Symptoms Of Low Thyroid That Require A Complete Thyroid Panel
July 6, 2018// by Dr Hagmeyer
Hey everybody Dr Hagmeyer here and todays video is on the 12 Signs Of An Under-Active Thyroid. Maybe you have been suspecting a thyroid problems for a while and you went to your doctor complaining of low thyroid symptoms- only for your doctor or the nurse to call you and tell you that your thyroid is completely fine.
Is it possible to have a thyroid problem with normal thyroid testing. This is tricky question and a question I am asked daily. So lets dive into these symptoms a little bit and then I will let you know what you want to do if you can related to more than three of these symptoms.
What Is Included In A Complete Thyroid Panel
ALP , Free is the preferred test alternative for T3 uptake and Free Thyroxine Index tests.Comprehensive Metabolic Panel 004598: Ferritin : 004580: Lipid Panel + VLDL + TC/HDL Ratio + LDL/HDL Ratio + CHD Risk : 070104: Reverse T3 : 716910: Selenium, liver function, is a panel of 14 blood tests which serves as an initial broad medical screening tool, Anti-TPO, thyroglobulin antibody and thyroid peroxidase antibody to provide a detailed evaluation of the thyroid, This blood test measures how much overall thyroid stimulating hormone is in your blood.
Should You Get A Full Thyroid Panel Performed
We strongly recommend consulting your doctor about a full thyroid panel, especially if you have noticed any of the previously mentioned symptoms fatigue, unexplained weight gain or loss, trouble sleeping, tremors, dry skin etc. A full thyroid panel is also strongly recommended to all of you who have a family history of thyroid problems, especially thyroid cancer, hyperthyroidism, and hypothyroidism. Women in or near menopause, pregnant women, and women after birth should also get a full thyroid panel performed because of the risk of thyroid problems that we mentioned before. Do not hesitate to consult your doctor if you are experiencing any of the previously mentioned symptoms or if you belong to any of the previously mentioned groups.
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Why Not Check Thyroid Hormones Directly
Why not check the thyroid hormones themselves, to see if the gland is not functioning properly?
The thyroid only makes small amounts of T3. Even in cases of severe hypothyroidism, T3 levels dont go down that much. T4 is produced in large quantities by the thyroid. However, TSH is a far superior screening test because small changes in T4 cause large TSH spikes. Usually when a person has hypothyroidism, TSH levels become very high way before T4 levels fall below normal. So, in our analogy, the thermostat is very sensitive to small variations in temperature.
Thats why a normal TSH almost always means the thyroid gland is healthy and producing enough thyroid hormones. Research finds that a simple TSH test is enough to identify hypothyroidism in 99.6% of the tests performed.
You may have heard of expanded or full thyroid panels, which often include tests for TSH, total T3, total T4, free T3, free T4, anti-TPO antibodies, thyroglobulin, and reverse T3. There is no evidence these extra tests help to diagnose and manage thyroid disease, although they definitely add to health care costs. Proponents of expanded thyroid analysis believe more data may support a personalized intervention plan. However, what happens in a lab test often fails to mirror the elaborate dance of hormones in the body. Additionally, findings are highly variable. What happens in your body today may change in a matter of days or weeks, even without significant interventions.
Drawing Blood For Thyroid Function Tests
Talk to your doctor about any medications youre taking, and tell your doctor if youre pregnant. Certain medications and being pregnant may influence your test results.
A blood draw, also known as venipuncture, is a procedure performed at a lab or a doctors office. When you arrive for the test, youll be asked to sit in a comfortable chair or lie down on a cot or gurney. If youre wearing long sleeves, youll be asked to roll up one sleeve or to remove your arm from the sleeve.
A technician or nurse will tie a band of rubber tightly around your upper arm to make the veins swell with blood. Once the technician has found an appropriate vein, theyll insert a needle under the skin and into the vein. You may feel a sharp prick when the needle punctures your skin. The technician will collect your blood in test tubes and send it to a laboratory for analysis.
When the technician has gathered the amount of blood needed for the tests, theyll withdraw the needle and place pressure on the puncture wound until the bleeding stops. The technician will then place a small bandage over the wound.
You should be able to return to your normal daily activities immediately.
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When To Seek Help
Many thyroid conditions present with a wide-range of vague symptoms. While feeling under the weather is a normal occurrence at some point, long periods of persistent symptoms may be an indication of something more serious.
If you are experiencing lethargy, bulging eyes, depression, hair thinning, tremors, or an enlarged thyroid gland, visiting an endocrinologist can help. Most people have a variety of symptoms and do not exhibit every discomfort.
