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Thyroid 101


b2ap3_thumbnail_Thyroid1.jpgDo you have (or suspect that you have) low thyroid function? 

Are you tired of feeling sluggish and foggy only to be told that your thyroid tests “look normal”?

You are not alone! Thyroid health is one of the most common reasons why patients seek my care - and for good reason! Optimal thyroid function is an essential component of your health and well-being. 
Your thyroid gland is part of your hormone system (also referred to as your endocrine system). The thyroid gland is shaped like a butterfly and is located inside your neck over your windpipe.
Thyroid hormones play a major role in regulating many bodily functions, including:

  • Metabolism
  • Weight
  • Energy
  • Mood
  • Temperature control
  • Bowel function
  • Cognitive function
  • Heart health
  • Skin integrity
  • Muscle development
  • Gingival health

Many conventional practitioners take a “one-size-fits-all” approach to low thyroid hormone, also called hypothyroidism. They rely on one laboratory value and prescribe one type of thyroid hormone for all patients, because that is how we are taught to approach hypothyroidism in medical school. While some patients are fine with this approach, others are not and find themselves continuing to experience symptoms without an adequate diagnosis or treatment plan.

If you have (or suspect that you have) low thyroid function, a practitioner skilled and experienced in a more comprehensive approach to hypothyroidism may help you to better understand why your thyroid hormones are low, and partner with you to create a customized treatment plan to restore energy, vitality, and well-being.


LOW VS HIGH THYROID

It is far more common to have low thyroid than high thyroid levels.
When you have a low functioning thyroid it is called hypothyroidism.
Symptoms of hypothyroidism include:
  • fatigue 
  • dry skin
  • weight gain
  • constipation
A less common condition is hyperthyroidism, when your thyroid is over-active.
Symptoms of hyperthyroidism include:
  • weight loss
  • “bulging” eyes
  • hot flashes
  • rapid or racing heart beat
UNDERSTANDING THYROID TESTING 

b2ap3_thumbnail_Thyroid2.jpgTSH = Thyroid Stimulating Hormone
TSH (Thyroid Stimulating Hormone) is made by your brain, not by your thyroid. Your brain makes TSH when it senses that your body needs more thyroid hormone. The TSH made by the brain sends a signal to the thyroid to make more thyroid hormone. 

When thyroid hormone levels in your body are low, the brain makes TSH to "turn on" your thyroid.
  • TSH high = body needs more thyroid hormone
  • TSH low = body does not need more thyroid hormone
The TSH is only test many doctors will order to evaluate thyroid function, however relying on the TSH alone does not give you a complete picture of thyroid function, and may miss a certain percentage of people with low thyroid hormone.
If you have symptoms of low thyroid and are told your TSH is "normal" - test beyond the TSH!

T4 and T3
Your thyroid makes different types of thyroid hormones. The two most important are T4 and T3.
Here’s what you need to know about T4 and T3:
  • You make much more T4 than T3
  • T4 gets converted in your tissues to T3
  • T3 is far more active than T4
Why does this matter?
If you have a normal TSH, but a low free T3, you will have all of the symptoms of low thyroid (hypothyroid) even though your doctor tells you that your thyroid is “fine”!
b2ap3_thumbnail_Thyroid3.jpg

(the lab tests shown here are taken from a patient of mine who had this issue)

BOTTOM LINE:
  • listen to your body
  • test beyond the TSH
  • know your levels of T3 hormone
My standard thyroid laboratory testing always includes:
  • TSH
  • Free T4 hormone 
  • Free T3 hormone
Additional testing often ordered include:
  • Reverse T3 (which “hides” T3 and prevents it from dong it’s work)
  • Thyroid Antibodies (to evaluate underlying autoimmune disease)
  • Levels of nutrients important to thyroid health, such as zinc and selenium

Now that you know the "Thyroid Basics", are you ready to learn more about your thyroid health?
You can This email address is being protected from spambots. You need JavaScript enabled to view it.or contact my office for more information 231-638-5585. 



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many that are linked to unhealthy hormone imbalance. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface”  to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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Low Thyroid - Five Keys to Getting the Results You Are Looking For

Do you have (or suspect that you have) low thyroid function?

Are you tired of feeling sluggish and foggy only to be told that your thyroid tests “look normal”?

