It could still be your thyroid..
It is one of the most common things that women tell me at their first appointment -“ I thought that it might be my thyroid because I have all of the signs but I had it tested and it was normal”.
Unfortunately ‘normal’ thyroid function, or a thyroid stimulating hormone (TSH) result which falls within the clinical reference range of 0.5-5 does not give a true indication of how well your thyroid is functioning. Normal also doesn’t mean optimal and Naturopaths prefer to see TSH between between 0.5-2. Many endocrinologists are now also preferring to see lower TSH and there is a move to lower the clinical reference range which is a good thing. However, the other issue is that TSH alone only gives us a very small part of the picture. For accurate pathology investigations into thyroid health and function, we also need to see the thyroid hormones T4 and T3, thyroid antibodies and also reverse T3.
Some GPs will test T4 and T3 if there is an abnormal TSH or where there is already a history of a diagnosed thyroid condition.
Thyroid antibodies are also rarely tested unless TSH is abnormal and even then not always.
Reverse T3 is very rarely checked unless you see an integrative GP. Reverse T3 is a mirror copy of T3 and if it is high, it doesn’t matter how much T3 you make, it won’t be able to do it’s job because reverse T3 locks onto the T3 receptor on the cell.
So, no wonder many women are struggling along with undiagnosed subclinical thyroid conditions and feeling pretty terrible!
Thyroid conditions become more common in women through the peri—menopausal and menopausal years with an estimated 20 percent of women over 60 having undiagnosed subclinical hypothyroidism! They can develop at any time, but also may come about following pregnancy.
Some women are more prone to developing hyperactive thyroid conditions, however out of the women who I work with both locally in person and from further afield in Australia and beyond via phone/skype, 9 out of 10 women with thyroid issues have an underactive thyroid (although it is not uncommon for women with Hashimoto’s to experience swings between underactive and overactive thyroid).
If you already have a diagnosed thyroid condition, whether overactive or underactive thyroid condition, it is a good idea to find out whether you have an autoimmune component to your thyroid condition. Unfortunately many women who have a diagnosed thyroid condition don’t actually know whether or not it has autoimmune involvement.
So to truly rule out a problem with your thyroid being behind your symptoms, we need to look beyond a TSH test and see the full thyroid picture. From there, we can also begin to support the health and function of your thyroid naturally and this is still important alongside any prescribed thyroid medication which provides synthetic thyroid hormone, but doesn’t support the health or actual function of your thyroid.
We also need to look at the potential underlying reasons that your thyroid has developed a problem and this can vary but may involve looking at gut function and diet, nutritional deficiencies, stress, heavy metals, hormone balance and food sensitivities.
So what are the common signs and symptoms of an underactive thyroid? Common signs include: fatigue, low mood, brain fog, poor memory/concentration, weight gain, difficulty losing weight, sluggishness, constipation, headaches, dry skin, hair loss, sensitivity to the cold, irregular or heavy periods, infertility, slow heart rate, creaky joints, muscle aches and heart palpitations.
Where thyroid involvement is suspected, I refer women for functional pathology testing which covers the full thyroid profile. Unfortunately Medicare doesn’t cover pathology tests if the referral is from a naturopath, but the cost of the full thyroid profile testing, whilst it can initially feel like a big outlay (full thyroid profile testing is approx. $160), it is a small price to pay in the scheme of things if it means finding the answer to why you’re feeling so terrible!
Be aware also that your thyroid function can fluctuate, so a test from 3 or 6 months ago isn’t necessarily going to be an accurate representation of what is going on now.
Another helpful way to get an indication of whether you may be experiencing low thyroid function is to measure your temperature at the same time every morning over a month. An average temperature below 36.5 is often an indication that the thyroid isn’t functioning optimally. Your core temperature does vary at different times of the month which is why doing it for just a week isn’t always accurate.
So if you still feel that there is something not quite right with your thyroid, but your TSH test came back in the 'normal' range, it could be worth having a more comprehensive test before it can be completely eliminated as an issue.
