When it comes to pathology tests, you only find what you look for and this certainly applies to sufferers of thyroid disorders. Over 40% of women suffer from an underactive thyroid, yet the majority of them are going undiagnosed or being told by their Dr they have 'normal' thyroid pathology results, despite presenting with classic underactive thyroid symptoms of fatigue, weight gain, depression and brain fog. Worse still, even the cases that are being diagnosed, are either receiving inadequate diagnosis and or treatment.
This was my experience over ten years ago, when I gained ten kilo's in ten weeks, despite no changes to my already healthy diet, or exercise routine ( running 6 laps of Bondi beach, 5 days a week). I later learnt the reason my metabolism had been turned on its head was thanks to developing a pretty severe case of Hashimoto's as well as a pituitary adenoma - a small benign tumor on the anterior of my pituitary gland - the master hormone gland in the body.) Dr's prescribed me the standard thyroxine medication and told me I'd feel better in a week and start to lose the weight. If only that were the case, thyroxine didn't provide an ounce of relief from my symptoms, even though my thyroid results looked 'pretty on paper' . I was told my Dr at the time that based on these results I was 'all better', despite the fact I continued to feel like a giant pile of crap, barely able to function each day... oh and I hadn't lost an ounce of those 10 kegs I had gained at this stage either!.
An underactive thyroid can have a devastating effect on your health, and so many women are suffering unnecessarily, largely because too many Dr's don't know how to test and assess thyroid function effectively. It's a little known fact that an underactive thyroid can also be the underlying cause of many other related illnesses - including depression, anxiety, chronic fatigue, cognitive dysfunction, atherosclerosis, high cholesterol and poor immune function.
I get so frustrated when I see a patient presenting with textbook classic symptoms for hypothyroidism, only to hear their Dr told them their thyroid function is completely 'normal', because their TSH ( thyroid stimulating Hormone) level was within range! Not only is the reference range for TSH outdated, (because it was developed to measure your health against a disease state vs a state of optimal health), but a patient can indeed have a 'normal' TSH level, yet still be suffering from an underactive thyroid.
If you have typical hypothyroid symptoms, but your lab tests are 'normal', your Dr may have prescribed you with an antidepressant, pain killer, or insomnia medication, rather than running the full gamut of pathology tests required for accurate diagnosis and treatment. Many thyroid conditions are resulting from chronic nutrient deficiencies, including essential minerals like selenium, iron and iodine as well as vitamin D - ALL of which are required by the thyroid to make sufficient levels of thyroid hormones. Yet the majority of Dr's are failing to even test these nutrient levels, let alone consider prescribing adequate doses.
There's no doubt thyroid physiology is highly complex, requiring an in depth knowledge of the endocrine system and experience in treating these disorders, and this is something I sadly see lacking in conventional medicine. If any of these steps are skipped, you will continue to experience hypothyroid symptoms. The tricky part is, not all of these necessary steps may show up in standard pathology tests, which is another reason so many hypothyroid sufferers fail to get diagnosed, OR continue to experience hypothyroid symptoms, despite taking thyroid medication.
There are many factors that can influence your thyroid function and why you may not be responding to treatment effectively.
Elevated cortisol - caused by chronic stress, pregnancy, acute infection, insulin resistance or diabetes exhausts the pituitary gland, impairing its ability to signal to the thyroid to release adequate thyroid hormone. In this situation, the function of the thyroid gland may be perfectly fine, but its just not receiving the right messages from the pituitary gland. So in this scenario, you need to address the cause of the elevated cortisol. Meditation is one sure fire way to regulate elevated cortisol as well as taking specific herbs that support adrenal function like rhodiola.
Failure to convert T4 to T3 - T4 is referred to as the 'inactive' form of thyroid hormone and needs to be converted to T3 before the body can use it to rev up your metabolism and energy amongst other things. Because the majority of thyroid hormone produced by the body is T4, if your body can not adequately convert it to the active form - T3 - you will continue to experience symptoms of hypothyroid. Considering the majority of hypothyroid patients are prescribed T4 in the form of Thyroxine, there's little wonder why so many sufferers don't respond to this medication adequately. The common cause of poor T4 to T3 conversion, is inflammation - usually associated with autoimmune and elevated cortisol levels. If you have your T3 levels tested in this situation, it likely to be low, despite TSH and T4 being within range.
Elevated Thyroid Antibodies - seen in the case of Hashimoto's autoimmune disease, is caused by chronic inflammation stemming from the gut, cortisol insufficiency, or elevated estrogen levels, due to taking the oral contraceptive pill or HRT for menopause which causes a condition known as oestrogen dominance. You can read more about the causes and effects of this condition in previous posts I've written here and here. I recommend undertaking my liver detox and gut repair program to clear excess estrogen from the body and reduce systemic inflammation and elevated thyroid antibodies by healing your gut.
Thyroid hormone resistance - this is usually caused by chronic stress and elevated cortisol levels, or even taking too much T3 hormone - if you are taking a compounded form. This is a classic scenario where more is not necessarily a good thing! I had one patient overdosed on her T3 thyroid hormone medication, thinking if she simply took more, it would speed up her metabolism, but instead it had the opposite effect and caused the thyroid hormone receptors to desensitise so she was unable to respond to treatment.
As you can see there are many intricate factors that influence thyroid function and pathology results, which is why it's essential to find a very experienced Dr or natural health practitioner to assess your case very thoroughly, and who will also take your symptoms into account, not just your pathology results because you're more than just a number on a page.
Want to discover I managed to turn my thyroid health around? Grab a copy of my book Love Your Gut and sign up to my online program