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Can A Thyroid Blood Test Be Wrong

Not Appreciating The Effects That Endocrine Disrupting Chemicals Have On Thyroid Function

Can Thyroid Tests Be Wrong ? [ 2021 ]

Endocrine disrupting chemicals have been shown to reduce T4 to T3 conversion, lower T3 levels in the serum all while NOT affecting the TSH .

Nowadays, detox really needs to be part of your treatment regimen.

At the very least you should actively be avoiding these chemicals that may potentially cause thyroid problems.

I would go a step further and recommend that you not only actively avoid these chemicals, but that you also try to eliminate them from your body!

You can do this by following some very simple steps:

  • Drinking from filtered water only
  • Avoiding plastics of any kind – especially avoid microwaving your food in plastics!
  • Eat organic, hormone free foods
  • Drink out of glass containers, and store your food in glass containers
  • You can find more tips on how to eliminate and detox here.

What Is The Role Of The Thyroid Gland

The thyroid is located at the front of the neck and consists of two lobes, one on each side of the windpipe and adjoined by a small strip of thyroid tissue known as the isthmus. The three hormones produced by the thyroid are:

  • T3
  • T4
  • Calcitonin

T3 and T4 are the active forms of the thyroid hormone, thyroxine, and are involved in the regulation of:

  • The bodys metabolic rate
  • Heart function
  • Bone maintenance

What Do Thyroid Antibodies Tell You

Three antibodies related to autoimmune thyroid diseases can tell what type of autoimmune disease a person has, and how severe or advanced it might be.

  • Anti-thyroglobulin High levels of TgAb are present in 8 in 10 patients with Hashimotos and in 4 in 10 of people being diagnosed with Graves disease.
  • Anti-thyroperoxidase High levels of TPOAb are found in 9 in 10 patients with Hashimotos and 8 in 10 of patients with Graves disease.
  • Anti-TSH receptor High levels of TRAb are found in 9 in 10 patients with Graves disease and in less than 2 in 10 patients with Hashimotos.

Its important to note that high levels of either TgAb or TPOAb can be found in 1 in 10 of people without an autoimmune thyroid disease, as well as in 2 in 10 of people that are considered healthy.

Theres also a small percentage of people with autoimmune diseases who have no antibodies detected.

TPOAb testing in early pregnancy can predict if a person is at risk of developing postpartum thyroiditis. Postpartum thyroiditis occurs in about 1 in 10 people after giving birth. About 5 in 10 of pregnant people with high TPOAb will develop postpartum thyroiditis .

TgAb or TPOAb are found in 1 in 10 healthy people, more likely females and elderly people .

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What Are Thyroid Hormones

The thyroid gland produces hormones that are essential for normal body metabolism. Blood testing is now commonly available to determine the adequacy of the levels of thyroid hormones. These blood tests can define whether the thyroid gland’s hormone production is normal, overactive, or underactive.

The thyroid gland is located in the lower part of the neck, below the Adam’s apple.The gland wraps around the windpipe and has a shape that is similar to a butterfly – formed by two wings and attached by a middle part .

The thyroid gland uses iodine to produce thyroid hormones.

  • The two most important thyroid hormones are thyroxine and triiodothyronine , which account for 99.9% and 0.1% of thyroid hormones present in the blood respectively.
  • However, the hormone with the most biological activity is T3.
  • Once released from the thyroid gland into the blood, a large amount of T4 is converted into T3 – the active hormone that affects the metabolism of cells.

Are There Any Specific Diagnostic Tests For Hyperthyroidism

Why Your Thyroid Test May Be Wrong!

The majority of cases of hyperthyroidism can be diagnosed with a single blood test that measures the total thyroxine concentration. Because hyperthyroidism in cats is due to the excess production of thyroid hormones , the blood T4 concentration is usually noticeably elevated in cats with the disease.

