Are you constantly tired? Is your hair and skin dry and dull? Do you feel the cold and have trouble losing weight? These are all classic symptoms of a struggling thyroid gland, yet despite your suspicions your blood test results may have shown nothing wrong. Or are you taking thyroxine, your levels seemingly within range yet you’re still not feeling yourself?
If this sounds like you, read on because undiagnosed thyroid issues may yet be behind your symptoms.
Firstly, a quick introduction to your thyroid. This gland produces thyroxine, the hormone controlling the rate you produce energy, acting like an accelerator pedal for your body. So if it’s not functioning well, everything will slow down, meaning weight gain, sluggish digestion, depression, joint pains and low body temperature among a long list of other possible symptoms.
Your thyroid gland produces thyroxine at the request of another hormone released by your brain’s pituitary gland, called Thyroid Stimulating Hormone or TSH. Your pituitary constantly monitors the amount of thyroxine in your blood and when it detects levels are low it releases TSH. Once thyroxine levels have increased again, TSH production slows and so too does thyroxine release. It’s a neat system and should be fool-proof, however as you’ll see later, problems can and do occur.
You make thyroxine in two forms called T3 and T4, the only difference being the amount of iodine contained in each. You produce far more T4 than T3, with thyroxine usually travelling around your body as T4, as a kind of thyroxine reserve.
Hormones produce an effect by stimulating receptors located on cells. T3 is more active because it’s much better at affecting your cells’ receptors than is T4. Your body simply alters T4 to T3 when it’s needed by chopping off a part of the molecule, altering its structure and size so your receptors recognise it and respond.
Conventional blood tests usually look at your levels of TSH, and often T4 too. If TSH is high and T4 is low, it would suggest your pituitary is instructing your thyroid to make more thyroxine, but for some reason it’s not doing so.
However, looking primarily at TSH can miss many problems with thyroid functioning. Several things can go wrong with your thyroid and they’re not always reflected in TSH and T4 levels.
If your body isn’t converting T4 to T3 very well, your T4 levels may be normal or even high, yet your cells aren’t responding because there’s very little T3. TSH levels will probably be normal – because there’s plenty of T4 in your blood your pituitary doesn’t think there’s any need to produce additional TSH. So this issue won’t be picked up by conventional thyroid tests.
This problem can occur because of shortages of the specific nutrients needed to perform the conversion, or it can be connected with excess inflammation, stress, lack of sleep and some medications.
It’s also worth mentioning both T3 and T4 can be free, or active, or bound to a protein, and therefore inactive. Any test which doesn’t distinguish between free and unbound hormones could give a skewed result.
Sometimes, a biologically inactive substance called reverse T3 is produced instead of regular T3. Similar in structure but not identical, reverse T3 attaches itself to your thyroid receptors but doesn’t produce an effect, so it effectively blocks the action of regular T3. Scientists believe the more reverse T3 you have, the less efficiently you can produce regular T3 from T4.
Many circumstances encourage the formation of reverse T3, particularly ongoing stress. Again, reverse T3 isn’t tested for in conventional tests so your results could indicate there is nothing amiss.
Finally, your body may be making antibodies to your thyroid gland. This happens when your immune system mistakes it for an invader. This can damage your thyroid gland, adversely affecting its function.
A blood test to detect how much T3 you have in your blood, to what extent you’re producing reverse T3, how much free T3 and T4 is in circulation and whether your immune system is producing antibodies to your thyroid can be useful to reveal the real reasons behind your struggling thyroid.
Interpretation of your test results will help understand exactly what’s going wrong with your thyroid gland.
Because so many issues can affect the health of your thyroid such as stress, hormone balance, medications and even whether your liver and gut are happy, identifying these factors with a detailed case history will help your therapist formulate a personalised plan to improve your thyroid health.
If you’d like to start your journey to optimal thyroid health, contact me.
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