Thyroid, More Complicated than a TSH
Dr. Heather Boyd-Roberts

Your thyroid generates your energy, determines the rate of your metabolism, and stimulates the function of every cell in your body. It is your battery. Weight gain, constipation, climbing cholesterol, menstrual irregularity, infertility, PMS, depression, anxiety, fibromyalgia, fatigue, and memory loss are clues that your thyroid may not be working properly. Unfortunately, the standard tests performed to assess thyroid function are limited and often miss underlying low thyroid function.

Thyroid Hormone Testing

TSH (thyroid stimulating hormone) is the medical gold standard for testing thyroid function. When your TSH is high you are considered hypothyroid.
There are a few challenges with relying solely on TSH to identify hypothyroidism.

First, the normal range is much too large and some people with hypothyroid fall into this grand normal range. Only the most extreme cases are identified. People generally feel best when their TSH is 0.5-1.5.

Second, there are many extraneous hormonal influences that will lower your TSH and make your thyroid function appear normal when it is not. Some of these influences include: Excessive Stress or Elevated Cortisol, Infection, Pain or trauma, Caffeine, Fever, Adrenaline, Somatostatin, Dopamine or L-dopa, and Amphetamines.

Third, other aspects of thyroid hormone stimulation are not taken into consideration. Lets take these step by step. Your pituitary, a gland that lives in your skull, sends out a signal to your thyroid. This signal is called thyroid stimulating hormone, TSH, which tells your thyroid to work. If your thyroid is not doing its job the pituitary will release more TSH attempting to tell your thyroid to work. This will show up on your test results as a high TSH suggesting you are hypothyroid.

Your thyroid's job is to respond to the TSH and release T4. If you are on thyroid medication such as Levothyroxine, Levoxyl or Synthroid, your are taking T4. The T4 then goes to the liver and kidneys and is converted into the more active form of thyroid hormone called T3. T3 is about 50% more metabolically active that T4. Being metabolically more active means you will feel like you have more thyroid hormone in your body. Remember up above we said thyroid was your battery. With more T3 your battery will feel more powerful.

Problem one was your thyroid not responding to the pituitary's signal, the TSH. Problem two is your tissues not converting T4 to T3 properly. If you have a T4 that lies near the top of the normal T4 range on your blood work and a T3 that lies on the bottom of the normal range this could be you. If this is the case your cells will not have the proper stimulation and thus the energy they need to function optimally and hypothyroid symptoms will ensue, in spite of a normal TSH.

What can cause T4 to not convert into T3 properly? Two primary reasons. First, nutrient deficiencies such as zinc and sel enium can impair the conversion of T4 to T3. Second, the stress hormones, cortisol and adrenaline, inhibit the conversion of T4 to T3. So not only do nutrients need to be replaced, but testing for cortisol levels and support with proper adrenal support based on your test results needs to be addressed along with the thyroid.

Problem number three. Cortisol and Adrenalin also cause other problems. They increases the conversion of T4 into reverse T3, which is inhibitory, instead of into T3, which is energizing. Your body directs T4 to be converted into reverse T3 instead of T3 during times of stress or extreme low carb dieting. Reverse T3 blocks your body from using your most energy producing hormone, T3. This can be advantageous during extreme life threatening measures when energy needs to be conserved, but the problem is when the stress is gone conversion of T4 to reverse T3 instead to to T3 can get stuck. In order to break the pattern reverse T3 must be depleted by lowering your T4 and replacing some of your thyroid prescription with T3. T3 cannot be converted into reverse T3.

Problem number four. Auto-immune Hashimotos thyroiditis is a condition where you immune system is attacking your thyroid and slowly reducing its function. If you have had a hard time regulating your TSH you should ask your doctor to have your anti-TPO and anti-thyroglobulin tested. These are two antibodies that can slowly destroy your thyroid. Using iodine without proper selenium and allowing your TSH to remain higher can cause these antibodies to rise and cause further thyroid hormone damage. If you have elevated levels of these antibodies the antibodies can bind up to your cell receptors blocking your T3 from binding. If your T3 can't bind, it can't become your battery and hypothyroid symptoms will result.

