Thyroid Dysfunction
Underactive thyroid (hypothyroidism) is often overlooked or misdiagnosed and can be the underlying cause of these symptoms. Patients and their doctors often disregard these common signs of thyroid hormone deficiency, mistaking them for normal aging.
Role of the Thyroid
The thyroid is a butterfly-shaped organ located just below the Adam’s apple in the neck. Made up of small sacs, this gland is filled with an iodine-rich protein called thyroglobulin along with the thyroid hormones thyroxine (T4) and small amounts of triiodothyronine (T3). The primary function of these two hormones is to regulate metabolism by controlling the rate at which the body converts oxygen and calories to energy. In fact, the metabolic rate of every cell in the body is regulated by thyroid hormones, primarily T3. In healthy individuals the gland is imperceptible to the touch. A visibly enlarged thyroid gland is referred to as a goiter. Historically, goiter was most frequently caused by a lack of dietary iodine. 8 However, in countries where salt is iodized, goiter of iodine deficiency is rare.
Subclinical hypothyroidism, an often under-diagnosed thyroid disorder, manifests as elevated TSH, normal T4 and normal T3 levels.30 Individuals with subclinical hypothyroidism are at greater risk for developing overt hypothyroidism.31 An August 2010 study reported that 8.3% of women with no history of thyroid disease suffer from subclinical hypothyroidism.32 An article in the American Family Physician in 2005 estimated that about 20% of women over the age of 60 suffer from subclinical hypothyroidism.
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormones, characterized by a reduction in metabolic rate. The main symptoms of hypothyroidism are fatigue, weakness, increased sensitivity to cold, constipation, unexplained weight gain, dry skin, hair loss or coarse dry hair, muscle cramps and depression. However, most symptoms take years to develop. The slower the metabolism gets, the more obvious the signs and symptoms will become. If hypothyroidism goes untreated, the signs and symptoms could become severe, such as a swollen thyroid gland (goiter), slow thought processes, or dementia.
There is evidence that the standard blood TSH test reference range may cause many cases of hypothyroidism to be missed. Most physicians accept a reference range for TSH between 0.45 and 4.5 mU/L to indicate normal thyroid function. In reality, though, a TSH reading of more than 2.0 may indicate lower-than-optimal thyroid hormone levels.
According to a study reported in Lancet, various TSH levels that fall within normal range are associated with adverse health outcomes.26
- TSH greater than 2.0: increased 20-year risk of hypothyroidism and increased risk of thyroid autoimmune disease
- TSH between 2.0 and 4.0: hypercholesterolemia and cholesterol levels decline in response to T4 therapy
- TSH greater than 4.0: greater risk of heart disease
There is another and separate problem brought on by these overly broad normal ranges for TSH. People already diagnosed and being treated for hypothyroidism are often not taking correct doses of thyroid replacement hormone. A November 2010 study reported that about 37% of people being treated for hypothyroidism were taking incorrect doses, about half too much and another half too little hormone.
Consequences of Hypothyroidism
Gastrointestinal problems: Hypothyroidism is a common cause of constipation. Constipation in hypothyroidism may result from diminished motility of the intestines. In some cases, this can lead to intestinal obstruction or abnormal enlargement of the colon.36 Hypothyroidism is also associated with decreased motility in the esophagus, which causes difficulty swallowing, heartburn, indigestion, nausea, or vomiting. Abdominal discomfort, flatulence, and bloating occur in those with small intestinal bacterial growth secondary to poor digestion.31
Depression and psychiatric disorders: Panic disorders, depression, and changes in cognition are frequently associated with thyroid disorders.37 Hypothyroidism is often misdiagnosed as depression.38 A study published in 2002 suggests that that thyroid function is especially important for bipolar patients: “Our results suggest that nearly three-quarters of patients with bipolar disorder have a thyroid profile that may be suboptimal for antidepressant response.” 39
Cognitive decline: Patients with low thyroid function can suffer from slowed thinking, delayed processing of information, difficulty recalling names, etc.40 Patients with subclinical hypothyroidism show signs of decreased working memory,41 and decreased speed of sensory and cognitive processing.42 An evaluation of thyroid hormones along with TSH may help avoid misdiagnosis as being depressed. 43
Cardiovascular Disease: Hypothyroidism and subclinical hypothyroidism are associated with increased levels of blood cholesterol, increased blood pressure, and increased risk of cardiovascular disease. 44 Even those with subclinical hypothyroidism were almost 3.4 times as likely to develop cardiovascular disease than those with healthy thyroid function.