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What Does The Thyroid Do

Your thyroid has an important job to do within your body releasing and controlling thyroid hormones that control metabolism. Metabolism is a process where the food you take into your body is transformed into energy. This energy is used throughout your entire body to keep many of your bodys systems working correctly. Think of your metabolism as a generator. It takes in raw energy and uses it to power something bigger.

The thyroid controls your metabolism with a few specific hormones T4 and T3 . These two hormones are created by the thyroid and they tell the bodys cells how much energy to use. When your thyroid works properly, it will maintain the right amount of hormones to keep your metabolism working at the right rate. As the hormones are used, the thyroid creates replacements.

This is all supervised by something called the pituitary gland. Located in the center of the skull, below your brain, the pituitary gland monitors and controls the amount of thyroid hormones in your bloodstream. When the pituitary gland senses a lack of thyroid hormones or a high level of hormones in your body, it will adjust the amounts with its own hormone. This hormone is called thyroid stimulating hormone . The TSH will be sent to the thyroid and it will tell the thyroid what needs to be done to get the body back to normal.

What Are Normal Thyroid Hormone Levels

The thyroid itself is regulated by another gland that is located in the brain, called the pituitary. In turn, the pituitary is regulated in part by the thyroid and by another gland called the hypothalamus.

The hypothalamus releases a hormone called thyrotropin releasing hormone , which sends a signal to the pituitary to release thyroid stimulating hormone . In turn, TSH sends a signal to the thyroid to release thyroid hormones. If a disruption occurs at any of these levels, a defect in thyroid hormone production may result in a deficiency of thyroid hormone .

Hypothalamus – TRH

Thyroid – T4 and T3

The rate of thyroid hormone production is controlled by the pituitary gland. If there is an insufficient amount of thyroid hormone circulating in the body to allow for normal functioning, the release of TSH is increased by the pituitary gland in an attempt to stimulate more thyroid hormone production. In contrast, when there is an excessive amount of circulating thyroid hormone, TSH levels fall as the pituitary attempts to decrease the production of thyroid hormone.

  • In persons with hypothyroidism , there is a continuously decreased level of circulating thyroid hormones.
  • In persons with hyperthyroidism , there is a continuously elevated level of circulating thyroid hormones.

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Inquire About A T3 Drug

There are many doctors who consider the addition of a T3 hormone, in the form of Cytomel , wholly unnecessary and problematic. They will point to the fact that it is prone to rapid uptake in the intestines and may quickly turn a hypothyroid problem into a hyperthyroid problem. T3 hormones can also interfere with T4 blood test results and complicate the monitoring of your disease. All of these things are true, but to a degree.

If you are able to maintain control of your TSH and T4 but are feeling unwell, the addition of Cytomel may improve your symptoms, according to research from Spain and the National Institute of Diabetes and Digestive and Kidney Diseases.

The same research suggests that the combination of Cytomel and levothyroxine may improve symptoms without any additional side effects compared to levothyroxine alone.

How Do I Know If My Thyroid Dose Is Correct

Why TSH is the wrong test for Thyroid Function.

Monitoring thyroid levels on medication Correct dosing of thyroid hormone is usually assessed using the same tests for diagnosis of thyroid disease, including TSH and FT4. Thyroid tests are typically checked every 4-6 weeks initially and then every 6 to 12 months once stable. In special circumstances, such as pregnancy, a history of thyroid cancer, central hypothyroidism, amiodarone therapy, or use of combination T4 and T3 thyroid hormone replacement, your endocrinologist may check different thyroid tests. Additionally, your endocrinologist will evaluate for symptoms of hyperthyroidism and hypothyroidism and peform a physicial exam.

Women who are pregnant and women who may become pregnant should only be treated with levothyroxine . Only T4 efficiently crosses the placenta to provide thyroid hormone to the developing fetus. Thyroid hormone is critical in early pregnancy for brain development. Normal ranges for thyroid tests in pregnancy are different and change by trimester. Women with thyroid disease in pregnancy or who are considering pregnancy should be under the care of an endocrinologist to guide therapy.

Got Questions About Normal Thyroid Hormone Levels?

