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The Silent Thyroid Epidemic

The Silent Thyroid Epidemic

Maybe you are one of the millions of Americans that have one or more signs and symptoms of low thyroid like fatigue, weight gain, dry skin, bad memory and focus, and depression. Yet your physician runs a standard thyroid test and tells you that all is well. Things just do not seem to add up. There is a good chance you do have a thyroid issue ... but just not what your doctor thinks.

I have found in my 26 years of practice and research that the rate of thyroid disease in America is closer to 25% of the American population! And there are many signs and symptoms that indicate possible hypothyroidism:

  • Reduced appetite
  • Sleep problems
  • Muscle pain, joint pain, weakness in the extremities
  • Emotional lability
  • Constipation
  • Menstrual disruptions, impaired fertility
  • Reduced perspiration
  • Paresthesia and nerve entrapment syndromes
  • Blurred vision
  • Reduced hearing
  • Fullness in the throat, hoarseness
  • Slowed speech and movements
  • Jaundice
  • Pallor
  • Coarse, weak, straw-like hair
  • Loss of axillary hair, pubic hair, or a combination
  • Dull facial expression
  • Coarse facial features
  • Periorbital puffiness
  • Macroglossia
  • Goiter (simple or nodular)
  • Reduced systolic blood pressure and increased diastolic blood pressure
  • Bradycardia
  • Pericardial effusion
  • Abdominal distention, ascites (uncommon).
  • Hypothermia (only in severe hypothyroid states)
  • Nonpitting edema (myxedema)
  • Pitting edema of lower extremities
  • Hyporeflexia with delayed relaxation, ataxia, or both

Keep in mind that your thyroid gland makes thyroid hormones, which are the primary hormonal drivers of your cell metabolism and the burning of calories.

Do You Have Subclinical Hypothyroidism?

Many individuals have what is called subclinical hypothyroidism. This is a condition where a person does not have obvious or easily identifiable hypothyroid (low thyroid) on a lab test ... unless you are trained like me in detecting subtle imbalances that cause significant health problems. Doctors need to know that an individual's signs and symptoms are just as important as lab testing. If you have several hypothyroid signs and symptoms, then you most likely do have a thyroid imbalance.

According to the Endocrine Society, subclinical hypothyroidism is more prevalent than normal hypothyroidism (based on regular lab testing). Subclinical hypothyroidism is referred to in traditional medicine as when the TSH (message from the brain telling the thyroid to produce more or less thyroid hormone) is slightly raised, yet the circulating thyroid hormones (T4 and T3) are normal. The TSH is usually less than 10mIU/L but above the reference range of 5.5 mIU/L. People with subclinical hypothyroidism have a high rate of progression to overt hypothyroidism.

Holistic Thyroid Ranges

However, holistic doctors, like myself, use tighter reference ranges. Also, we pay close attention to an individual's signs and symptoms. One might have "normal" thyroid lab values yet have issues with their thyroid activity. In my opinion, this would fall under the category of subclinical hypothyroidism. One of the reasons for this is that we can only measure the blood level of thyroid hormones. We do not measure thyroid activity inside the cell, which is the most crucial level. This is why an individual's signs and symptoms may be indicative of subclinical hypothyroidism even though the blood work does not identify a problem. The typical doctor in America does not consider this fact and disregards the person's symptoms.

Now returning to thyroid hormone lab testing, it is likely your doctor tests TSH hormone. The higher the number, the more hypothyroid you are (it may seem confusing, but it is the opposite of what some think at first, the higher the TSH, the more messaging from your brain (pituitary gland) telling your thyroid to produce more hormone).

The National Academy of Clinical Biochemists suggests that TSH levels should be lower than 2.5 mU/L as this is what is found in more than 95% of normal people There are several other tests you will want to check. This includes the actual hormones that have activity in your cells, which include Free T3 and Free T4. Out of these two, it is the Free T3, which is the most powerful in terms of strength. I also test reverse T3, because an elevated level blocks the active Free T3. And it is constantly important to check thyroid antibodies because autoimmune thyroid disease called Hashimoto's Thyroiditis is by far the most common cause of hypothyroidism.

The following is a summary of thyroid tests I order with patients:

TSH (Thyroid Stimulating Hormone)

  • Typical range is 0.3-0.5 to 5.5 mU/L
  • Optimal range is 0.5 to 2.5 U/L

Free T3

  • Typical range is 2.4 to 4.2 pg/mL
  • Optimal range is 3.0 to 3.8 pg/mL

Reverse T3 (rT3)

  • Typical range is 9.2 − 24.1 ng/dL
  • Optimal range is mid-range

Thyroid antibodies (thyroid peroxidase, thyroglobulin)

  • Levels should be lower than the range given by the laboratory

Important Note 1: Biotin supplementation might affect thyroid function tests and need to be avoided for two days before blood is drawn.

Important Note 2: If you are on thyroid medication, it is best to be consistent on the time of day when you have your blood drawn. It is typically suggested to have testing done first thing in the morning (fasting not necessary) prior to taking thyroid medication or supplements, or 4 hours or longer after taking drugs or supplements.

Take Action

If you have signs or symptoms of subclinical hypothyroidism or have suboptimal thyroid lab testing, then work with a holistic doctor to achieve thyroid balance. At the Stengler Center For Integrative Medicine, we help patients with subclinical hypothyroidism on a daily basis.