- High blood pressure: Hypertension is relatively common among patients with hypothyroidism. In a 1983 study, 14.8% of patients with hypothyroidism had high blood pressure, compared with 5.5% of patients with normal thyroid function. “Hypothyroidism has been recognized as a cause of secondary hypertension. Previous studies … have demonstrated elevated blood pressure values. Increased peripheral vascular resistance and low cardiac output has been suggested to be the possible link between hypothyroidism and diastolic hypertension.”
- High cholesterol and atherosclerosis: “Overt hypothyroidism is characterized by hypercholesterolemia and a marked increase in low-density lipoproteins (LDL) and apolipoprotein B” These changes accelerate atherosclerosis, which causes coronary artery disease.43 The risk of heart disease increases proportionally with increasing TSH, even in subclinical hypothyroidism.49 Hypothyroidism that is caused by autoimmune reactions is associated with stiffening of the blood vessels. Thyroid hormone replacement may slow the progression of coronary heart disease by inhibiting the progression of plaques.
- Homocysteine: Treating hypothyroid patients with thyroid hormone replacement might attenuate homocysteine levels, an independent risk factor for cardiovascular disease: “A strong inverse relationship between homocysteine and free thyroid hormones confirms the effect of thyroid hormones on homocysteine metabolism.”
- Elevated C-reactive protein: Overt and subclinical hypothyroidism are both associated with increased levels of low-grade inflammation, as indicated by elevated C-reactive protein (CRP). A 2003 clinic study observed that CRP values increased with progressive thyroid failure and suggested it may count as an additional risk factor for the development of coronary heart disease in hypothyroid patients.
Metabolic Syndrome: In a study of more than 1,500 subjects, researchers found that those with metabolic syndrome had statistically significantly higher TSH levels (meaning lower thyroid hormone output) than healthy control subjects. Subclinical hypothyroidism was also correlated with elevated triglyceride levels and increased blood pressure. Slight increases in TSH may put people at higher risk for metabolic syndrome.
Reproductive system problems: In women, hypothyroidism is associated with menstrual irregularities and infertility. Proper treatment can restore a normal menstrual cycle and improve fertility.
Fatigue and weakness: The well known and common symptoms of hypothyroidism, such as chilliness, weight gain, paresthesia (tingling or crawling sensation in the skin) and cramps are often absent in elderly patients compared with younger patients, fatigue and weakness are common in hypothyroid patients.
Hypothyroidism: What you need to know
- Thyroid diseases occur about five times more frequently in women than in men. As many as 20% of women over 60 years old have subclinical hypothyroidism.
- If untreated, chronic hypothyroidism can result in myxedema coma, a rare, life-threatening condition. Mental dysfunction, stupor, cardiovascular collapse, and coma can develop after the worsening of chronic hypothyroidism as well.
- An autoimmune disease called Hashimoto’s thyroiditis is the most common cause of low thyroid function in the US. The body’s immune system mistakenly attacks the thyroid tissue impairing the ability to make hormones.79 Hypothyroidism caused by Hashimoto’s disease is treated with thyroid hormone replacement agents.
- Hashimoto’s disease usually causes hypothyroidism, but may also trigger hyperthyroid symptoms.
- Hyperthyroidism is usually caused by Graves’ disease, in which antibodies are produced that bind to TSH receptors in the thyroid gland, stimulating excess thyroid hormone production.20
- The distinction between Hashimoto’s thyroiditis and Graves’ disease may not be as important as once thought. In 2009 researchers wrote that, “Hashimoto’s and Graves’ disease are different expressions of a basically similar autoimmune process, and the clinical appearance reflects the spectrum of the immune response in a particular patient.”81 The two diseases can overlap causing both thyroid gland stimulation and destruction simultaneously or in sequence.82 Some clinicians consider the two conditions different presentations of the same disease.83 About 4% of patients with Graves’ disease displayed some symptoms of Hashimoto’s thyroiditis during childhood.
- Pregnant women are especially at risk for hypothyroidism. During pregnancy, the thyroid gland produces more thyroid hormone than when a woman is not pregnant,85 and the gland may increase in size slightly.
- Uncontrolled thyroid dysfunction during pregnancy can lead to preterm birth, mental retardation, and hemorrhage in the postpartum period. 86 It is important to work closely with a physician to monitor thyroid function during pregnancy.