Medical professionals can help diagnose thyroid complications. By administering a blood test, they can detect hormone irregularities in the body. This is a short test and results are usually ready within one to two weeks. Call us at .
What Are Thyroid Blood Tests And Why Are They Taken
Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. They are done by withdrawing blood from a vein in your arm. These blood tests help to diagnose thyroid diseases.
The thyroid is a butterfly-shaped gland located in the front part of your neck. Its job is to produce thyroid hormones, which travel through your bloodstream and regulate many aspects of your bodys metabolism, including temperature, weight, and energy.
Thyroid blood tests show if you have:
- Hyperthyroidism: Overactive thyroid producing more thyroid hormones than your body needs. Hyperthyroidism speeds up your metabolism, which can cause weight loss, rapid heartbeat, insomnia, puffiness around the eyes, anxiety and other symptoms. The most common cause of hyperthyroidism is Graves disease.
- Hypothyroidism: Underactive thyroid producing too few thyroid hormones. Hypothyroidism slows down your metabolism, which can cause weight gain, menstrual irregularity, dry and puffy skin, fatigue and other symptoms. The most common cause of hypothyroidism is Hashimotos disease.
Thyroid blood tests are used to diagnose thyroid disorders associated with hyper- or hypothyroidism. These include:
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How To Get Tested
A thyroid panel requires a blood sample. Laboratory testing involves using a needle to remove a small amount of blood from a vein in your arm. The procedure can happen in the doctors office, hospital, or another laboratory.
In most cases, a thyroid panel is ordered by a doctor. Sometimes the thyroid panel analysis is automatically done by the lab on the original blood sample if an initial evaluation finds abnormal levels of thyroid-stimulating hormone.
Most Common Conditions That Cause An Abnormality In The Levels Of Tsh T3 And T4
1- Hyperthyroidism is a term that is used to describe the over activity of the thyroid gland and the excessive production of the thyroid hormones due to which all the functions of the body increase their speed. The usual symptoms are increased heart rate, weight loss, diarrhea, anxiety, weakness, trouble sleeping, and tremors in the hands. What a full thyroid panel in a case of hyperthyroidism would show is low levels of TSH, and high or normal levels of T3 and T4 hormones.
2- Hypothyroidism Hypothyroidism is a term that is used to define the condition in which your thyroid is not able to produce the needed levels of hormones in order to let your body function properly. It is also known as under active thyroid disease, and surprisingly it is a very common condition. The usual symptoms of hypothyroidism include weight gain, constipation, fatigue, dry skin and menstrual irregularity. In a case of hypothyroidism, what the thyroid panel would show is high levels of TSH, and normal to low levels of T3 and T4 hormones
3- Pregnancy During pregnancy, you may experience hypo or hyperthyroidism caused by various causes including Hashimotos disease and Graves disease being the most common causes of hypo and hyperthyroidism. Both conditions are systematic, autoimmune diseases which cause the body to attack its own thyroid gland and cause abnormalities in its function to occur.
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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 .
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.
Why Is Thyroid Testing Important
The thyroid impacts many vital body functions, including breathing, heart rate, body weight, body temperature, and more. According to the American Thyroid Association, more than 12% of the U.S. population will develop a thyroid condition in their lifetime. Thyroid problems can be uncomfortable and affect various organ systems, but many can be managed with proper diagnosis and treatment. Thyroid testing can determine if your thyroid is overactive or underactive . This can be helpful for a doctor to determine the right treatment plan for you.
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What Thyroid Markers Are We Checking In A Complete Thyroid Panel
TSH The most common marker used to asses thyroid function and the most sensitive. This hormone is released by the pituitary when it gets the signal from the hypothalamus. TSH levels increase when T4 levels drop, and TSH decreases when T4 levels are elevated. Sometimes this is the only marker your doctor will order.
T4 This is the most prevalent form of thyroid hormone made by the thyroid gland. Levels of T4 in the blood act as the feedback loop for the brain and signal it to stop producing TSH. The vast majority of it is bound to carrier proteins. It is considered metabolically inactive, and must be converted to its active form to be used by cells to regulate metabolism. Typically the only other marker tested other than TSH.
T3 The active thyroid hormone. If it is not directly made in the thyroid gland, then conversion takes place in the liver, kidney, and GI tract. The majority of T3 is bound to carrier proteins. Once unbound, T3 acts directly on the cell nucleus to regulate the metabolism of that cell.
Free T4 This is the unbound version of T4. This marker can be influenced by thyroid hormone replacement, chronic illness, as well as disorders that affect the amount of carrier proteins.
Free T3 The unbound form of T3. This is the best marker to see what amount of active thyroid hormones are available for the cells. This can be effected by stress, thyroid disorders, and pregnancy.
