Redefining Hypothyroid in terms of TSH levels

Do these hypothyroid symptoms sound familiar: decreased energy, difficulty loosing weight, easy weight gain, lethargy, constipation, dry skin, edema, fogginess, forgetfulness, depression, muscle cramps, slow speech, decreased libido, or intolerance of cold? Think you have hypothyroid, but your doctor tells you your thyroid is just fine? Your doctor is relying on lab tests, but new evidence is showing those lab results may be misinterpreted and insufficient to make the diagnosis.

The most common test done for screening of hypothyroid is the TSH (Thyroid Stimulating Hormone) level. The hormone comes from the pituitary gland in the brain as part of a feedback mechanism to measure out the right amount of thyroid for your body. Elevated levels of TSH indicate the brain is telling the body to make more thyroid hormones, but the thyroid is not able to keep up with demand. Over the last few years normal levels of TSH has redefined.

Many labs are using 0.3 to 4.0 uU/ml as normals for TSH levels. Two years ago the American Endocrine Society called for lowering the normal TSH range to 0.3 to 3.0. Current thinking from the American Thyroid Society is that ideal levels for TSH are between 0.3 to 2.0. Persons with TSH levels greater than 2.0 to 4.0 frequently have hypothyroid symptoms, but are not usually diagnosed.

The change to the norms for TSH level has stirred some controversy. Over 50% of the American population has TSH levels greater than 2.0. It defies logic to think that ½ of our population is not normal, unless you take into consideration environmental influences. Xenoestrogens, plastics, pesticides, herbicides, fertilizers, and heavy metals interfere with thyroid function and are impossible to avoid completely. Imbalances in other hormones systems can also interfere. Elevated cortisol can lead to an inhibition of TSH. Elevated estrogen levels tie up the thyroid sites in the cells, blocking thyroid function. Stress, high carbohydrate diets, starvation, or caloric restrictions can also affect thyroid function.

The occurrence of autoimmune thyroiditis seems to be increasing, as well. This makes the reliability of TSH levels for diagnosis even more unreliable. Autoimmune attacks on the thyroid can make the thyroid hormone levels vary considerably. If blood tests happen to occur on a “good” day, then the thyroid may appear normal or even hyper. An additional test, TPO (Thyroid peroxidase antibodies) screens for antibodies to the thyroid, and can diagnose autoimmune thyroiditis, even when the TSH levels are optimal. A measurement of the actual levels of the thyroid hormones in the blood is done with Free T4 (optimal at 1-2 ng/ml) and Free T3 (optimal at 3-4 pg/ml) levels. Low levels of either hormone can occur with normal levels of TSH. A thorough thyroid panel screen would include TSH, TPO, Free T4 (thyroxine) and Free T3 (tri-iodothyronine). This presents a picture to aid in prescribing and treatment of hypothyroid and thyroiditis.

The thyroid hormones influence every organ, cell and tissue in the body. It helps set metabolism, energy, fluid distribution, and temperature control. Thyroid disease, if left untreated, can lead to elevated cholesterol levels and heart disease, infertility, muscle weakness, decreased immune response, and osteoporosis.

Herbal and mineral support for the thyroid can be useful. Iodine from Bladderwrack or other sea sources, and tyrosine are used by the body to create the thyroid hormones. Selenium is used by the body to convert the storage form of thyroid hormone, Free T4 to the usable form, Free T3 at the cellular level. Selenium is also used to reduce interfering toxins from the body. Zinc, glutathione, cobalt (B12), vitamin D and riboflavin (B2) deficiencies have been implicated in hypothyroid. Anti- inflammatories such as the omega-3’s in Cod liver oil are useful to reduce hypothyroid induced aches and for autoimmune symptoms.

Prescriptions of thyroid hormone may be necessary while toxin levels are being reduced and healing occurring or may be a life long requirement. There are a variety of prescription forms of thyroid including: the natural porcine T4 and T3 in Armour thyroid, natural T4 and T3 without the porcine glandular in Thyrolar, the synthetic T4 in Synthroid, time release forms of T3 in Cytomel. Untreated adrenal insufficiency is a contraindication for thyroid hormone supplementation.

Proper treatment of thyroid can be challenging for the patient to find and the doctor to deliver. Too high levels of thyroid supplementation can cause diarrhea, restlessness, palpitations, anxiety, and tachycardia. Good communication between the doctor and the patient aids in finding the right course of treatment and supplementation. Your local Naturopaths would be glad to work with you using the latest information on thyroid diagnosis and treatment.

Dr. Andersen practices in Newport. Appointments can be made at 541-574-6000..