THYROID: Why Your Test Results Can Be Misleading
Every week, I see patients in my clinic with a variety of complaints that indicate probable thyroid involvement, yet their lab results are considered within “normal” range. Why? Because the purpose of conventional reference ranges is to diagnose disease or pathology, not to assess the risk for disease before it develops.
Most adverse health conditions take time, sometimes years, before they reach a stage that will cause conventional tests to return a positive result. In the meantime, lab results that come back reading “normal” can easily obscure the whole story. In fact, their narrow reference ranges provide many conditions with more time for symptoms to worsen before a diagnosis is finally made.
Thyroid disorders are rampant in the U.S. It is estimated that 27 million Americans suffer from thyroid-related illnesses, and women are five to eight times more likely than men to have thyroid problems, according to the American Thyroid Association. Hormone medications to treat thyroid conditions have been on the Top 10 most-prescribed medications list for decades; Synthroid is at the top of the list.
When a positive diagnosis is finally made using conventional testing, symptoms have usually advanced enough that the patient requires medication for years to come— possibly the rest of their life—and often experiences a diminished quality of life as well. Yet, if their condition had been caught early enough, a patient who adheres to a temporary, corrective, natural-remedy protocol and makes lifestyle adjustments—possibly including temporary use of thyroid medications—can restore their hormone balance to healthy levels and experience improved symptoms.
A complex issueEvery cell in the body has receptor sites for thyroid hormones, so thyroid dysfunction can be complex and cause problematic symptoms affecting everyday life. Both hypo-, underactive, and hyper-, overactive, thyroid hormones can contribute to decline in all bodily systems. Hypothyroidism is the most common thyroid condition in the United States, and most cases of it are caused by an autoimmune condition called Hashimoto’s disease or Hashimoto’s thyroiditis. The next most common is hyperthyroidism, followed by goiter and thyroid cancer.
Common Symptoms of Hypothyroid:
- Weight gain
- Morning headaches
- Chronic digestive issues
- Hair falling out easily
- Thinning of outer edges of eyebrows
- Blood sugar imbalances
- Other hormonal imbalances
- Dry skin
- Need for excessive amounts of sleep
- Cold hands and feet
Common Symptoms of Hyperthyroid:
- Unexplained weight loss
- Rapid or irregular heartbeat
- Feeling irritable
When to test for autoimmune disorderWhen thyroid issues stem from an autoimmune problem, symptoms can swing from those of hypothyroid to hyperthyroid, and lab results will fluctuate too. One sign of possible autoimmune involvement is this fluctuation. Testing antibodies helps to determine if the immune system is involved; if it is, the result is a diagnosis of Hashimoto’s or Grave’s disease.
Testing of the thyroid-stimulating hormone (TSH)—which is the most common way that physicians assess thyroid function—can be a setup for failure if done alone. Results will likely give an incomplete picture of the overall thyroid function and the reasons there is dysfunction in the first place. More complete testing is needed to determine where the breakdown is. For example, TSH testing alone discloses pituitary function in relation to the thyroid gland, but it doesn’t reveal whether the thyroid hormones are working normally in the body or whether an autoimmune disorder is involved. Simply put, more lab tests are needed. So, if you are one of the millions of Americans who have been prescribed thyroid medication, but your symptoms have continued or even worsened, it is highly likely that the cause of your thyroid imbalance is not being addressed.
For example, if a woman’s low thyroid function is caused by adrenal stress or results from taking birth control pills, administering thyroid hormones would not address the problem and might even worsen her condition. On the other hand, if her TSH is within normal ranges, but her thyroxine (T4) hormone is not converting sufficiently to the useable form, Free T3, she’ll likely be feeling exhaustion and low energy, among other symptoms. Administering the most common thyroid medication prescribed, Synthroid, will not address these symptoms, but it can alter TSH blood values to be within normal range. In other words, blood tests would come back “normal” but her energy could remain at an all-time low.
Hashimoto’s: The leading cause of hypothyroidBecause autoimmune Hashimoto’s is the leading cause of hypothyroid in the United States, it is worth taking some time to review key elements of the condition. This information can make or break your healing process.
Hashimoto’s thyroiditis is an autoimmune condition that, over time, results in the destruction of the thyroid gland, if not adequately treated. The Japanese physician Hakuro Hashimoto first described the condition in 1912. People with Hashimoto’s frequently fluctuate between hypothyroid and hyperthyroid symptoms because as thyroid cells are destroyed, stored hormones may release into circulation. This causes an excessive thyroid hormone accumulation resulting in an over-functioning thyroid. If antibody tests reveal autoimmune involvement—meaning either Hashimoto’s or Grave’s disease is present—both the immune system and the thyroid condition must be addressed, or destruction of the thyroid gland will continue.
Most doctors do not test for Hashimoto's because there is no known way to treat the autoimmune component using conventional medicine. The patient will be prescribed thyroid medication, and their serum hormone levels will be monitored. Because it is anticipated that, due to autoimmune involvement, the thyroid will lose function, thyroid medication is increased as this occurs and is revealed in serum hormone levels. As additional symptoms appear from this loss of the gland’s function, other strong medications are administered to lessen the severity of those symptoms. Some doctors even suggest surgical removal of the thyroid completely, which can invite other problems.
Thyroid medicationsThyroid medications are a delicate matter. There is a narrow range in blood-test results that determines which one or what combination of them to prescribe and what dosage(s) will make a substantial difference in symptoms. Medications need to be monitored and adjusted; some medications contain fillers that can cause reactions. It is recommended that you consult a health care provider who is knowledgeable about the complexity of thyroid involvement. At the same time, it can be beneficial to incorporate medication while balancing the underlying causes.
Taking medication need not be seen as a surrender or a lifelong requirement provided the condition is caught early enough and the root causes are addressed. In addition, many dietary and lifestyle adjustments are essential. For example, removing gluten completely from the diet can benefit autoimmune thyroid healing tremendously. Because gluten mimics thyroid tissue, it triggers the destruction of the gland by the immune system. Additionally, with autoimmune conditions, it is vitally important to maintain healthy levels of Vitamin D3, which assists in regulating the cells involved in the autoimmune reaction. Stabilizing any blood sugar imbalance is also critical for healing thyroid problems. Many other steps can be taken to improve thyroid function.
Thyroid imbalance is reversibleAccording to conventional medicine, the progression of normal thyroid function to hypothyroidism is irreversible and eventually leads to total cell damage of the gland. This perspective excludes the 20 percent reported to have a spontaneous return to normal function and to remain at normal levels even after stopping hormone replacements.
In fact, studies have demonstrated that once the autoimmune attack stops, the damaged thyroid can regenerate. Thyroid ultrasounds have shown normal tissue that has regenerated, and thyroid antibodies that no longer test positive. More information on this can be found in Dr. Izabella Wentz’s book, Hashimoto’s Thyroiditis.
Lifestyle modifications to slow the progression of thyroid conditions and even turn them around are not generally acknowledged in conventional medicine. The human body is masterfully created, however, and when given the proper elements and environment, it is able to accomplish what it was designed to do.
Janine Romaner, ND, is a naturopathic doctor practicing at her clinic, Naturally Healthy, in Woodstock, Georgia. She studied at the BioMolecular Institute of Medicine in British Columbia and Washington state and earned degrees in natural health and naturopathy. For more information, visit NaturallyHealthy.ws or call 770-640-6690.