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What Is A Thyroid Function Test

A thyroid function test is a blood test to check the levels of the hormones made by your thyroid gland. The test also checks the level of a hormone made by the pituitary gland in your brain, which acts on your thyroid gland.

The two hormones, thyroxine and thyroid-stimulating hormone , work together and are usually in balance. In a healthy person the brain produces just the right amount of TSH to keep the thyroid gland ticking over. The thyroid gland then produces just the right amount of thyroxine.

This is called a feedback loop: if the thyroid gland makes too much thyroxine it will feed back to the brain to make less TSH. This diagram shows the feedback loop between the thyroid gland in your neck and the pituitary gland in the brain:

See the separate leaflet called Thyroid Problems for more details.

Can I Live A Normal Life With A Thyroid Disease

A thyroid disease is often a life-long medical condition that you will need to manage constantly. This often involves a daily medication. Your healthcare provider will monitor your treatments and make adjustments over time. However, you can usually live a normal life with a thyroid disease. It may take some time to find the right treatment option for you and control your hormone levels, but then people with these types of conditions can usually live life without many restrictions.

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What Is Hypothyroidism

At the front of your neck lies the thyroid, a butterfly-shaped gland that makes the hormone T4. When released into the bloodstream, T4 converts to T3, the most active form of thyroid hormone. Having sufficient levels of these hormones is important because the thyroid regulates body temperature, metabolism, blood pressure, and heart rate.

Hypothyroidism occurs when the thyroid is underactive . It affects as many as five in 100 people. Symptoms of hypothyroidism include fatigue, cold intolerance, constipation, dry skin, hair loss, muscle weakness, weight gain, and fertility problems.

In my primary care practice, Im finding that more and more of my patients are reporting feeling tired and concerned about whether they have hypothyroidism. Some patients request many different thyroid blood tests to diagnose and treat hypothyroidism. But are these tests really necessary?

Why Is Tsh Important

Thyroid Blood Work

Thyroid hormone production is based on a feedback system, where all hormones and related endocrine organs are important. To get a complete picture of how the thyroid functions, you need to understand what the pituitary is doing. The only way to assess pituitary functioning in this whole feedback loop is to assess thyroid-stimulating hormone .

If TSH is high, it indicates that the thyroid is underactive and may suggest a patient has hypothyroidism. On the contrary, if TSH is low, it may show that the thyroid is overactive and the patient has hyperthyroidism. However, these diagnoses cannot be made solely based on TSH levels.

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What More Should I Know About Thyroid Blood Tests

Ranges noted here are approximate your providers may differ slightly. Its important that you remember abnormal readings do not necessarily mean a thyroid disorder is present, as each test can be affected by a variety of factors.

No preparation is required for these tests. They can be taken any time of day without fasting.

Last reviewed by a Cleveland Clinic medical professional on 12/27/2019.

References

How Can Truly Hypothyroid Patients Be Accurately Diagnosed Within The Enlarged Subclinical Category

My main concern with the new guidelines is for the health of patients who are truly hypothyroid despite TSH and T4 levels that place them within the now broader subclinical hypothyroidism category.

I believe âfalse-negativesâ will genuinely suffer without appropriate therapy if they are over 30 and not pregnant. A person is a false negative when they are denied the diagnosis and therapy for overt hypothyroidism because they are miscategorized as subclinical.

The 21-item review by Feller et al, 2018 said quite explicitly in their âLimitationsâ section that because only 2 of the 21 studies focused on people with TSH higher than 10, the findings of their review âmay not be generalizable to people with subclinical hypothyroidism and a level higher than 10 mIU/L.â Therefore, why didn’t the guidelines keep the TSH subclinical / clinical boundary at 10 mIU/L?

If the TSH-T4 paradigm contributed to overtreatment and ineffective therapy, and if this paradigm resulted in many false positives, then how is it helpful to expand the gray area created by this paradigm, use it to make the subclinical category even wider, and then forbid therapy within that category? This creates a larger gray area for false negatives.

