So Whats Your Thea Score
Do you know what yours is? If not, do a quick calculation now by taking the assessment it is easy to do. Assign points as per the chart based on your TSH, TPO antibodies and family background. Again, low risk is considered in the 0-7 range. This means the Hashimotos is or would not be super aggressive. But, you are still at risk.
Why Should You Get Your Thyroid Checked
If youre still here reading this, then you must recognize a connection between your thyroid function and your overall health or quality of life. Only by having your thyroid levels checked can you confirm if youre walking around with subclinical hypothyroidism.
Subclinical hypothyroidism refers to a subtle thyroid imbalance that many doctors miss in their rush to move to the next patient or next issue. Women with this condition feel very real symptoms but show normal thyroid hormone levels in conventional thyroid screenings.
These women like you! get lost in the middle between patients with overt thyroid disorders, forcing them to suffer without an official diagnosis or professional treatment. If you have subclinical hypothyroidism, your doctor might tell you its all in your head or stick you on antidepressants for an easy solution.
All of this is exacerbated by the fact that most patients get less than ten minutes to visit with their primary doctors each year. Regular doctors are under so much pressure to move quickly from patient to patient that they cant stop to listen, carefully assess symptoms, and compare lab tests to uncover the truth.
T3 And T4 Interpretations
- A normal TSH and normal T4 show a normal thyroid
- A low TSH and high T4 generally means an overactive thyroid
- A high TSH and low T4 means an underactive thyroid
- A low TSH and low T4 mean low thyroid function because of another problem, such as with the pituitary gland or hypothalamus of the brain
A low T3 value with a high TSH value is diagnostic evidence of low thyroid function. By contrast, a low TSH value with a high T3 value is the opposite, and means an overactive thyroid.
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Why Does The Thyroid Matter In Fertility
The thyroid is an endocrine gland which produces hormones that regulate the growth and function of other bodily systems. It is crucial for regulating metabolism, energy production, oxygen utilisation and hormone levels.
Thyroid hormones are produced by everybody, and play an important part in growth. As such they are critical in pregnancy. If the thyroid is over or underactive, this can affect ovulation regulation and reduce fertility. Many women suffer from thyroid dysfunction around 25% of women in their lifetime, which is around 4x more women than men. Graves disease is the most common thyroid dysfunction, affecting 1% of the population. These conditions are important in fertility, because thyroid hormones are important in regulating ovulation, preventing miscarriage and aiding foetal brain development.
Thyroid Questions Let Us Answer Them
Now you know all about normal thyroid hormone levels and when you need to seek treatment.
PrimeHealth is devoted to answering peoples questions about medical conditions and autoimmune diseases, like Hashimotos thyroiditis. We believe its important to make patients feel heard and educate them on what is going on in their bodies.
Did you know? A lot of peoples hypothyroidism can be permanently cured. Even what conventional doctors might call permanent hypothyroidism may be treatable. Our patients prove it.
To schedule a FREE phone consultation with a member of our medical staff, schedule your appointment today.
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What Is Thyroid Medication
Thyroid Hormone Treatment Levothyroxine is thestandard of care in thyroid hormone replacement therapy and treatment of hypothyroidism. Levothyroxine is equivalent to the T4 form of naturally occurring thyroid hormone and is available in generic and brand name forms.
How do I take levothyroxine? To optimize absorption of your thyroid medication, it should be taken with water at a regular time each day. Multiple medications and supplements decrease absorption of thyroid hormone and should be taken 3-4 hours apart, including calcium and iron supplements, proton pump inhibitors, soy, and multivitamins with minerals. Because of the way levothyroxine is metabolized by the body, your doctor may ask you to take an extra pill or skip a pill on some days of the week. This helps us to fine tune your medication dose for your body and should be guided by an endocrinologist.
For patients with celiac disease or gluten sensitivity, a gluten free formulation of levothyroxine is available.
Some individuals may have genetic variant that affects how the body converts T4 to T3 and these individuals may benefit from the addition of a small dose of triiodothyronine.
Liothyronine is replacement T3 thyroid hormone. This medication has a short half-life and is taken twice per day or in combination with levothyroxine. Liothyronine alone is not used for treatment of hypothyroidism long term.
