Every day, your thyroid is speaking to you, but if you don’t speak the language, you’ll be hard-pressed to understand what’s going on with it, much less how to support it. Why does a healthy thyroid matter? Well, for starters, the thyroid, the small gland located at the base of your throat, controls the way your body uses energy, helping to regulate your metabolism and governing your responsiveness to other hormones. In other words, it’s the great balancer, working 24/7 to help keep you on a hormonal even keel.

When your thyroid isn’t functioning optimally, you’ll likely feel sluggish, even exhausted much of the time, have cold hands and feet, dry skin, thinning hair, brittle nails, brain fog, constipation, and have a hard time losing that extra weight you put on in the last year or two. Unfortunately, thyroid dysfunction is extremely common among people in their forties, fifties, and beyond, especially in women. But thyroid dysfunction is missed by conventional doctors shockingly often.

So, what’s the best route to keep your thyroid humming, and get the help you need if it’s not? How to figure out if your thyroid needs a light tune-up or a major overhaul? Here’s where to start, so you can get some insight into the possibility that an underactive thyroid (aka hypothyroidism) may be getting in the way of your feeling great:

The thyroid is one busy – and very important – gland.

If you’re not too clear on what the thyroid does, think of it as the Great Balancer. The thyroid gland regulates temperature, metabolism, digestion, tissue repair, hormone levels, how quickly or slowly energy is used – and much more – affecting every cell in your body. Working hand-in-hand with the thyroid are the adrenal glands which manage how your body reacts to physical, mental and emotional stress.

When the adrenals head into overdrive, they pump out more cortisol and adrenaline – stress and alertness hormones. The result is that unwelcome feeling of being way too wound up. That excess cortisol circulating through your system forces the thyroid gland to work harder to calm and rebalance your body, further stressing your adrenals and triggering the release of even more cortisol. That chronic stress eventually wears down the thyroid and it starts to perform sluggishly, in turn, slowing muscular, digestive and metabolic function. Weight creeps up, losing it gets tougher, digestive problems escalate. It’s a vicious circle.

When things go wrong, check under the hood.

Even though advancing years may be a factor, thyroid problems are not the inevitable result of aging or exclusively caused by an auto-immune disease called Hashimoto’s. Rather, they’re often the end-result of years of an out-of-balance system. So, do you have undiagnosed thyroid dysfunction? Here are some questions, which if you answer ‘yes’ to three or more, are an indication that it’s time to consider enlisting the help of good functional-medicine practitioner, particularly if your doc brushes off your concerns:

  • Are you frequently tired?
  • Do you have cold hands and feet or get cold easily?
  • Is your hair thinning or falling out?
  • Are your nails brittle? Is your hair brittle, coarse or very dry?
  • Are you constipated?
  • Have you been gaining weight in spite of eating well?
  • Are you struggling with depression?
  • Do you have brain fog?
  • Do you frequently experience menstrual irregularities?
  • Do you suffer from aches and pains? Muscle aches or weakness?

Other common signs of a poorly-functioning thyroid? Low sex drive; dry, scaly skin; fluid retention or puffiness; hands and feet that are cold all the time; decreased sweating; poor memory, concentration and focus. If these symptoms are undermining your quality of life, then it’s time to dig deeper. 

Three reasons why your doc may be missing the diagnostic boat.

OK, so, let’s say your symptoms are bothering you, you get your thyroid checked, and your doc says basically, there’s nothing to see here, your levels are within the normal range. But you’ve still got a bunch of symptoms that aren’t reflected in the numbers. What gives? There are several common reasons why conventional doctors might tell you that your thyroid is normal when you could really use some more support:

Reason #1: For starters, Western medicine tends to view illness in black and white terms, rather than recognizing a spectrum. You might have thyroid levels that read as normal on conventional tests—but which are not normal for you, or, more accurately, which are not optimal for you.  Consequently, your conventional doctor might tell you that your symptoms are the natural result of getting older or perhaps are caused by some underlying depression, rather than recognizing that you need thyroid support.

So, before they whip out the Prozac prescription, push them to do a deeper thyroid diagnostic dive.

Reason# 2: Your doc may be overlooking the possibility of thyroid resistance, in which your blood levels of thyroid hormone are normal, but the hormones are not getting into the cells or your cells are not correctly metabolizing the hormone.  As a result, your tests look fine, but your actual condition is not.

Reason #3: Another reason for misleading test results is that some conventional tests measure the presence of T4, the inactive form of thyroid hormone, but not of free T3, the active form. Your body needs to convert T4 to active T3 for the hormone to be active in the body. So, if you’re having problems converting T4 to T3, your T4 levels can be technically ‘normal’ even while you suffer with some or all the symptoms of an underperforming thyroid.

