DEMYSTIFYING THE DIAGNOSIS AND TREATMENT OF THYROID DISORDERS
According to the American Thyroid Association, approximately 20 million people in the US suffer from some form of thyroid dysfunction, and 60% of those people don’t realize it. Women are much more likely than men to experience thyroid disease (five to eight times), with one in eight women experiencing a thyroid disorder during their lifetimes.
A number of thyroid disorders exist; hypothyroidism (underactive thyroid),Low Free T3 Syndrome, the most common clinical picture, hyperthyroidism (overactive thyroid), Grave’s Disease and Hashimoto’s thyroiditis, thyroid cancer and benign thyroid nodules.
The biggest challenge practitioners face in treating thyroid dysfunction is widespread misdiagnosis, as many common symptoms of thyroid disease are often attributed to other diseases and aging. These symptoms include fatigue, weight gain, depression, brain fog, anxiety and hair thinning, among others.
COMMON SYMPTOMS OF HYPOTHYROIDISM
- Fatigue and drowsiness
- Difficulty learning and forgetfulness
- Depression and anxiety
- Chronic pain
- Slowed speech and hoarseness
- Puffiness in the face
- Dry, itchy skin
- Dry, brittle nails and hair
- Hair loss
- Queen Anne’s sign (thinning/loss of outer 1/3 of eyebrows)
- Heightened sensitivity to the cold
- Weight gain and fluid retention
- Heavy or irregular periods
- Constipation
- Sore, achy muscles
- Increased risk of miscarriage
WHY DO SO MANY CASES OF HYPOTHYROIDISM GO UNDIAGNOSED?
Or as our patients say: “Why do I have normal thyroid numbers but still suffer symptoms of low thyroid?”
The answer is most often Low Free T3 Syndrome.
Many patients come to us for answers. They want to know why they’re experiencing many of the telltale signs of low thyroid, yet their lab tests show their thyroid is functioning just fine. Unfortunately, many medical practitioners rely too much on a single lab test (the TSH—thyroid-stimulating hormone—test) to diagnose hypothyroidism, which only tells one part of the story.
Recent clinical studies regarding thyroid function are urging healthcare providers to pay much closer attention to the active thyroid hormone, Free T3. The Free T3 can be low, even in the presence of a normal TSH blood test. Why is this? It is because TSH is a reflection of T4, the primary thyroid hormone made by the thyroid gland. However, T4 must convert to Free T3, the active hormone that exerts its action in the cell.
Many things can cause decreased conversion of T4 to T3- chronic physical and emotional stress, low calorie diets, depression, insulin resistance/diabetes, chronic pain, chronic fatigue, low iron and even the commonly prescribed synthetic thyroid medication, Levothyroxine. This is why so many people on this medication still have symptoms of low thyroid, despite “normal” lab values. This is a very important concept to understand, as Low Free T3 Syndrome is highly linked to heart disease, heart failure, increased all-cause mortality (all cause of death), adult respiratory distress, and depression, to name a few.
Other research points to a similar syndrome known as thyroid hormone resistance. Believed to be an inherited condition, thyroid hormone resistance is characterized by “a reduced responsiveness of target tissues to thyroid hormone due to mutations on the thyroid hormone receptor.” Much like a car, you may have plenty of fuel (thyroid) in your tank but it can’t get into your engine (the tissues and cells in your body) due to faulty thyroid receptors.
Patients with thyroid hormone resistance or hypothyroidism II may experience symptoms of hyperthyroidism or hypothyroidism and have “elevated thyroid hormones and a normal or elevated thyroid-stimulating hormone (TSH) level.”
You can see why the single TSH lab test shouldn’t be the only tool practitioners use to diagnose thyroid dysfunction, right? Especially if the problem is malfunctioning thyroid receptors. No wonder so many people go undiagnosed! In fact, the widespread adoption of thyroid blood testing has left scores of patients erroneously untreated.