The Take Hormone Message
Ultimately, our understanding of TSH is continually evolving and expanding as researchers add to the growing body of information on the matter. For this reason, itâs essential to work with healthcare professionals who are committed to staying abreast of this research and are experts in their chosen field. The body of literature is brimming with examples in which a TSH that is too high or too low may become problematic, so I recommend working closely with a healthcare professional to ensure a TSH within not only the ânormalâ range, but within an optimal range for your personal health and circumstances.
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Discover Your Best Thyroid Levels Today
Far too often I have heard of other doctors simply dismissing patients by saying that their labs are completely normal, when they should really be optimal. That is why I hope we have uncovered a bit more about your levels, and what they mean, today.
Would you like to learn more about what your results are based? What your best levels of free T3 and T4 are? Do you want to know how to accurately test your thyroid?
If so, we can send you a free personalized report specific to you and your thyroids health. Try the Thyroid Calculator today and contact the folks at Integrative Health to get your very own thyroid advisor visit to help put your health on the right track.
Physiologic Issues In Assessing Tsh Values
Considerable literature exists regarding what the normal range for TSH really should be, and this topic is covered at length in recent reviews, and in clinical guidelines for the diagnosis and management of hypothyroidism., Indeed, even though the normal range for TSH is generally listed at between 0.35 mIU/mL and 4.50 mIU/mL, it is likely that the most normal range is between 0.5 mIU/mL and 2.50 mIU/mL. It is for this reason that the target TSH in the management of hypothyroidism is within this latter range., Note that the goal range for replacement therapy is different than the range at which hypothyroidism is diagnosed dose, it does not warrant initiation of replacement therapy in a non-pregnant patient). The mean inter-assay precision for the TSH measurement is generally good. The method used at our institution has a precision of ~3.2%, indicating that variations in the result over time in a single patient are not likely to be related to the assay itself but rather to other factors . Lastly, it is important to understand that normal ranges are calculated based on the 2.5th to 97.5th percentiles of the distribution of values measured in the population tested. Therefore, 2.5% of people with completely normal thyroid function will have a TSH slightly below the listed normal range .
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Normal Vs Optimal And Best Thyroid Levels
This is one of the major pitfalls of lab results that I want to address. There is a cutoff that exists between normal and optimal based on an entirely biased population. Here are some relevant factors that you should consider
What optimal would ideally take into account is what we call diurnal variation. People who get thyroid tests do not have them all done at the same time. In a perfect world, we would instead be comparing values taken between 6 and 10 in the morning.
This is because, during other times of the day, your scores can be different. Many that have been tested have ultimately skewed the average because of this .
Fasting status can also result in wildly erratic scores, as can goiters .
Summary: What Is The Normal Ft: Ft4 Range And Average
Gullo and team discovered that the average ratio among healthy controls throughout the normal TSH range is approximately 0.32-0.33 per quintile in a population with an average age of 49 years.
- Andersons 2020 TSH data set coincidentally fits almost perfectly with Gullos range and average. Mid-range ratios of average FT3:FT4 in the table are approximately 0.33 mol/mol for all four normal TSH quartiles.
- This is a very narrow average. The average conceals the full range of individual diversity within any given quartile or quintile of TSH.
Gullo and team found the reference range for the ratio was from 0.20 to 0.50 pmol/L. This reference range is calculated, like most laboratory ranges, as the 95% interval, omitting the 2.5% high and 2.5% low outliers. It represents the wide range of normal human variation in the ratio.
- In Anderson et als 2020 data, including values outside the normal TSH reference range, the lowest ratio was 0.24 and highest ratio was 0.53. This is shifted only slightly higher than Gullos reference range of 0.20 to 0.50.
- Note that Andersons data set was not screened for overall health or thyroid health because the data set explored associations with disease, even within the reference range.
Therefore, these FT3:FT4 ratio findings can assist in identifying metabolic dysfunctions and HPT axis interferences that may otherwise be misdiagnosed or overlooked.
Metabolic principles taught by ratios
1. The FT3:FT4 ratio must always be anchored in a FT4 level.
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What Are Thyroid Hormones
Thyroid hormones are secreted by the thyroid gland secretes. Three thyroid hormones exist, but T4 and T3 are the most prominent.