You are not alone! Thyroid health is one of the most common reasons why patients seek my care - and for good reason! Optimal thyroid function is an essential component of your health and well-being, as thyroid hormones play a major role in regulating many bodily functions, including

  • Metabolism
  • Weight
  • Energy
  • Mood
  • Temperature control
  • Bowel function
  • Cognitive function
  • Heart health
  • Skin integrity
  • Muscle development
  • Gingival health

Many conventional practitioners take a “one-size-fits-all” approach to low thyroid hormone, also called hypothyroidism. They rely on one laboratory value and prescribe one type of thyroid hormone for all patients, because that is how we are taught to approach hypothyroidism in medical school. While some patients are fine with this approach, others are not and find themselves continuing to experience symptoms without an adequate diagnosis or treatment plan.

If you have (or suspect that you have) low thyroid function, a practitioner skilled and experienced in a more comprehensive approach to hypothyroidism may help you to better understand why your thyroid hormones are low, and partner with you to create a customized treatment plan to restore energy, vitality, and well-being.

LOW THYROID - FIVE KEYS TO GETTING THE RESULTS YOU ARE LOOKING FOR

#1 - GET THE RIGHT TESTING AT THE RIGHT TIME
I can’t tell you how many patients I have encountered who have been told that their thyroid function is “normal“ based upon just one laboratory value - the TSH.

TSH = Thyroid Stimulating Hormone

TSH is made by your brain, not by your thyroid. Your brain makes TSH when it senses that your body needs more thyroid hormone. The TSH made by the brain sends a signal to the thyroid to make more thyroid hormone.
Patients are often confused when interpreting their TSH number because it is an “opposite” test. A high TSH value indicates low thyroid hormone in the body.

When thyroid hormone levels in your body are low, the brain makes more TSH to "turn on" your thyroid.

Getting a more accurate picture of your current thyroid health involves testing beyond the TSH and including:

  • thyroid hormone levels - Free T3, Free T4, and Reverse T3
  • Anti-thyroid antibodies

The time at which a hormone is tested will impact results. Thyroid hormones measured first thing in the morning will look different than those measured in the late afternoon. You should also have clear instructions on if and when to take your medication in relationship to your thyroid test. I generally hold thyroid medication for a first morning testing, and sometimes I have my patients take their morning medication and then test mid-afternoon for a different picture.

#2 - RECOGNIZE THE MANY FACTORS THAT CAN CONTRIBUTE TO THYROID HEALTH
If your thyroid function is not optimal, ask the question WHY? Do you have an auto-immune condition affecting your thyroid? Are there “missing ingredients” that your thyroid needs to properly function, or something interfering with your thyroid gland? There are many factors that contribute to thyroid health, including:

  • Nutrient deficiencies (such as iron, iodine, zinc and selenium)
  • Physical and emotional stress
  • Exposure to toxins (such as fluoride, pesticides, mercury)
  • Food sensitivities
  • Underlying infections and inflammation
  • Physical trauma
  • Certain medications or other medical conditions (such as celiac disease)

#3 - AIM FOR OPTIMAL HORMONE LEVELS, NOT “NORMAL RANGE” 
While “normal ranges” are provided for each laboratory test, these ranges can vary widely. To feel and look your best, the goal should be optimal hormone levels! Thyroid hormone testing is perhaps best examples of this. I can’t tell you how many patients I have met with who had been told their thyroid levels were “normal“ despite ongoing symptoms. After shifting the focus to target optimal levels, these patients are able to experience improved energy, vitality, and well-being.

#4 - GET THE PRESCRIPTION THAT IS RIGHT FOR YOU
If prescription thyroid hormone therapy is needed, there are many options available. This allows treatment plans to be individualized for each patient. In addition to the industry standard synthetic T4 hormone (Synthroid/levothyroxine), there are various forms of natural porcine thyroid available containing both T4 and T3 hormone. Experienced practitioners can prescribe precise combinations of T4 and T3 prepared by compounding pharmacies, in both immediate and sustained-release forms.

#5 - PARTNER WITH YOUR PRACTITIONER IN THE DECISION MAKING PROCESS
To optimize thyroid function, the relationship between a patient and a practitioner needs to be viewed and treated as a partnership. Optimal thyroid function is a little different for each person, and patients should feel comfortable asking questions and expressing any symptoms or concerns. When prescribing thyroid hormone, I encourage patients to listen to their body for signs and symptoms that give us insight into thyroid health, such as body temperature, mood and energy, heart palpitations and more.



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including hormone imbalance and low thyroid.  During the COVID-19 pandemic, I continue to see both new and returning clients via our easy, secure, video-visit format. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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