makes and are very easy to use. As long as there are no symptoms of overstimulation (elevated heart rate, internal trembling) and the patients feel well, I do not necessarily focus on what the lab levels show. The basic idea is that in the end it is good practice to treat the person sitting in front of you and not the piece of paper that may be saying “all is fine”.
