One of Oprah's viewers diagnosed her as having a problem with her thyroid. That was one factor in her constant struggle with weight. Your thyroid is the main hormone of metabolism and it affects your energy, weight, mood, temperature, fertility, menstrual cycles, hair growth, bowel movements, sleep and more. It's a hormone that is sometimes misunderstood and it is suggested that the range of normal be changed. I will shed some light on the symptoms and tests. These are the most common symptoms and is not a complete list:
Symptoms of Overactive Thyroid- Hyperthyroidism
- Rapid heart beat
- Chest pain
- Weight loss
- Irregular menses
- Feel hot & sweaty
Symptom of Underactive Thyroid - Hypothyroidism
- Weight gain
- Excess sleep
- Dry coarse hair & skin
- Poor memory
- Hair loss
- Muscle pain and weakness
- Feeling cold
These symptoms can overlap with other conditions. You may have one or more of these and should report these to your doctor, have a check up and get laboratory studies to determine if an overactive or underactive thyroid is causing the symptoms. You may find a difference in opinion when it comes to measuring and interpreting thyroid levels. Here are some tests you should be aware of:
- TSH - this is a common screening test and most doctors order this. It is the signal from the pituitary gland in your brain that tells your thyroid to make more hormones. If it is high, it means it is shouting at your thyroid gland to make more hormones because your levels are too low. The common misinterpretation is that high means high thyroid levels and it is actually the opposite.
- New range of normal - The current range of normal for TSH is quite wide 0.5-5. Normal and optimal are not the same. People with symptoms who are on either end of the range, may be considered normal and won't be treated. The American Association of Clinical endocrinology and the National Academy of Clinical Biochemistry have recommended changing the range since people who don't have severe symptoms may be suffering and can benefit from treatment. They recommend a range of 0.3-2.5.
- Free versus bound - most hormones are carried through the blood stream by protein carriers. If they are bound to protein, they are inactive. When it comes to thyroid, the free hormone is what counts.
- Free T4 - has 4 iodine molecules, it is a reserve or storage hormone that becomes active when it is converted to the active hormone free T3 by removing one iodine molecule.
- Free T3 - is the active hormone. This conversion can be halted by aging, stress, nutritional deficiencies, trauma, infection, surgery, medications, hormone imbalance and diet. The hormone's actions can also be blocked by thyroid antibodies (Antithyroglobulin or Anti Thyroid Peroxidase (TPO) Antibodies) and/or Reverse T3. The standard of care is to measure TSH and free T4 or to calculate free T4, however you can see that there is more to it than that. There also seems to be a subset of people with depression that respond better when a combination of T3 and T4 is given. The most commonly used thyroid replacement medication, synthroid, only has T4 and if you have a problem converting to the active form, it may not feel as effective.
- Reverse T3 - binds to the same receptor as T3 and blocks its actions. If it is too high, even though all of the other lab tests are "normal" you may have symptoms of low thyroid function. The most common causes are stress and hormone imbalance. Anything that interferes with the conversion of free T4 to free T3 can also cause an elevation of reverse T3. The ratio of free T3 to reverse T3 is important. Just think of one as the gas (free T3) and the other the brake (reverse T3). If you are below the midpoint of the range of free T3 you have less gas, and if you are above the midpoint of the range of reverse T3 you have too much braking action.
Hormone balance is complex. It requires a nutritionally balanced diet, hormone balance, stress management and other factors. There may be restrictions on your doctor to do the full battery of thyroid tests. If that is the case, consult an anti aging, metabolic or functional medicine physician to help you get to the root cause of your issues and find a natural approach.
Lorraine Maita, MD is a recognized and award winning physician and author transforming people's lives through preventive and anti aging medicine. She is a Diplomate of the American Academy of Anti Aging and Regenerative Medicine and Board Certified in Internal Medicine and has over 18 years experience in Preventive Health and Wellness, Internal, Occupational and Travel Medicine and Executive Health.