The diagnosis of low thyroid is becoming increasingly more prominent as stress levels in our society increase. Some symptoms of a low functioning thyroid are weight gain, dry skin, hair loss, and significant fatigue.
Thyroid screening is part of your regular annual physical, however, it is important to understand how the thyroid works so that you can ask for the correct tests at your next office visit. Most physicians routinely run a test called TSH (thyroid stimulating hormone) yearly to screen for thyroid dysfunction. Unfortunately, this is missing a lot of cases of a condition called “subclinical hypothyroidism”. In this case, the thyroid is functioning at a “sub optimal” level, resulting in symptom development with the appearance of “normal” thyroid labs.
TSH has become a standard screening tool for thyroid disease because it controls the brains release of thyroid hormone. When thyroid hormones (T4 and T3) are low, TSH is increased because it represents the brain “asking” for more thyroid hormone. In low stress environments, this test can be a very valuable and accurate tool. Unfortunately, the way of life nowadays is putting a lot of stress on our bodies. This is impacting our thyroid function. Many times, the actual levels of thyroid hormone are sub optimal, but still producing thyroid, so TSH appears “normal” on lab work. Alternatively, in some cases, an autoimmune condition called Hashimoto’s Disease has developed. This situation causes a rise in TSH, but the thyroid levels can be normal. Many patients are being placed on thyroid therapy based of the TSH value. This can worsen the situation and many patients do not see relief from thyroid therapy.
It is important to take a look at the entire thyroid profile prior to administering therapy. I recommended screening TSH, Free T4, Free T3, Reverse T3 and Thyroid Antibodies in every patient who shows symptoms of potential thyroid dysfunction.
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