Problem number five. An excess amount of estrogen or an elevated amount of estrogen in comparison to progesterone, a condition called estrogen dominance, will prevent your thyroid from releasing its hormone and instead it will build up in the gland itself. As a result your body will not get the thyroid stimulation it needs and hypothyroid symptoms can result. This is particularly important with Hashimotos thyroiditis and goiters. So if you are dealing with of these conditions it is imperative that you work on regulating your estrogen and progesterone levels.

Problem number six. Liver congestion or liver stress can lead to hypothyroid symptoms because of its crucial role in converting 2/3 of your T4 into T3. If your liver is bogged down from working hard eliminating metabolic waste from exposure to plastics, phthalates, aluminum in deodorant, pollution, pesticides, pharmaceutical medications, heavy metals commonly found in mercury amalgams and now a growing concern in the supplement industry, mycotoxins from old exposure or exposure to water damaged buildings, metabolic byproducts from overgrowth of fungus or bacteria in the intestinal tract, due to chronic infection or any other toxicity that the liver has to work hard to protect us from, the conversion of T4 to T3 will slow down. When the conversion of T4 to T3 slows down T4 will accumulate in your body which will give a signal to slow the production of T4 and push you deeper into a hypothyroid state.

As you can see testing for thyroid function is much more complex that simply performing a TSH. It takes expert skill in identifying and properly treating the type of hypothyroidism that you have. Make sure you find a practitioner who can take an in-depth look at all the parameters of the thyroid.

Symptoms of Low Thyroid

Weight gain, difficulty losing weight
Fatigue, feelings of sluggishness
Depressed mood (usually not as severe as major depression, but may be mistaken for primary depression)
Menstrual irregularities, difficulty becoming pregnant/infertility
Low body temperature (may also occur with low estradiol, low testosterone or heavy metal toxicty)
PMS, with premenstrual mood changes, premature menopause
Dry, scaly, itchy skin and scalp
Dry, brittle hair and nail
Yellowed skin on hands or yellowing calluses
Losing hair (alopecia)
Chronic constipation
Elevated cholesterol
Puffiness of face, lower legs and feet
Slowed heart rate, unusually low blood pressure
Diminished reflexes
Difficulty tolerating cold environments, climates (canít get warm)
Sleeping much more than normal, and not feeling rested
Tingling in wrists/hands, mimicking carpal tunnel syndrome
Clotting problems
Multiple joint aches (arthralgias)
Achy muscles (myalgias), leg cramps, muscle weakness
Diminished or lost sexual desire
Worsening allergies
Decreased memory & concentration is also a brain effect of low thyroid and may be misdiagnosed as dementia in an older person

I Have all the Symptoms of Low Thyroid, but my Tests are all Normal! Can I Get Help?

For decades doctors have been prescribing T4, the non-active form of thyroid. The assumption is the T4 is easily converted into T3, the form your cells are able to use. The most common prescription forms of T4 are Synthroid, Levothyroxine and Levoxyl. This therapy can cause a build up of T4 in your body, which will slow your thyroid function down further. If your body has challenges with the conversion of T4 to T3 the medication can actually make your hypothyroidsm worse.

There is a complex array of nutrients that could possibly be needed to correctly address hypothyroidsim including various minerals, liver drainage (toxin elimination at a cellular level), glandualars, and homeopathics to support your specific kind of hypothyroidism. In addition, regulating blood sugar and reducing stress are two crucial lifestyle habits that need to be addressed to fully restore proper thyroid function.

Your first step to wellness is making an appointment.

Dr. Boyd can identify exactly what tests need to be done and determine if there are associated conditions that will cause your thyroid to not function properly.

To get help now email us at or call directly to 360 573 CARE (2273).