I have spent the last couple of months buried deep in all things thyroid, lectures, books, testing. WOW, the thyroid is amazing, it’s the bodies “option” key. I remember someone saying that the “option” key on the keyboard makes everything better, hold down the option key and all kinds of good stuff happens, well that’s the thyroid. A properly functioning thyroid makes everything better.

As you may already know, one of the things the thyroid controls is metabolism. We all know there’s nothing better than a metabolism that works properly and hums along.

I’m going to jump right in and give you one of my big take aways from all things thyroid – there’s a LOT of undiagnosed thyroid dysfunction. One of the big problems, lab reference ranges used by traditional medicine.

  • Traditional medicine believes that normal TSH levels range from 0.5 – 5.0 – in order to be treated for thyroid disorders your TSH must fall outside of that (very large) range. If your TSH is within that range, even if you suffer from classic hypothyroid symptoms most doctors will not investigate thyroid function further.
  • Functional medicine believes lab reference ranges are way off and doctors should treat symptoms. Dr. Steve Hotze, an expert on thyroid health believes that an optimal TSH level is below 1. Mary Shomon, the founder of Thyroid-info.com and the thyroid expert at about.com ThyroidDisease believes normal TSH is typically less than 2.0. Dr. Wiggy Thyroid MD says normal TSH is 1.5.

As you can see, functional medicine is looking at about a 2 as the top end of a healthy TSH range. That’s a lot different than 5 and you can bet there are a whole lot of people with TSH between 1-5 who are suffering from hypothyroid symptoms and told they’re fine. FYI, it’s not uncommon for people with undiagnosed thyroid dysfunction to be given prescriptions for antidepressants.

So now you’re wondering what the symptoms of hypothyroid are. Well, it’s a long list. I’ll hit some of the more common complaints and give you a link to a more extensive list. Keep in mind, you don’t have to have all of the symptoms

Some Common Symptoms of Hypothyroid

  • Fatigue
  • Weakness
  • Unexplained weight gain or difficulty losing weight
  • Coarse, dry hair
  • Dry Skin
  • Hair loss
  • Outer third of eyebrow disappearing
  • Sensitivity to cold
  • Cold hands and feet
  • Elevated cholesterol
  • Depression
  • Impaired memory
  • Muscle cramps and aches
  • Constipation

You can find a really great, very long list at HyprothyroidMom.com. Remember, you won’t have all symptoms on the list, everyone is different and thyroid dysfunction is just like anything else, it manifests differently for everyone.

I don’t really want to focus on TSH. Why? Because TSH is not the best indicator of thyroid dysfunction. TSH stands for thyroid stimulating hormone – the measurement of a hormone that stimulates the thyroid to release thyroid hormone. That’s a little confusing. TSH or thyroid stimulating hormone is actually released by the pituitary gland. If there isn’t an adequate amount of thyroid hormone in the blood the pituitary gland gets the message and screams at the thyroid to step it up and produce more thyroid hormone.

If the thyroid gland is functioning normally, then TSH will be in the “normal” range. Why, because the thyroid is producing adequate amounts of hormone so the pituitary gland is happy and doesn’t have to scream (throw more TSH) at the thyroid to get it to do its job. Sounds good, right?

Well, that’s what is supposed to happen. Pituitary gland pumps out TSH to tell thyroid to make thyroid hormones, the thyroid pumps out thyroid hormones, the body gets the thyroid hormones and everything is great.

Unfortunately, dysfunction can happen even if the thyroid is functioning normally. This is where the disconnect happens. Just because the TSH is normal doesn’t mean there isn’t thyroid dysfunction. This is when symptoms speak way louder than labs. Unfortunately if you have a doctor that just looks at labs and doesn’t listen to your symptoms or passes your symptoms off as something else (remember that thing I said earlier about antidepressants) you could suffer from thyroid disease and never know it.

Let’s say your TSH is within the “normal” range. That means the thyroid has done its job, it’s pumped out a bunch of hormone, T4. The pituitary gland is satisfied so it’s not pumping out high levels of TSH, hence the “normal” TSH number. All should be good, right?

T4 is an inactive form of thyroid hormone. You can have lots of T4 floating around in the blood but until it gets converted to T3 it isn’t active. That’s step one, conversion from T4 to T3. Step two is getting the T3 into the cells where it’s needed. So, you can probably see where things could go wrong, conversion of T4 to T3 and/or T3 getting into the cells.

Testing your free T4 and free T3 is an excellent way to get a glimpse of what is actually going on with your thyroid hormones and understand if you are thyroid healthy. To get a complete picture of your thyroid health you also need to test for reverse T3 and thyroid antibodies.

You can be “Thyroid Sick” even if you have plenty of thyroid hormone (T4) circulating, but if it’s not being converted into the active form, T3 and being transported into the cells then all that thyroid hormone isn’t doing anything. And you know what that thyroid hormone does once it gets into the cells, it controls the cells ability to produce energy. Energy used for things like metabolic function and brain function. Pop back up and look at the common list of hypothyroid symptoms again: fatigue, tiredness, brain-fog, weight issues etc… It’s all starting to fit together.

TSH levels don’t give any clue about what’s happening on a cellular level. Suzy Cohen, the author of Thyroid Healthy makes the point that long before TSH becomes abnormal people are miserable and suffering from being “thyroid sick”.

Functional Medicine Lab Test Ranges:

  • Free T3: 3.5 to 4.3
  • Free T4: 1 – 1.5
  • Ratio, Free T3/Reverse T3: 20 or higher
  • TSH: less than 2
  • Antibodies: ideally zero

Have you had your thyroid tested? How do you feel? Should you get tested? Maybe. If you don’t feel great, maybe there’s an imbalance. I think we are all conditioned to think of everyday complaints as issues of age but the more I learn the more I realize the aging process and the symptoms that go along with it are signs of imbalance. By the time we hit our 40’s our bodies can’t compensate for all the partying and bad food anymore and it starts to show. Instead of thinking there isn’t anything you can do about it, start making changes. The body is amazing, give it a little support and it can heal.

My next post will be about why we run into trouble converting T4 to T3 and why T3 has trouble getting into our cells.

I hope you found this as interesting as I did.

Eat well, feel good, have fun!! 


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