- Tests to diagnose and monitor hypothyroidism include: Thyroid Stimulating Hormone (TSH), Total T4, Total T3, Free T4 (fT4), Free T3 (fT3), Reverse T3 (rT3), Thyroid peroxidase antibody (TPOAb), Thyroglobulin antibody (TgAb)
Treatment
Conventional treatment almost always begins with synthetic T4 (levothyroxine) preparations like Synthroid® or Levoyxl®. Low doses are usually used at first because a rapid increase in thyroid hormone may result in cardiac damage.
Desiccated Thyroid: Armour thyroid , Nature-throid, and Westhroid are prescription medications that contain desiccated porcine thyroid gland. Natural thyroid extracts have been used since 1892 and were approved by the Food and Drug Administration in 1939. Armour thyroid and most other natural glandular preparations are made to standards approved by the United States Pharmacopoeia.
Armour thyroid is preferred by some clinicians because it may achieve results in patients that fail to respond to levothyroxine alone. Patients with hypothyroidism show greater improvements in mood and brain function if they receive treatment with Armour thyroid rather than Synthroid®.96 One argument favoring natural hormones is that other naturally occurring hormones and chemicals found in these preparations may buffer or enhance the effect of the active hormones.
Absorption of Thyroid hormone Medications: Coffee,97 aluminum antacids,98 ferrous sulfate (iron),99 calcium carbonate,100 soy 101 and possibly grapefruit juice102 can all decrease the absorption of thyroid hormone prescriptions. Most doctors simply advise patients to take thyroid away from any food or medication.
If you have concerns about your thyroid function, call today to schedule an appointment with Dr Carnahan for an complete evaluation and treatment of thyroid dysfunction.
I think that anyone on the synthroid pills and still feel tired all day should try switching. I’ll bet there are many individuals who just don’t know this alternative exists, when it might be the most effective thyroid supplement for them.
Thanku . I wanted to know some other details related to thyroid.
Thank for the comprehensive list of serum tests. They only use TSH as the be-all-end-all thyroid test here, but now I can specifically request them all.
Thank you for this article! I have a question. I have Hashimoto’s and my eyes bulge. They are so noticeably bulgy that people ask me if I have a thyroid problem. Every time I get thyroid numbers tested, I’m always slightly hypo, not hyper. I have been tested specifically for Graves and I’m negative for Graves antibodies. I have had a cat scan done and it showed no thyroid eye disease and no tumor. My right eye bulges significantly more than my left eye. And my opthamologist measured my eyes and confirmed that my right eye is out a lot more than my left eye. Do you have any idea what’s going on with my eyes? I’ve read your eye tissue looks like your thyroid tissue so I’m freaked out that my eyes are being attacked. Thank you.
Hi Natalie,
Exophthalmos is most common with Grave’s disease but you should not take it lightly and continue to see your doctor to see if there is anything they can do for you. It’s possible that you had Grave’s disease that burned out and now you are hypothyroid but still suffering the effects of Exophthalmos.
Warmly
Dr Jill
Thank you Jill for your very informative report. I was first diagnosed with an overactive thyroid gland in my thirties and after being treated for a few years, things started going wrong and I was given steroids for a very short time which increased my weight but eventually I was given a radioactive isotope which caused my thyroid gland to under active. 10 years later I was diagnosed with AVN in my hips and had both my hip bones replaced in 1997 and 1998 respectively. After my first hip replacement I was diagnosed with DVT in that leg and later learned from a report by Dr. Glueck that anyone with an underlying blood clotting disorder should never be prescribed steroids. I am now 81 and take 100 mg. Levothyroxine per day. I had 2 nasty flare-ups 3 years ago and now walk with a cane but pain has eased and I’m still able to get out and about at a slower pace of course.
Hi Pamela,
Thanks for sharing… I am sorry you have had so many difficulties.
warmly
Dr Jill
Hi,
Does Hashimoto’s hypothyroidism cause an inability to tan at all? When I was younger, I got super dark and had no problems tanning. Now when I try to tan outside, my tan gets kinda reddish/orangish. It’s hard to describe but it doesn’t get dark like it used to be or how other people’s tan looks. I didn’t know if maybe hypothyroidism can cause this by making the skin so dry or if this is related to something else?
No but abnormal MSH may cause pigmentation issues…
Hi ! I have the same problem not being able to tan since hypothyroidism and I’m Seneca Indian and Italian. I should be able to ran just like always but also turn red. Interesting ……
Hi I have hypothyroid and diverticulosis and have yet to find a dietician to work with me on a balanced diet that will work for both and also high blood pressure and high cholesterol any ideas Any help I will greatly appreciate…thank you. [email protected]
Hi Daenna,
Please contact one of our nutritionists, Megan Forbes or Judy Converse who will be able to help you!
