Fatigue, cold sensitivity, constipation, dry skin, weight gain, thinning hair, brain fog, depression… If these symptoms are still lingering after your thyroid function has been normalized by medication or was normal to begin with, there may be more to the story.
TSH, or thyroid stimulating hormone, is most commonly used to investigate thyroid function. For some, a normal TSH (or thyroid medication that puts TSH back in the “normal” range), doesn’t always resolve the symptoms that brought them into the doctor in the first place.
Why isn’t normalizing TSH making me feel better?
First to consider, thyroid symptoms are extremely generalized. Unless there is a visible enlargement, goiter, or hoarseness developing in the voice, this little butterfly gland at the base of your neck doesn’t usually show us very specifically that it’s struggling.
There can be countless reasons unrelated to thyroid function to explain why you are tired, why you are constipated, or why your hair is thinning. I think the majority of us would say being cold is miserable. So if these symptoms aren’t going away, work with someone who can get to the bottom of it.
That being said, thyroid function HAS to be assessed, and assessed thoroughly, in order to move on to consider other causes of this grouping of symptoms. If your provider is only checking TSH and sending you on your way, it might be time to expand your care team.
How to evaluate thyroid health
TSH is the most common lab for thyroid function. It is what your provider checks when considering whether you may need thyroid supportive supplements or medication. The problem with TSH is that it can be in the “normal range,” while other markers of thyroid function can be off.
Besides TSH, there are a half dozen other markers that can give you more information about thyroid function and round out the picture of what might be going on.
Free T4, total T4, free T3, total T3, reverse T3, T3 uptake, TBG (thyroxine binding globulin), anti-TPO and anti-TG antibodies, are some of the tests that demonstrate if thyroid hormone is available, active, and effectively doing its job.
A CBC, CMP, hemoglobin A1c, lipid panel, iron panel, and vitamin D assessment are often considered to better understand how the body is functioning as a whole, and what may be impacting thyroid function and being impacted by it.
A naturopathic doctor, functional or holistic provider may look at these lab studies and tell you that while your numbers might be “normal,” they may not be functional. For example, if a normal lab range for a test is 5-10 and your number is 5.1, although you are in the normal range, your body might be struggling to function at this less than optimal level.
Are you sure it IS my thyroid?
By doing this holistic assessment of the thyroid, evidence can be gathered about why thyroid function is compromised to begin with.. Questions that might be addressed:
Are there inflammatory processes going on in the body, activating autoimmunity?
Are there nutrient deficiencies or issues with the cofactors necessary for the production of thyroid hormone?
Are there peripheral issues with activating thyroid hormone into the form that can be used by the body?
Are gut issues, hormonal imbalances, or stress getting in the way of an otherwise healthy thyroid?
As mentioned above, symptoms of low thyroid function are very generalized and could be pointing to many other root cause issues.
However, if these symptoms are present and thyroid function is less than optimal as illustrated by a TSH level, your provider will likely start medication.
Levothyroxine (Synthroid) is the medication used for under active thyroid function, and it is one of the most prescribed drugs in the US. This medication supplies the body with inactivated thyroxine (T4). This is the most abundant form of thyroid hormone in the body that must be activated for use by conversion to triiodothyronine (T3) in the body. T4 supplementation can be absolutely crucial when a true deficit of thyroid hormone exists in the body.
If the thyroid is under autoimmune attack, or the nutrients aren’t present for thyroid hormone production, or there is a problem with T4 to T3 conversion, all the additional T4 in the world may not be resolving symptoms, even if TSH is normalizing with the treatment.
A comprehensive approach to thyroid health and functioning is so important. It’s the gland responsible for regulating our metabolism, influencing heart rate and body temperature, digestion, growth and development, mood and hormones.
What does holistic support of the thyroid gland look like?
A holistic approach to thyroid health may include recommendations on:
Nutrition - Addressing specific nutrient requirements to correct deficiencies and to support the production and utilization of thyroid hormones
Movement - Optimizing how the body uses thyroid hormones
Sleep - Establishing the proper rhythms that support thyroid health
Hormones - How blood sugar and stress hormones can affect thyroid health and compromise function of the gland
Digestion - Correcting imbalances in the gut that can lead to less than optimal usage of thyroid hormone
Immunity - Addressing the role of the immune system in thyroid health and function, rebalancing and calming an over-active immune system
Supplementation - Specific recommendations on thyroid supportive botanical remedies and supplements for the optimal production and usage of thyroid hormones
Make sure you have the support you need to evaluate thyroid function thoroughly, to supply the gland with what it needs, and to remove obstacles in its way.
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