Optimizing Thyroid Health - Get the Right Testing

As a functional medicine physician, I frequently encounter patients who have been struggling with persistent symptoms that conventional testing has overlooked. Many have been told their thyroid is "normal," despite experiencing classic signs of thyroid dysfunction. This happens because they haven’t received a complete and optimal thyroid workup. This blog highlights the essential aspects of thyroid function and testing, empowering you to seek the comprehensive care you need.

Thyroid Basics

The thyroid gland is a butterfly-shaped gland located at the front of your neck. It plays a crucial role in regulating metabolism (how your body uses energy) and also influences several other bodily functions, including:

• Metabolic rate

• Heart rate

• Blood pressure

• Body temperature

• Gut motility

• Mental function

• Mood

• Menstruation

• Fertility

Signs of Thyroid Imbalance

Overactive Thyroid (Hyperthyroidism):
Symptoms may include feeling anxious or irritable, difficulty sleeping, a racing heart, shaking hands, clammy skin, sensitivity to heat, unexplained weight loss (or gain), and irregular periods.

Underactive Thyroid (Hypothyroidism):
Symptoms may include constant fatigue, mood swings, brain fog, dry skin, hair loss, brittle nails, constipation, sensitivity to cold, unexplained weight gain, and heavy periods.

Hypothyroidism is much more common than hyperthyroidism.

Thyroid Function Testing

The only way to determine how your thyroid is functioning is through testing.

TSH (Thyroid Stimulating Hormone):
Many patients misunderstand this test because it’s somewhat counterintuitive. TSH is produced by the brain, not the thyroid. When your brain detects that your body needs more thyroid hormone, it produces TSH, which signals the thyroid to release more hormones.

• High TSH indicates that your body needs more thyroid hormone.

• Low TSH suggests that your body has sufficient thyroid hormone.

While TSH is important, testing it alone does not provide a complete picture of thyroid function. Many conventional practitioners rely solely on TSH to evaluate thyroid health, which may lead to missed diagnoses. I often see new patients who display classic symptoms of low thyroid function but have been told their thyroid tests are "normal." A comprehensive thyroid panel often reveals underlying issues.

T4 and T3 Hormones

Your thyroid produces several hormones, with T4 and T3 being the most important.

Key Points About T4 and T3:

• The thyroid produces much more T4 than T3.

• Free T4 is converted into Free T3 in your tissues.

• T3 is far more active and potent than T4.

Why is this important?
If your TSH is normal but your Free T3 is low, you may still experience symptoms of hypothyroidism, even if your doctor says your thyroid function is “fine.”

Bottom Line:

• You need to test beyond just the TSH.

• Know your Free T3 levels.

• Speak up! Request the tests you need.

My standard thyroid laboratory tests typically include:

• TSH

• Free T4 and T3

• Anti-thyroid Antibodies (TPO Antibodies and Thyroglobulin Antibodies)

Additional tests often ordered include:

• Reverse T3 (which can “hide” T3 and prevent it from functioning)

• Nutrient levels crucial to thyroid health, including zinc, selenium, iodine, and iron

• Toxin levels such as mercury, which can interfere with thyroid function

If you suspect thyroid issues but feel your concerns haven't been fully addressed, I can help! As a board-certified Integrative & Functional Medicine physician, I can help you “think outside of the box and dig deeper with a variety of laboratory testing to help uncover the underlying root causes of your symptoms and create a plan personalized for you that goes beyond the prescription pad to incorporate diet/lifestyle change, nutritional supplements, holistic therapies, health coaching and more! Contact us to get started!