by Dr. Vikki Petersen
This article could also be entitled:
What Your Doctor Doesn’t Know About Your Thyroid and What You Can Do About It
Let’s begin with some statistics:
- An estimated 20 million Americans have some form of thyroid disease.
- Up to 60 percent of those with thyroid disease are unaware of their condition.
- Women are five to eight times more likely than men to have thyroid problems.
- One woman in eight will develop a thyroid disorder during her lifetime.
- Thyroid disease is quite common and too many of those suffering are missed completely as having a problem.
First let’s look at some of the symptoms that may be bothering you.
Symptoms of a Sluggish Thyroid (Hypothyroid)
• Dry skin
• Hoarse voice
• Weight gain
• Feeling cold
• Muscle weakness
• Joint or muscle pain
Symptoms of a Hyperactive Thyroid (Hyperthyroid)
If your thyroid is working too hard, it’s called hyperthyroid and with it you may experience:
• Intolerance to heat
• Increased bowel movements
• Weight loss
• Decreased concentration
• Rapid heart rate
If You Have Thyroid Disease and It’s Missed, What Might Happen?
Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis and infertility.
Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.
Let’s assume you actually do have a problem with your thyroid and you have some of the symptoms listed above. If your doctor has run a standard blood panel why did he or she miss it?
What Lab Tests Need to be Performed for a Complete Thyroid Evaluation
Here’s potentially why: The standard thyroid blood test is called TSH, this is an abbreviation for “thyroid stimulating hormone”, which is a name that is pretty self explanatory. It’s the measurement of the hormone produced in the brain that stimulates the thyroid to do its job. According to conventional medicine’s testing procedure, which is guilty of not being sensitive enough in my opinion, the level of this hormone can be as high as 5.5 and still be within the “normal range”. The complete range is 0.4 to 5.5, conventionally speaking. This means that you can have this higher end value and your doctor is going to deem your thyroid normal.
In clinics such as HealthNOW that practice root cause medicine, our clinical nutrition department considers such a value as high and out of range. As a matter a fact anything above 2 warrants closer inspection of the thyroid. The range we use is 0.4 to 2. This is significant because as that TSH number rises, it means that the brain is putting out more demand on the thyroid to function. Why? Because the thyroid is not functioning at a high enough level and the brain has to produce more stimulating hormone in an effort to get the thyroid “going”. Waiting until that number gets as high as 5 or above is waiting too long because it means that malfunction has been occurring for quite some time.
TSH is not the only value to look at however. Even if the TSH seems okay, that’s but a small part of the picture. Sadly doctors often stop there, missing patients who have legitimate thyroid dysfunction. Measuring TSH only measures pituitary (a gland in the brain) production- it is not sufficient to measure the true function of the thyroid gland.
The other hormones to look at are T4, T3 and RT3. Let’s look at them one by one and why they are so critical to evaluate.
T4 is a thyroid storage hormone and it is inactive. The active form of the hormone is called T3 or FT3, which stands for free T3. Conversion from the inactive T4 to the active free T3 requires the minerals selenium and zinc, two minerals we often find deficient in patients. In addition to selenium and zinc, vitamin A and exercise improve sensitivity to thyroid hormones.
[Health Tip: Want to get enough selenium each day? Eat one brazil nut. Yup! Throw it in your green smoothie or just munch on it. Apparently one is all most people need.]
One of the biggest secrets behind missed thyroid disease lies in this piece of information: there is a hormone called RT3, which stands for reverse T3. Reverse T3 opposes the function of T3, the active hormone, therefore negating its function. So you see, someone could have a “normal” looking profile, but if you never measured their RT3, which many doctors don’t, you’d miss the fact that the active hormone is being opposed and therefore inactivated.
And what’s particularly interesting is what causes RT3 to be produced – things that are very, very common, namely stress, infections, inflammation and toxins. And to reiterate, those things are very common amongst Americans.
Factors that Increase Production of the Dangerous RT3 Hormone
• Low-calorie diet
• Liver or kidney dysfunction [Health tip: If you’ve been told you have a fatty liver or elevated liver enzymes, it’s time to work on your liver to heal it.]
• Certain medications
Another important mineral level to assess is iodine. Both low and high levels can be a problem, so your iodine levels need to be within normal range. We tend to find deficiency more than excess and areas of the world with low iodine levels are renown to haven increased rates of hypothyroidism. With that said, both low and high levels can create hypothyroidism and excess is associated with the autoimmune disease of the thyroid called Hashimoto’s thyroiditis.
[Health tip: consider avoiding any toothpaste with fluoride as it is not only considered a toxic element but it is an antagonist to iodine and therefore prevents its absorption, potentially creating thyroid problems.]
Factors that Inhibit Normal Thyroid Hormone Production
When evaluating factors that inhibit the proper production of thyroid hormones, the list is quite similar to those factors causing the production of RT3.
• Certain medications
• Autoimmune disease: e.g. Celiac
Autoimmune Thyroid Disease and Gluten? Yes, there is a link
Speaking of autoimmune disease, autoimmune of the thyroid is also often missed. Once again the proper test is often not performed. There are three different tests, each measuring the body’s immune system and whether it’s attacking an aspect of the thyroid. In the test TPO Ab,an enzyme (called thyroid peroxidase) involved in the production of thyroid hormones is assessed to see if it’s being attacked by the immune system. This test diagnoses Hashimoto’s thyroiditis.
The other two autoiimmune tests, TG Ab and TR Ab, measure whether the immune system is attacking the protein from which thyroid hormones are made (called thyroglobulin) and TSH respectively. Both are indicative of thyroid autoimmune disease, with the latter specifically associated with hyperthyroid (or Graves’ disease).
It should be noted that a significant number of patients with autoimmune thyroid disease also have celiac disease. The link between celiac disease and autoimmune thyroid disease is well established. Celiac disease and autoimmune thyroid disorders share common genetic profiles, likely explaining the higher incidence of thyroid autoimmune disorders among celiacs as compared to the general population.
In studies it has been shown that the prevalence of celiac disease in patients with autoimmune thyroid disease is 4-15 times greater than that in the general population. A study published in the World Journal of Gastroenterology in 2007 concluded that the diseases were so linked that patients with Hashimoto’s thyroiditis should be screened for celiac disease and patients with known celiac disease should be screened for Hashimoto’s thyroiditis.
Vitamin D deficiency is also associated with autoimmune thyroid disease. It’s amazing the number of conditions that low vitamin D can cause, therefore it’s very important to ensure you get your levels evaluated at your annual physical and more often if you’re trying to increase a deficiency you’ve discovered.
What Can You Do?
The bottom line is that thyroid problems abound in this country and while many are diagnosed, too many continue to suffer due to insufficient testing. The thyroid is associated with so many crucial body functions that missing its malfunction can lead to needless suffering.
Dr. Vikki Petersen, a Doctor of Chiropractic and Certified Clinical Nutritionist, is founder of the renowned HealthNOW Medical Center in Sunnyvale, California. She is co-author of The Gluten Effect: How “Innocent” Wheat Is Ruining Your Health
a bestselling book that has been celebrated by leading experts as an epic leap forward in gluten sensitivity diagnosis and treatment.
HealthNOW Medical Center serves San Jose, Sunnyvale, Cupertino, Mountain View – and all cities of Santa Clara and San Mateo counties.It is also a Destination Clinic, treating patients from across the country and internationally.