Warmly
Dr Jill
Hi I have Hashimoto’s and hypothyroid and it is extremely difficult for me to keep weight on. I have to eat a lot of food, and it’s still a struggle. I keep hearing about Hashimoto’s and hypothyroid causing weight gain so I don’t understand why I’m having difficulty gaining weight. I greatly appreciate any advice. Thank you!
Hi Sara,
You may have SIBO or malabsorption. You may be in the initial thyroiditis stage where the thyroid is leaking hormone and eventually burns out. Or you may be overrated by thyroid medication. Work with your doctor to find out why you are having so much trouble gaining weight.
warmly
Dr Jill
I have had been diagnosed with Hypothyroidism since I was 3 months old, now 54 and on Levothyroxine/synthyroid all my life was and was told would be the rest of my life. I’m not sure the cause of it(type). Recently diagnosed with high blood pressure and am taking meds for it. Being a Hypothyroid patient how many more problems/diseases could I be looking at in the future?
Hi Robin
If you have Hashimoto’s thyroiditis, having one autoimmune disease will make you at greater risk for developing another autoimmune disease.
warmly
Dr Jill
I have very dry skin on my face only it seems like which could be thyroid related I’m not sure. I’m only 18 and I have lots of fine lines, crows feet, wrinkles on my forehead, just major wrinkles and aging. I have never smoked or gone tanning. Do you know a really good eye cream or product to help with this? Thank you!
Hi Meghan,
We have an amazing line of clean anti-aging products that would work well for you…. I suggest the RA 0.05% cream applied to entire face every other night. IF you do well, you may increase to every night. In the morning you can use the Vita-CE serum which will decrease excess pigmentation and load antioxidants onto your skin. There is also a NeutralEYEs special cream just for the eyes if you need more targeted therapy. Call Amy at 303-993-7910 to order these products… I promise you will not be disappointed!
warmly
Dr Jill
Hi I have Hashimoto’s and am slightly hypothyroid. I am allergic to thyroid medication. I have tried every kind on the market and I break out in hives and have shortness of breath. My doctor said if I get antibodies down, my natural thyroid function is likely to return because I’ve had Hashimoto’s at most for 6 years. And she said she’s heard of people who have had it for 20 years get off their medication. Could you tell me how to get antibodies down please? I’m on a gluten, dairy, grain free diet. Stool testing showed nothing. Organic acids testing revealed mild yeast/fungal dysbiosis (markers in yellow).
Hi Olivia
Start by treating the gut… you’ll need to look for any triggers (infection, toxin, stress, foods, etc) and deal with each thing that is contributing to autoimmunity before things may reverse.
Warmly
Dr Jill
I have graves and I had radiation treatment. For thirteen years I’ve struggled with this. Here lately I can’t do much like walk a long distance or clean house because I get short winded and my legs start to ache. 2weeks ago I was at a dance and I danced half the song and I started to feel like I was gonna have a heart attack well I passed out walking to the girls restroom. Don’t remember passing out . Went to the ER and nothing was found wrong with me. Could this be a factor to my meds. That I take? Any info on this for me?
Thanks
Monica
Hi Monica,
This could certainly be related to your thyroid… have your doctor check thyroid labs, TSH, Free T4, free T3, TPO, TgAb and TSI. You may also need a thyroid ultrasound.
warmly
Dr Jill
Hi Dr Jill
All my life I’ve had thyroid problems but never been diagnosed until 17 years ago after my pregnancy!
4 years ago I had a full hysterectomy surgery!
After that my thyroid had worsened doctors keep adjusting my dose. i have gained over 30 pounds, I look 5 months pregnant! Have bowel problems, my hands hurt like I have arthritis, muscle weakness, trouble sleeping, no energy I literally have to force myself to get things done, Slow thinking, memory problems, brain fog, hard to focus.After 20 min of working out i lost all my energy for the rest of the day! I now have 2 teenagers and When I’m stressed I feel worse! Dr put me on antidepressants so I can sleep!
My neck and glands is swollen sometimes I have a hard time swallowing and voice becomes horse, my face is puffy! I have read different books and it all points to hypothyroidism! I’m not getting any support from my Family they think it’s all in my head! And that I shouldn’t even be on thyroid meds! No one understands what I’m going through! I have read different articles what foods to stay away from! I have some good days than others and some days I just want to crawl somewhere and hide, not in the mood to socialize. And i like to socialize, don’t know who I am anymore not comfortable in my own body! Not getting anywhere with my doctors! They said you can’t believe everything you read about thyroids!
