Thyroid disorders are often the most difficult to diagnose
as the symptoms are often confused with other illnesses. It is therefore very important to work with a physician or health practitioner who will take your symptoms seriously and be willing to work with you in partnership. It also is very helpful if you are prepared to advocate for yourself.
Often someone feels “fine” until they undergo a stressor. There are three main factors, which can push you into active thyroid disease.
Inflammation is intrinsic to autoimmune disease and contributes directly to thyroid imbalance.
Many times a patient will be in my office who has a family history of thyroid disease present with clear thyroid symptoms, but tell me “My doctor said there’s nothing wrong with my thyroid because my laboratory work was normal.”
I don’t let the number dictate diagnosis of thyroid disease. If a patient has a family history of thyroid disease and presents with clear thyroid symptoms, hypo and/or Hashimoto’s thyroiditis, or hyperthyroid, and their blood work up is not yet in the abnormal range, I will treat them as if they are experiencing a thyroid problem, ruling out other possible diagnoses, of course.
Many times, doctors order screening test for thyroid disease and not the tests needed to properly diagnose Hashimoto’s or Hashimoto’s Thyroiditis. Hashimoto’s is an inflammatory process which targets the thyroid and requires additional blood workup to obtain a comprehensive picture of what is happening in your body.
These tests measure the immune response of your body towards your thyroid gland. These numbers can change with nutritional support, and lifestyle changes, so it’s a good idea to ask your practitioner to repeat these tests every six to eight months. These are often the tests that are not performed but the information they provide can confirm a diagnosis of Hashimoto’s Thyroiditis or Graves’ Disease (hyperthyroidism).
Thyroid Peroxidase or TPO
Thyroid peroxidase is an enzyme made in the thyroid gland that is important in the production of thyroid hormone. TPO is found in thyroid follicle cells, where it converts the thyroid hormone T4 to T3. Thyroid peroxidase is a test that measures the level of an antibody that is directed against thyroid peroxidase. Autoantibodies to thyroid peroxidase are produced within the body and their presence in the blood reflect an attack on the thyroid tissue by the body’s immune system.
Thyroglobulin Antibodies or TgAB
Antithyroglobulin antibody measure antibodies to a protein called thyroglobulin, which is found in thyroid cells and plays a crucial role in hormone synthesis, storage, and release. It is not secreted into the systemic circulation unless there has been follicular inflammation, as seen with thyroiditis and autoimmune hypothyroidism.
Thyroid Stimulating Hormone is produced by the pituitary gland and signals the thyroid glad to release the hormone T4 and T3. Functional Medicine™ practitioners have further defined normal reference ranges as being between 1 and 2μIU/ml for a healthy person not taking thyroid medications.
Reverse T3 or rT3
This molecule acts to slow down the energy production of T3.
T4 is converted to T3 in our body, and this test measures the unbound form. But there are many biochemical imbalances that can contribute to this not being a full conversion. So it is possible to continue to experience extreme fatigue, even with a T4 in the “normal” range.
This is the primary hormone produced by your thyroid and this test measures the unbound or active form of T3. It is representative of the amount of energy you have to provide to your cells.
Functional Medicine™ is a basis for the treatment approach for recovery from thyroid disease.
If you would like further detailed information on thyroid and autoimmune disease, here are three excellent books on the subject.
I look forward to helping you uncover the root cause of your chronic or autoimmune illness, so you can recover your health.