Thyroid assessment is an area where the standard allopathic approach tends to be incomplete and can lead to misdiagnosis. When symptoms are ignored and incomplete lab testing is relied on, what's missed is that the thyroid gland itself could be functioning perfectly, but the metabolism and cellular uptake of the hormones is a problem that is overlooked.
One of my passions as a practitioner is thyroid health. It is critical if a person wants to feel their best, yet thyroid disease has now grown to epidemic levels.
Why is this happening? The possibilities are endless: diet, lifestyle, stress, toxic load…and trying to figure out the “why” is something I believe our broken healthcare system should be taking much more seriously. If and when it does, I will be celebrating right along with all the other functional healthcare practitioners who are fighting for that needed change.
In the meantime, the very real problem I find myself facing is how to best help my clients. A high percentage who come to me are taking medication for hypothyroidism or have been diagnosed with autoimmune thyroiditis, otherwise known as Hashimoto’s.
How does thyroid testing affect the client, and how in a hundred ways could it go wrong? There are some instances that the symptoms are similar but it is never really a thyroid-related problem and might misdiagnose the client.
Other clients have been misdiagnosed altogether and prescribed antidepressants or anti-inflammatory medications for symptoms that clearly point to possible thyroid dysfunction, yet their healthcare practitioner either is not recognizing or not understanding how to look for the root cause of their issues.
So how do you get to the root cause of thyroid issues? In my practice I have had real success by testing for markers many conventional doctors still don’t acknowledge and expanding testing to include markers that can indicate early signs of thyroid imbalance. Proper support and intervention can go a long way to help correct the root cause before it turns into a debilitating problem.
Which markers and additional tests should you look into? And if there is a problem, how do you nip it in the bud?
How Thyroid Hormones Work
Thyroid stimulating hormone (TSH) is produced by the pituitary gland and tells the thyroid to produce thyroxine (T4). But T4 is the stored form of the hormone and is converted to the active form, triiodothyronine (T3), by the enzyme deiodinase.
There are two forms of T3: the T3 that is bound by proteins, and Free-T3 which isn’t. Although both circulate in the bloodstream, Free-T3 is the active form available to be used by the body.
When these hormones are in balance, the thyroid is typically working at an optimal level, but not always. And understanding the early signs of imbalance can play a critical role in disease prevention.
Interpreting Thyroid Markers and Levels
Typically, a practitioner in conventional medicine will order a routine blood analysis and measure TSH as the only indicator of thyroid health.
Many labs have not caught up with the correct range for TSH. At one time, if it fell between .5 and 5.5 it was considered acceptable. However, this range was too broad and allowed for subclinical and sometimes even overt thyroid problems to be missed.
The American Academy of Endocrinology revised the range to somewhere between 1 and 3. It’s important to know the correct range.
Using TSH as the only measure of a healthy thyroid can be misleading. It doesn’t give the whole picture. For example, a person with higher than recommended TSH levels is often prescribed Synthroid or another form of T4, yet could be producing an adequate amount of T4.
High TSH can indicate that the thyroid is nonresponsive, but it doesn’t explain why. You have to look beyond TSH to get a complete picture.
What Causes a Non-responsive Thyroid?
When TSH levels are high, it indicates that the thyroid is non-responsive. Additional markers can help shed light as to why and guide your next steps.
If total T4 is good, but Free T3 isn’t, the problem could lie in the conversion process. This is why I always look at the ratio of Total T4 (what the thyroid is producing) to Free-T3 (what is available to tissue).
It may not be a thyroid problem at all but instead a result of liver dysfunction, poor digestion, a pituitary issue, or too much cortisol.
Every cell in the body has thyroid hormone receptors that need to be open to receiving the hormone. High cortisol levels due to stress, inflammation, and other imbalances can shut down these receptors and lead to thyroid resistance.
The thyroid may be producing enough hormones, but it’s not getting into the cells. This is why hormone levels can be normal, but a client is still showing symptoms of thyroid disease: depression, dry and rough skin, difficulty losing weight, slow reflexes, hair loss, lack of motivation, high cholesterol, anemia.
This leads to prescribed medications that don’t help the problem. In fact, it often makes it worse.
Hashimoto’s occurs when the body’s own immune system attacks the thyroid, compromising its ability to make T4. Years before irreversible damage takes place, the body starts producing two antibodies; thyroid peroxidase and antithyroglobulin.
I always make antibody testing a basic part of my general screening. It’s possible to improve antibody levels with proper support and diet.
Much can be done to support the thyroid, particularly if a client needs to reduce antibody levels in order to prevent long-term damage. My clients have had remarkable results using the following guidelines.
Remove gluten from the diet.
Gluten is closely associated with antibody levels in those that have a sensitivity. If unsure, better to remove it altogether.
Identify additional food sensitivities.
People in my Empowered Self-Care Lab have access to an elimination diet that helps clarify food sensitivities. Those who stick with it have remarkable results.
Selenium is vital to maintaining thyroid health. This nutrient helps maintain good thyroid hormone levels, helps hormone conversion, and reduces antibody levels.
400 micrograms consumed daily, (found in 2-4 Brazil nuts) over a six week period of time, reduced antibody levels significantly.
Support the immune system.
If antibodies are present, being sure the body is making enough glutathione is critical to immune system health. Supporting methylation pathways with lots of leafy greens, antioxidants, and a diet rich in phytonutrients is also important.
Adequate Vitamin D is necessary for thyroid support, digestion, and the liver’s antioxidant system to function properly. Be sure to test levels to see if your client is getting enough.
To find more information on what labs I order for a complete thyroid assessment, check out my blog, Understanding How to Help Clients With Fatigue: Fringe is the Future!
When you can recognize and support optimal thyroid health, it will go a long way toward boosting your practice, especially as news spreads you are able to help people who have suffered for years when looking for answers from the broken, conventional healthcare system.
New and cutting-edge ways to clean up digestion, support the liver, reduce stress, and optimize antioxidant systems not only help chronic thyroid issues but are all part of my Nutritional Endocrinology Practitioners Training (NEPT) program.
Check out www.INEMethod.com for more resources, and join our community on Facebook in the Nutritional Endocrinology for Health Practitioners group if you, like so many, are looking for real and lasting ways to help your clients.
Epidemic levels of debilitating thyroid issues should not be tolerated or accepted as normal. Get more on the Reinvent Healthcare Podcast under the thyroid theme, and download our FREE Guide to Optimal Thyroid Function.
You can be the change so desperately needed!