I quite my full time job a year after my hysterectomy surgery! It started to get too much for me! Now I’m turning to you for help! What do you recommend? I’ll take any advice!
Thank you
Hi Sandra
I recommend finding a functional medicine doctor to help you test and treat the root cause. You can search at http://www.functionalmedicine.org
warmly
Dr Jill
I am having an uncomfortable feeling on my right side bottom of rib (seems like bottom of liver area), bloating, and constipation. My T3 is 2.8 which my doctor thinks is fine. Where do I go from here?
Hi Deb
Best to see your doctor to have a physical exam and further testing…
warmly
Dr Jill
Hi Dr. Jill,
I have Hashimoto’s and have unexplained iron deficiency anemia. My ferritin is 4 and my TIBC is high. I was wondering what you see as the most common cause of this? I saw several doctors and they said I might not have an enzyme in my large intestine that allows me to absorb iron, and that they can test me for it. But when I looked online, it says that iron is absorbed in the small intestine. And I’m in my 20’s so if I didn’t have an enzyme that allowed me to absorb iron, I wouldn’t have ever had that enzyme and would have been anemic a long time ago. I’m also having a lot of bloating. I asked the doctors if they think that’s related to the low iron and they said no. I would think there can’t be too many things that cause unexplained anemia but I’m not a doctor so I don’t know. Have you seen anything like this before? Is there anything you would recommend testing for?
Hi Lindsey,
Check the gut… many patients with Hashimoto’s also have SIBO or SIFO…
warmly
Dr Jill
Hi Dr. Jill,
My daughter has Hashimoto’s and is hypothyroid and is having severe malabsorption. Her nutrient levels are all low, everything. B12, iron, Vitamin C, Vitamin D, protein deficiency, fatty acid deficiency. Doctors can’t figure out what is wrong. These nutritional deficiencies are really affecting her and causing symptoms. Does hypothyroidism cause nutrient malabsorption?
Hi Linda
Hypothyroid may cause sluggish bowel motility and SIFO or SIBO. Both of these can cause malabsorption.
warmly
Dr Jill
Hi Dr. Jill
At one time my Dr. said my thyroid was low and started me on medications but about 6 months of taking it he a aid I didn’t need any longer. I have low iron, dry skin, unable to lose weight I look like I am pregnant It feels like something crawling around my ear my hair is falling out I have been diagnosed with panic disorder I can’t any anti-depressants I have a reaction every time I take one I am tired all the time also have hypertension and 1 time my eye did actually pop out of the socket please help I live in Oklahoma
Sounds like you need to recheck your thyroid and find a functional doctor to help you get the right dose….
Hi Dr. Jill,
I have Hashimoto’s and I’m hypothyroid, and I read this can cause low stomach acid and slowed motility which can result in gut infections or make gut infections that are already there worse. Does taking thyroid medication like Levoxyl and/or Cytomel return stomach acid levels and gut motility to normal?
Hi Hanna,
Normalizing the thyroid may help return your digestion to normal.
warmly
Dr Jill
Hi Jill, I had a TT in Oct 2016. For the last few months I’ve had pain in my right arm from shoulder to fingers. It’s often excruciating like a pinched nerve. Could this be caused by my Synthroid? I’ve heard it might get better with Armour. Is joint pain common after TT?
Hi Kim
You may be reacting to an inactive ingredient in the thyroid medication. You might try switching meds to see if it goes away
warmly
Dr Jill
Hi I had a serious metabolic break down according to an endocrinologist. I have struggled with depression for years. I had very dry skin and would break out in large water blisters. Had visiting nurses come in to dress them and keep infection down. Had one that would not heal. Have had a open wound for four years. I have during that time been diagnosed with hypothyroid disease. Can the thyroid problem keep my wound from healing? I have become very weak and tired. Have trouble sleeping, changes in my voice, headaches, at times feel like I can’t breath. I am cold most of the time be without warning I feel like I’m on fire. Wound care Dr. had a flap procedure done to no avail for my wound. I seem to get weaker and more sick with each passing day. I have stage 4 kidney disease from dehydration and talk of more surgery
Is it time to give up?? Open for help
Dear Linda,
There is always hope… find a good functional medicine doctor to help you
Warmly
Dr Jill
Hi, I’ve read that people who have Hashimoto’s have low stomach acid or lack of stomach acid. And this leads to bloating and poor absorption of nutrients. Is it true that just about everyone with Hashimoto’s has low stomach acid?
