Understand Your Thyroid Health!
The thyroid gland is a butterfly-shaped gland that is positioned at the front of the neck near the Adams apple. It is a part of the endocrine system, as it produces thyroid hormones called T4 and T3. The thyroid gland has effects on the heart, metabolism, brain, bones, colon and skin/hair. 1 in 13 Americans have thyroid disorders and 1 in 20 are undiagnosed in the USA. 1 in 8 women will be diagnosed with thyroid disease in their lifetime.
As stated above, the thyroid gland makes mostly T4 and a small amount of T3. These powerful hormones are made up of the amino acid, Tyrosine and Iodine (T4 is Tyrosine with 4 Iodine molecules and T3 is Tyrosine with 3 Iodine molecules). The T4 then circulates around the body and converts in to the more active T3 hormone. T4 can also turn in to Reverse T3, which does not activate cells. Although many consider Reverse T3 an 'inactive' hormone, it actually shuts down thyroid function despite the fact that lab values look normal.
Low Thyroid symptoms are typically ADD in children, fatigue, high cholesterol, low body temperature or cold intolerance, irritability, dry skin, brittle nails, generalized hair loss, constipation, depression, "foggy brain", inability to lose weight despite ones efforts. Low thyroid is also associated with Ulcerative colitis, anemia, and irregular menstrual cycles.
When I look at thyroid function in a symptomatic patient, I always order TSH, Free T4, Free T3, Reverse T3 and thyroid antibodies. By running these labs right up front I am able to get a good idea of what is happening with the patients thyroid function as a whole picture. Most doctors start with just the TSH and may run a total T4. Although this may screen for those who have high TSH levels, it does not catch the population of people who are undiagnosed, 'sub-clinical', those who have T3 conversion disorders or the patient who has Hashimotos and is symptomatic, but the thyroid is still working on its own.
Many patients are afraid of thyroid medication. People either feel that the commercial products, such as Synthroid and Cytomel are evil simply because they are pharmaceutical; or they are fundamentally opposed to prescriptions at all and feel that the thyroid gland will heal on its own if the rest of the body is renewed into homeostasis.
I have seen very rarely, a person with primary hypothyroidism able to stop their medication for brief periods of time. Typically, when the patient goes through stress, then the thyroid needs to be supported with medications.
People are also afraid to take thyroid medication as they feel by using it, their own thyroid function will stop all together. This is only true if a patient takes very high doses of thyroid medication for long periods of time. In the person who has Hashimotos hypothyroidism, the immune system is attacking the thyroid gland and it already is not producing T4 or T3 as well if at all.
I am not oposed to using the synthetic thyroid hormones and actually have found that in the patient with Hashimotos, they actually regulate the thyroid labs and the patients symptoms resolve more evenly than with the glandular products. On the other hand, the glandular products such as NatureThroid or Armour have more than just T4 and T3 in them and are very well tolerated by others with non-autoimmune primary hypothyroidism.
When a patient comes to see me and may need thyroid support, it is an individualized process that we engage in. I look at comprehensive blood work, do physical exam and listen carefully to the patients symptoms. I discuss all of the options and together we begin working on a plan to establish balance in Thyroid function. I use a combination of lab results and symptoms to come up with a treatment plan.