What Does The Test Result Mean
If the feedback system involving the thyroid gland is not functioning properly due to one of a variety of disorders, then increased or decreased amounts of thyroid hormones may result.
- When TSH levels are increased, the thyroid will make and release inappropriate amounts of T4 and T3 and you may experience symptoms associated with hyperthyroidism.
- If there is decreased production of thyroid hormones, you may have symptoms of hypothyroidism.
The test results alone are not diagnostic but will prompt your healthcare practitioner to perform additional testing to investigate the cause of the excess or deficiency and thyroid disorder. As examples, the most common cause of hyperthyroidism is Graves disease and the most common cause of hypothyroidism is Hashimoto thyroiditis.
The following table summarizes some examples of typical test results and their potential meaning.
|Note: Laboratory results must always be correlated with the clinical findings of the patient.|
|Hypothyroidism resulting from a problem with the hypothalamus or pituitary signals that govern the thyroid gland|
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How Is Hypothyroidism Diagnosed
Most major medical associations recommended diagnosing hypothyroidism through a blood test using a simple two-step approach.
- First, we check the level of thyroid stimulating hormone , which the pituitary gland in the brain releases to stimulate thyroid hormone production.
- If TSH is high, we confirm low thyroid function with a test called free or unbound T4 .
It may help to think of the pituitary gland as a thermostat and the thyroid gland as a heater. The thermostat senses low temperatures outside of the body and turns on the internal heater. When body temperature reaches a set threshold, the thermostat signals the heater to stop working. In the body, it is the TSH produced by the pituitary gland that signals the thyroid to make more T4. When there is less free T4 in the blood, the pituitary senses the low levels and starts making more TSH.
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What Do The Results Tell Us
An enlarged thyroid also called a goiter can be a sign of an iodine deficiency that hasn’t yet affected the function of the thyroid. But it could also be a sign of an overactive thyroid or an underactive thyroid , where too many or too few hormones are made respectively.
Nodules that can be felt from the outside may also be a sign of a thyroid problem. But sometimes people have an enlarged thyroid gland or nodules without it affecting the function of their thyroid gland.
So this palpation examination can only tell us whether there might be a thyroid problem. Further tests and examinations are needed in order to be sure.
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Does Your Thyroid Panel Include These Markers If Not
The T3 and Reverse T3 markers are used to look at the T3/Reverse T3 ratio and the last two markers help in identifying an autoimmune disease called Hashimotos which incidentally accounts for the majority of hypothyroid cases in the US.
If you dont have these Thyroid biomarkers or your doctor wont run a Complete Thyroid Panel you can purchase a complete Panel and consult here
If you have a free T3 and Reverse T3 levels you can go to my website watch a video that explains how to calculate your ratio.
So there you have it folks- hope you found todays video helpful I hope it sheds some light on why your levels might seem normal range despite having symptoms.
I hope you understand why its so important to have more than a TSH and T4 test done.
If you are looking for more information in understanding your thyroid lab values I put together a free guide titled 5 patterns of thyroid disease that dont show up on standard blood testing If you want to see that I will put a link in the description- click on the link and you can download your free copy.
If you want to order a complete Thyroid Panel and consultation with me use the link here
Reason #: Lab Ranges Can Be Tricky
Like mentioned above, a normal TSH range is accepted by the medical community to be from 0.5 to 5.0. If you think about it, its a pretty wide range with a multiplier of 10! To demonstrate an example: Amy might feel good when her TSH is at 0.8 while Marianne might need to be at 1.8 to feel like herself. If Amys TSH was 1.8 she would start feeling hypo and possibly put on weight, experience fatigue and foggy brain. If Mariannes TSH was 0.8, she could start feeling hyper and experience heart palpitations, anxiety, problems feeling asleep, etc.
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How Often Should I Get Routine Blood Work
Your doctor will typically recommend that you get routine blood work at least once a year, around the same time as your yearly physical.
But this is the bare minimum. There are several major reasons you may want to get blood tests more often than that:
- Youre experiencing unusual, persistent symptoms. These could include anything from fatigue to abnormal weight gain to new pain.
- You want to optimize your health. Knowing levels of various blood components, such as HDL and LDL cholesterol, can allow you to tweak your diet or fitness plan to minimize unhealthy habits . This can also maximize the nutrients you put in your body and more.
- You want to reduce your risk of disease or complications. Regular blood tests can catch the warning signs of almost any disease early. Many heart, lung, and kidney conditions can be diagnosed using blood tests.
Talk to your doctor first if you want to get certain tests more often than once a year.
Some other tests that you may want include:
- enzyme markers if youre at risk for cancer or other conditions like liver cirrhosis, stroke, or celiac disease