Why Do I Have Thyroid Symptoms When My Doctor Tells Me My Lab Tests Are Normal?

thyroid zoomed

We refer to the adrenal gland as the “furnace” of our metabolism.  In a similar analogy, we can consider the thyroid gland as the “thermostat” for our metabolism.  It regulates the rate of metabolism of virtually every cell and tissue in the body and it is subject to control by the hypothalamus of the brain and the pituitary gland.  Thyroid dysfunction can occur due to problems with the hypothalamus, pituitary gland, the thyroid itself, tissue metabolism and conversion of thyroid hormones, and the action of the hormones at the receptor sites.  There is no symptom that is unique to the thyroid.  Each of the symptoms listed below can be due to a number of different problems.  The pattern helps to establish the diagnosis and is supported by the results of blood tests.  Many of the symptoms of hyperfunction (too high) and hypofunction (too low) overlap.

Symptoms of Thyroid Dysfunction

  • Decreased energy, fatigue
  • Weight gain or struggle to lose
  • Weight loss
  • Feel “too hot”
  • Feel “too cold”
  • Cold hands and feet
  • Dry skin and brittle nails
  • Thinning or loss of outside portion of eyebrow
  • Body temperature below 97.6
  • Hair thinning
  • Brain “fog” (trouble with learning, memory, making decisions)
  • Depression
  • Dislike tight collars or turtlenecks
  • Sore/tender/swollen lower neck
  • Heart palpitations
  • Constipation/gas/bloating
  • Menstrual problems – flow or irregularity
  • Fertility problems/miscarriages
  • Loss of sex drive

 

Over recent years the sensitivity of laboratory testing of thyroid hormones has improved markedly.  We are now able to measure precisely the “free” or active amounts of  hormones present in the blood.  Unfortunately, many people still suffer from undiagnosed thyroid dysfunction due to either incomplete testing or poor interpretation of the results.  According to JAMA, a premier medical journal, physicians suspecting thyroid dysfunction should check TSH (Thyroid Stimulating Hormone – the pituitary hormone that stimulates the thyroid gland) and T4 (the precursor or pre-hormone that is secreted by the thyroid gland).  Unfortunately, this strategy completely misses looking at the most potent or “active” thyroid hormone which is T3.  Since the thyroid gland secretes 90% T4 and 10% T3, the majority of T3 (the active hormone) is derived from the body tissues converting the T4 into T3.  Well, guess what?  Some people do not convert T4 to T3 very effectively and since most doctors are not taught to check T3, they never find out!

There are many reasons for poor conversion of T4 into T3 and stress is one such reason.  I have very few patients in my practice who are not stressed.  Stress favors the conversion of T4 into another thyroid hormone that is little known about called Reverse T3.  If our metabolism was a car, T3 would be the accelerator, and Reverse T3 would be the brake.  Yes, we can measure Reverse T3 also, but JAMA et al do not advise it and few physicians have ever heard of it even though it was identified in the 70’s.  We are far beyond the stage of having to rely on basal body temperatures (many things aside from your thyroid can effect basal body temperature), but numerous people are still suffering due to undiagnosed thyroid dysfunction.

To learn more about thyroid and other hormonal issues that affect your health, please call (330) 899-0050, and/or register for our next seminar, online here.