So You've Been Told That Your Thyroid is "Normal"

Well,.....you might want to ask some more questions.  In fact, even if you have been diagnosed with hypothyroidism, you will want to ask more questions.  There's a lot to this topic but I will try to encapsulate it the best way that I can so that you can direct your care better with your physician.

The thyroid gland secretes approximately one teaspoon of thyroid over an entire year, but it's becoming more and more obvious to me after my reading and research that that teaspoon is an absolute powerhouse in terms of metabolic control and disease prevention.   So let's highlight some things to help you understand better.  Today I will cover hypothyroidism.  NOT enough thyroid is basically what that means.

Signs and Symptoms of Hypothyroidism.  (pay attention here if you have been told things are normal yet struggle with these problems, okay?)

Brittle nails
Cold Hands and Feet
Cold intolerance
Constipation
Depression
Difficulty swallowing
Elevated cholesterol
Hypertension
Eyelid swelling or swelling under the eyes (periorbital edema)
Fatigue
Hair loss
Hoarseness in your voice
Low blood pressure
Inability to concentrate
Infertility
Menstrual irregularities
Muscle cramps/weakness
Nervousness
Slow heartbeat
Weight gain
Thinning of the eyebrows especially on the outer third portion (the "sign of Hertoghe") 

Diagnosing Hypothyroidism


Conventional:  The TSH value taken from a blood draw has been the gold standard for over 30 years.  The normal range from most laboratories is 0.5-4.5mIU/L. When TSH is above this range >4.5, a diagnosis of hypothyroidism is given.  I find it interesting that several decades ago the upper limit was 10.  So, that means that people were walking around with thyroid disease (according to today's ranges) and suffered unnecessarily.  Thankfully the range today is lower, but is it really low enough?  According to the thyroid guru Dr. David Brownstein, NO!!  It's not!!!  He uses a top number of 2 mIU/L as his laboratory guide in his patients.  That's 2 (t.w.o) and not 10 (t.e.n.)  Wow!  Huge difference from back in the day.  So, if you've had a TSH drawn in the past, you might want to revisit your records and see what the number was.

Listen to this from Dr. Brownsteins book, "Overcoming Thyroid Disorders" (second edition), a national best seller.

 "There are many physicians and organizations who believe the "normal" upper limit of the TSH range should be lowered from 4.5 to 3.  This may result in the doubling of the numbers of individuals diagnosed with hypothyroidism by blood tests from approx 13 million to 26 million."  Imagine what the numbers would be if we were still following 10 as the upper limit.  Yikes!!!

Holistic: Thyroid blood tests including TSH, T3 (active form), T4 (inactive form), Reverse T3, medical history of symptoms (remember those listed above), basal body temperature (should be between 97.8-98.2 degrees), and physical exam.

Those additional labs are important because if someone is low on T3 for instance, they will feel worn out and fatigued, depressed, and will appear to age rapidly.   Most physicians will make the diagnosis and put patients on Synthroid (T4).  But what if you are also low on T3?  Levothyroxine alone is going to do nothing for that and you will not feel much better.  ALL HAVE TO BE CHECKED.  Many thyroid experts use a combination of T3/T4 (Armour Thyroid) in their patients because they feel so much better.  There also is a diuretic component of Armour Thyroid which can really help alleviate swelling that is commonly found in hypothyroidism. I actually make special strengths for patients in our lab which are free of fillers, preservatives, etc.  My patients on these products do very well!!!

A study from the New England Journal of Medicine found that adding a small amount of T3 to patients already on Synthroid or levothyroxine (T4 only) significantly improved mood and brain function.

Factors that Cause an Inability to Convert T4 to T3 ( and BTW, some people are just poor converters)
1)Nutrient Deficiencies: chromium, copper, iodine, iron, selenium, zinc, Vitamin A, Vit B's
2)Meds: Beta blockers, Birth control pills, Estrogens (synthetics), Lithium, Dilantin, Steroids, Theophylline
3)Other factors: Aging, alcohol use, Lipoic Acid, Diabetes, Fluoride, Lead, Mercury, Obesity, Pesticides, Radiation, Stress, Surgery and Chronic Illness.

If you are on any of these medications or have any of these conditions, your thyroid may have gone ca-put a long time ago.  It has left you struggling with the symptom list that I highlighted earlier.

Hormone replacement therapy often includes birth control pills to prevent pregnancy or synthetic menopause agents to help with the symptoms of menopause.  Anything other than bio-identical hormones can result in an increase of thyroxine binding globulin (TBG) which leads to a decrease in the amount of thyroid hormone that is available for the body to use.  The thyroid experts will only use bio-identical hormones which are customized to each an every individual patients needs.  That's what I do too.  According to Dr. Brownstein, patients thyroid function improves when they eliminate the synthetics and use bio-identicals.

Here's another one for you.  The relationship between infertility and hypothyroidism has been known for over 50 years.  Undiagnosed fertility problems can have thyroid disease at the core.  Get checked if you are trying to conceive a baby!!!  Physician colleagues at a recent conference that I attended shared story after story regarding patients who simply needed a comprehensive thyroid evaluation which later resulted in pregnancy.

In my experience of doing hormone replacement therapy for women, it's not uncommon for me to hear that a woman had a hysterectomy and took no supplementation of hormones.  Years later, wala, they end up with hypothyroidism.  They come to my office to see me and on their medication list I will find Synthroid or levothyroxine.  That's because when one gland system (ovaries in this case) are depleted of key hormones, then other glands try to compensate for the loss.  This ends up causing problems for the "overachieving" gland later on down the health road.  It's just the way the body works.  Getting hormones evaluated and into proper balance will help your body's system communicate better instead of short-circuiting.  Sooner....rather than later.... is the key here.


There's so much information surrounding good thyroid health.  I will cover more of this in the days and weeks to come but for now this is a lot to digest.  I certainly hope this helps you to realize that it's not all in your head when you are suspicious that something is out of whack internally.  I believe you!!!  Get this little POWERHOUSE gland checked out and let me know if I can help in my realm of expertise.

Remember: TSH of 2, T4, T3, Reverse T3, physical exam, medical history, and basal body temperature.  That's the place to start.  :)

To your good health,
Dr. Sonja