A sluggish thyroid
Common problem, commonly overlooked
Are you tired, constipated, mildly depressed, struggling to lose weight, with dry skin? You may suffer from hypothyroidism — an underactive thyroid.
Problem: the above symptoms may have other causes. Another problem: rigid blood test interpretation can lead to a missed diagnosis of hypothyroidism.
Your thyroid gland
Your thyroid is a butterfly-shaped gland at the base of your neck. It regulates your body’s energy production.
Your thyroid gland produces thyroid hormone (no surprise there). “T4” is the storage form. T4 is converted to “T3” in the thyroid, liver, brain and other tissues. T3 is the active form, 200 times stronger than T4.
The importance of TSH
TSH, made by the pituitary gland in the brain, stands for thyroid stimulating hormone. If your thyroid is sluggish, your pituitary produces more TSH, a kind of kick in the pants for the thyroid. The TSH blood test is the most useful test for thyroid function.
What causes a sluggish thyroid?
A common cause is autoimmune. Your immune system thinks your thyroid belongs to someone else and starts attacking it. This is called Hashimoto’s thyroiditis.
Other causes? Stress can suppress your thyroid. Sometimes large amounts of soy products, peanuts or raw cruciferous vegetables (broccoli, cabbage, brussels sprouts) may slow down the thyroid, although this is controversial.
Why is the diagnosis missed?
There is disagreement over what TSH level signifies disease. Some doctors believe your thyroid is OK, regardless of symptoms, if your TSH is below 5.0. Many specialists regard 3.0 and below as normal. They will sometimes treat patients until it’s below 1.0, if necessary.
Most specialists, including some holistic-minded doctors, use synthetic T4. Response is slow so your doctor will wait 6 - 8 weeks before checking your TSH again.
Nutritional support can help. Selenium (200 micrograms a day) and adequate Vitamin D levels are important. Iodine is often used. Stress reduction, as with most health problems, is essential. Nutritional support and stress reduction are all some need.
What about T3?
Some folks feel better with a small dose of T3. T3 alone or with antidepressants may help in depression. And some respond best to Armour Thyroid, which has both T4 and T3 (from ground up pig thyroids).
The use of T3 is controversial because most studies show little benefit. The studies, however, are inconclusive. I find T3 has a useful role in some patients.
A small number of people have trouble converting T4 to T3. A low free T3 blood value in someone with suspicious symptoms may respond to treatment.
Know and understand the meaning of your TSH level. Is it between 5.0 and 3.0? Do you also have symptoms? Then treatment may help. See a thyroid specialist. They take a broader, less dogmatic approach.