I propose a better way forward: Acknowledge the flaws of the TSH-T4 diagnosis paradigm, and then take steps to improve thyroid diagnosis. Surely medicine wishes to prevent harm. Identify the genuinely hypothyroid patients in this category.

24 May 2019

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Should I Exercise If I Have A Thyroid Disease

Regular exercise is an important part of a healthy lifestyle. You do not need to change your exercise routine if you have a thyroid disease. Exercise does not drain your bodys thyroid hormones and it shouldnt hurt you to exercise. It is important to talk to your healthcare provider before you start a new exercise routine to make sure that its a good fit for you.

A Note From Paloma Health

Blood Test Results/ Is Something Wrong With My Thyroid??

If your lab results come back normal, but you still experience symptoms that resemble hypothyroidism, take steps to find a trustworthy primary care physician. You deserve to work with a provider who takes a comprehensive approach to understand the root cause of your symptoms and optimize your treatment!

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Tsh Blood Test: Useful Or Useless

Thyroid conditions can be relatively straightforward to diagnose with the right tools. Indeed, by catching problems early on, people can have an action plan for keeping their thyroid healthy throughout their life. One of the best ways to assess thyroid function is with a thyroid blood test. By looking closely at various thyroid hormone levels in your body, a doctor can determine if your thyroid is functioning appropriately or not. Letâs talk about one of the most essential thyroid blood testsâTSH, and what it tells us about how to manage a thyroid condition like hypothyroidism.

So Is Tsh Useless Or Useful

Testing TSH is necessary to provide a complete picture of how the thyroid gland is functioning. However, a TSH test should be used with other thyroid tests to give a comprehensive view of your thyroid function. For comprehensive thyroid testing, order an at-home thyroid test kit to see how your thyroid is performing.

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What Do My Thyroid Test Results Mean

The two most common types of thyroid function tests are the T4 and TSH test. Typically, these two tests are ordered together.

The T4 testmore commonly known as the thyroxine testis used to determine if your thyroid is overactive. If this is the case, you will be diagnosed with hyperthyroidism.

Symptoms of hyperthyroidism include unplanned weight loss, tremors, diarrhea and anxiety.

The TSH test will reveal how much thyroid-stimulating hormone is in your blood. Normal levels range from 0.4 to 4.0 milli-international units of hormone per liter of blood.

If youve been diagnosed with hyperthyroidism and your TSH levels are above 2.0 mIU/L, you are at a heightened risk of developing hypothyroidism, which can result in weight gain, fatigue, depression and weak hair and nails.

If your doctor believes you have hyperthyroidism, he or she may order a T3 test to check for levels of the hormone triiodothyronine.

This hormone level should be within 100-200 nanograms of hormone per deciliter of blood. If your levels are abnormally high, it is possible that you are suffering from an autoimmune disorder called Graves disease.

The final thyroid function test your doctor may order is the T3 resin uptake test. Also known as a T3RU, this blood test will measure the binding capacity of a hormone called thyroxin-binding globulin.

Your doctors office should reach out to you within a matter of days to walk you through the results of your thyroid test.

Other Markers Necessary To Evaluate Thyroid Function

Can Thyroid Blood Test Be Wrong

Testing TSH alone is not sufficient enough to deliver the complete picture of how your thyroid is working. And sometimes, it is not useful, such as in people who have a pituitary disease or a history of pituitary radiation or surgery.

Most thyroid specialists order additional tests like free T4 and free T3. These are hormones produced by the thyroid and converted into a useable form once released into the bloodstream.

Additionally, some providers who are exceptionally proficient in thyroid care will order TPO antibodies. Antibodies are proteins in the body that serve to protect against infections and other invaders. Sometimes, antibodies can mistakenly attack your own tissues.

TPO is an enzyme in the thyroid gland that produces thyroid hormones. Part of the role of TPO is to covert iodide ions from food to a usable form for the production of T4 and T3. Suppose you do not have enough thyroid hormones in your bloodstream. In that case, an increase in TSH will also signal an additional production of TPO.

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