Monday, June 1, 2009

Thyroid hormone – the difference between normal and optimal, and which hormone to test and treat

Many patients came to me with all the symptoms of low thyroid function, but they were diagnosed that their thyroid tests were normal and nothing could be done. The tests ordered usually included TSH and T4.

I would order their complete hormone panel including thyroid hormone tests like TSH (thyroid stimulating hormone), free T3 (thyroxin 3), free T4 (thyroxin 4), thyroid antibodies and reversed T3.

I noticed some patients have normal thyroid hormone test, but in the low range; and yet,they have many low thyroid function symptoms like cold extremities, low body temperature, fatigue, especially in the morning when they wake up, hair thinning or loss, constipation and yes, middle weight gain that’s impossible to loose. Those conditions were called “suboptimal thyroid function” or “subclinical hypothyroidism”. These patients usually improved significantly after I gave them bioidentical thyroid hormon that contains the physiologic combination of T3 and T4.

We have to understand that laboratories get their normal value by measuring certain amount of patients' blood and they call the middle 90-95% normal. We could easily understand that when one third of our population is over weight, the normal does not mean healthy, not even to mention “optimal”. So it makes sense that when a good portion of general public has low thyroid function, the normal does not mean healthy, and the optimal would be close to upper third range for T3 and T4, and below 1.5 for TSH . But most of the physicians do not agree with this approach.

Many physicians do not order T3 test and they only replace hypothyroid patients with T4 (Synthroid). T3 is the active form of T4, and some patients have problem converting T4 to T3. So patients will have picture perfect thyroid hormone test if only T4 and TSH was checked and still have all the symptoms of hypothyroidism when their T3 were low. These patients’ symptoms improved again with bioidentical T3, T4 combined hormones.

Some patients’ low thyroid function was very difficult to correct due to other imbalanced hormones. Since they share some common pathway, their thyroid hormones are hard to be right when their adrenal glands were burnt out. The same is true with estrogen and progesterone for women. All hormones of our body synchronize with one another in their specific rhythms. The melody would not be in harmony until all instruments were tuned.

One easy way to test hypothyroidism at home is to check early morning temperature. Get the thermometer ready (shaken down) next to your bed, and put it under your arm for 5 minutes when you wake up first thing in the morning. Women should do it before their ovulation like from day 3 to day 11 of their cycle. Check it for three consecutive days and if your basal temperature is below 97 degrees F, come in to have your hormones tested.

Undiagnosed and untreated hypothyroidism, which affects the metabolism of every cell, undermines any health program and longevity.

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