No but some do…
I think you may be my daughters life saver, she has hyperthyroid and hashimotos she stays in bed 24/7 she says she doesnt want to live like this ,shes 23 years old she doesnt have her driver license she never gets out of the house. She is a beautiful girl and the diseases have not made her gain weight lose her hair,it is a miracle because she only goes to the doctor when she has to ,she goes to a reg medical doctor who never checks her levels and puts her on naturthroid and once every couple of years she goes to the only endocrinologist who gives her synthroid. Its the saddest thing youve ever seen she has no energy to do anything ,she is literally dieing. Can you help her? We are in Alabama, Im not sure where you are but I think you might could save her life.
Hi Brandy,
You may try searching for a functional medicine trained doctor near you at http://www.functionalmedicine.org
warmly
Dr Jill
Dr Jill I have a low thyroid been on lexothyroine for 12 years but still feel tired all the time no energy
Hi Jane
There are other causes of fatigue.. check adrenal function, other hormones and infections, toxic load. You may also need a different dose or type of thyroid hormone.
warmly
DR Jill
Dr. Jill. I had a total thyroidectomy two years ago. My levels fluctuate horribly. I have dry skin on one finger to the point of bleeding and peeling, by hair is really dry and breaking off, have IBS, had a total hysterectomy, and my anxiety on some days is so bad that I either come home or don’t go to work at all. One minute I feel good and the next I feel like I’m loosing my mind. Is this all from my levels being off. Any suggestions as to what is going on? How do I control my levels so my anxiety and panic goes away
Hi Patty,
This might be your thyroid…. please have your doctor check TSH, free T4, free T3 and TPO.
Warmly
Dr Jill
Hello,
I have Hashimoto’s. I have very low thyroglobulin antibodies, around 2 or 3. But my TPO antibodies are always very high. They fluctuate between the 900’s and the 1,000’s. They were checked recently and were 940. How can I get them down? How do I reverse the Hashimoto’s?
Hi Taylor,
You need to find root trigger to autoimmune disease – gluten, other foods, toxins, mold, chemicals, viruses or other stealth infections.
Treating this will help reverse the thyroid antibodies
warmly
Dr Jill
I have recently gotten my thyroid ‘under control’ and am within the normal ranges. Three months ago, my TSH was 291 and my T4 was >0.25. While my chemistry is correct, I don’t feel ‘right.’ My brain feels like it’s on fire or like someone poured icy-hot in my skull. I’m tired when I’ve slept. I have bouts of insomnia, I don’t want to eat much, and I’m not losing weight at all. My ability to draw has suffered and even my handwriting has changed significantly. If this is normal, why do I feel like I’m losing the parts that made me who I am?
Hi Leslie,
Work with your doctor to find the right combo of medication… T4 and T3 both
warmly
Dr Jill
I have Hypothyroidism and RA and high cholesterol. Unfortunately, the symptoms for all these conditions and drug side effects are just about the same, so diagnosed blood tests are vital for treatment.
Hi I have iga nephropathy which is stable at 70GFR. I have been itching all over for weeks, not sleeping well, forgetting stuff, tummy pain and constipation. So instead of bothering my GP i sent my blood off for a thyroid check, it has come back with a TSH level of 5.8 but T4,T3 normal. The doctors comments have said I have subclinical hypothyroidism, now I am wondering if I should I tell my doctor about this.. I feel like a total hypchondriac going to them with non-specific symptoms!
Hi Mary
Ideal ranges of TSH are < 3.0 so you should absolutely discuss options with your doctor if you have symptoms. warmly Dr. Jill
Thank you Dr Jill, i’m still having the same issues so will make an appointment now as it takes weeks to see a GP here in the UK!
In reading a document from the Canadian Society of Endo’s I found this, no wonder the endo cant correctly find problems they only look at the range of the TSH, just to save a couple dollars,
From: Canadian Society of Endocrinology and Metabolism,
Choosing Wisely Canada recommendation
“While measures of free T4 (fT4) and free T3 (fT3) have replaced previous measurements of total T4 and total T3 levels, they are only indicated in certain clinical instances. At Women’s College Hospital (WCH) in Toronto, 65% of fT4 and 59% of fT3 measurements were ordered in the setting of a normal TSH. This high proportion of “unnecessary” free thyroid hormone tests inspired the creation of a resource stewardship intervention aimed at reducing fT4/fT3 testing by 50% to promote high-value care