The best way to determine how effectively your body is converting T4 to T3 is by measuring it with a ‘Free T3’ test and ‘Reverse T3″ test— so ask your doc for these. (Note: depending on your coverage, there may be an additional charge involved, so check up front to minimize billing issues later.)

Guided by these specific results, some patients who are already on thyroid meds, but not yet not feeling relief, may find their symptoms disappear simply by tweaking their thyroid hormone prescription to include T3, or added adrenal support, which can often help the conversion of T4 into T3.

Collect intel for your doc with a simple DIY home test.

If you can’t see your doc right away or, wish to have a bit more info to back up your suspicions before your visit, try this simple do-it-yourself test.  To get a sense of your average temperature, simply take your temperature in the armpit first thing in the morning—before you start moving around —for about 10 minutes. Record the readings for 5-7 days in a row.

If your temperature averages less than 97.0, that could be an indication of hypothyroidism. For those with the classic symptoms of thyroid dysfunction and a temperature below 97.0, but with normal blood test results, it’s a likely indication of a simpler imbalance. With either result being helpful to present to your doc when it’s time to discuss diagnosis and treatment.

If your temperature averages less than 97.0 and you’ve got “normal” blood test results, likely you don’t have a failing thyroid gland (driven by an auto-immune disorder). Rather, you may be dealing with over-stressed adrenals or a T4-to-T3 conversion issues, imbalances that are generally easier to treat.

If you are a woman of childbearing age, take and record your temperature for 5 – 7 days in a row, but ideally starting on day 2 or 3 of your menstrual cycle to allow for hormonal fluctuations. Men, menopausal and post-menopausal women can take their temperature anytime, following the 5 -7 day, 10-minute, little movement protocol.

One person’s normal may not be your normal.

When your doc gets around to actually doing a lab test for thyroid dysfunction, he’ll typically offer up the standard test that measures thyroid-stimulating hormone (TSH). Here, a score of 5.0 is often considered the threshold for a diagnosis of an underactive thyroid. But those who work regularly with thyroid dysfunction patients often consider 2.0 to be the upper limit of normal TSH. That’s quite a standard deviation, particularly if you’re dealing with symptoms on the daily. A reading in the 2.0 – 5.0 range is, in my view, very often not acceptable, and I’d highly recommend addressing the thyroid dysfunction before it becomes more severe.

Bottom line: if you believe your thyroid needs attention, press your doc for a ‘compete thyroid panel,’ consisting of all these six tests, TSH, Free T4, Free T3, Reverse T3, Thyroglobulin Antibody and Thyroid Peroxidase Antibody. The last 2 antibody tests check for Hashimoto’s which is a common autoimmune thyroid disease.  

Upgrade your thyroid health with a few smart steps.

When the complete panel results are in, review them with your doctor and keep in mind when it comes to thyroid issues, there are degrees of dysfunction. Pay attention to “gray area” results and work with your doctor on a treatment plan. If supplemental thyroid hormone is required, ask for one of the natural, non-synthetic options, and start with the lowest dosage possible, slowly increasing it as needed in order to minimize side-effects or reactions from too much too soon. How else support your thyroid? Try the following tips:

  1. Eliminate gluten and sugar from your diet to help tame inflammation and decrease stress on the body.
  2. Exercise and move throughout your day to support overall health, taking it slowly at first, to avoid over-taxing your system which can stimulate excess cortisol production.
  3. Get serious about stress reduction techniques to help reduce strain on thyroid and adrenal glands.
  4. Avoid overdoing caffeine, which depletes your adrenal glands which, in turn, takes a toll on your thyroid.
  5. Eat a healthy, veggie-heavy diet to combat the role vitamin and mineral deficiencies can play in thyroid dysfunction. However avoid eating too many raw cruciferous vegetables, like broccoli, cabbage, cauliflower, kale and bok choi. These are “goitrogens” and can negatively affect thyroid function, although cooking them lessens that effect.
  6. To support thyroid health, be sure to get sufficient iodine, vitamin D, omega 3 fats, selenium, zinc, vitamin A and B.
  7. Easy upgrade: add just two Brazil nuts a day to your menu as they’re high in selenium, helpful for thyroid health.
  8. Eat organic foods whenever possible to help minimize exposure to pesticides, which act as hormone disruptors and interfere with thyroid hormone function.
  9. Minimize exposure to thyroid-disrupting fluoride and chlorine by filtering your drinking water.
  10. Minimize exposure to other environmental toxins, like Phthalates, PCB’s, BPA and mercury which can also affect thyroid function.

For more on what your Thyroid Test Results Really Mean, check out this recent post.

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