Heres what each thyroid hormone does within the body:
- T4 is the primary hormone produced by the thyroid gland. Also known as tetraiodothyronine, T4 is inactive. Its primary function is to become active T3.
- T3 is the active form of T4. It regulates your metabolism and other vital functions. 20% of it is made in the thyroid, while most T3 is produced in other organs from T4.
- Calcitonin is the less prominent hormone that your thyroid gland produces. It helps regulate calcium and phosphate levels in your blood, both of which contribute to healthy bones.
Overdiagnosis Of Hypothyroid Is Common
Research suggests that thyroid medication is overprescribed because many practitioners apply a very narrow range when reading thyroid hormone test results.
One very insightful study showed that up to 60% of patients may be taking thyroid hormone replacement unnecessarily . In this study, 291 patients taking Levothyroxine were asked to pause their medication for 6-8 weeks. Many of these patients had been taking thyroid medication for years but did not have strong diagnostic indicators of thyroid disease.
- After going without synthetic thyroid hormone replacement for several weeks, patients were given thyroid function tests. 60.8% of patients had results in the normal range, meaning their body produces enough thyroid hormone and they did not require thyroid medication.
While both conventional and functional medicine practitioners over diagnose thyroid disease, this is an area where conventional medicine tends to get it right more often than functional medicine.
If you suspect your diagnosis and/or treatment may have been premature or unnecessary, know that you can always get a second opinion. If your lab results did not show abnormally high TSH paired with abnormally low free T4 then you may not be truly hypothyroid and may not need medication. Of course, always check with your doctor before discontinuing your medication.
For help with your thyroid health, schedule an appointment at our center for functional medicine.
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Assessment Of Thyroid Function And Other Baseline Measurements
TSH and FT4 measurements were performed using the same methods and assay in blood samples collected between 1997 and 2008, depending on the cohort, and were stored at 80°C . Body mass index was calculated as body mass divided by the square of body height . Serum cholesterol was measured using standard laboratory techniques. Systolic blood pressure was calculated as the average of two consecutive measurements. More than 95% of participants were in a fasting state when blood was drawn at the Rotterdam Study center visit. Information on tobacco smoking was derived from baseline questionnaires. Information on medication use was obtained from questionnaires in combination with pharmacy records.
Differential Diagnoses Enabled By The Ft: Ft4 Ratio In Light Of Tsh
When healthy thyroid tissue expressing D1 and D2 is present, a higher TSH usually enhances the T3 side of the FT3:FT4 ratio.
Before treatment with thyroid hormone, when a normal or high TSH does not result in the normal or elevated FT3:FT4 ratio expected, something is amiss with
- thyroid gland function,
- poor D1 or D2 deiodinase function or elevated D3 deiodinase, and/or
- poor TSH hormone quality or TSHR signaling interference.
As for TSHR signaling interference, TSH concentrations in blood do not always correspond with the rates of TSH-receptor signaling because substances other than TSH, like TSH-receptor antibodies, can bind to the TSHR and boost or invert its signal.
Not just TSH concentration, but TSH-receptor signaling, influences the FT3:FT4 ratio.
When the FT3:FT4 ratio is inappropriate to TSH concentrations, the mismatch enables further diagnostic discernment of abnormalities in thyroid hormone supply and the TSH secretions response to that supply.
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In People Without Known Thyroid Disease
A high TSH in people who are not undergoing thyroid disease treatment usually indicates the presence of primary hypothyroidism.
This is by far the most common form of hypothyroidism, and it occurs because the thyroid gland produces an inadequate amount of thyroid hormones. The pituitary gland senses these low levels and increases the production of TSH.
An elevated TSH may also occur with normal thyroid function due to the presence of antibodies, proteins made by the immune system.
Reverse Triiodothyronine Test Results
Following is a sample of the results of the Reverse T3 blood test. The reference interval indicates the normal ranges and the flag indicates a result outside of those ranges. Reverse T3 is the mirrored image of T3. Reverse T3 is the nonactive hormone where T3 is the active hormone.
- Reverse T3 can inhibit the action of the T3 hormone causing symptoms of hypothyroidism.
- Elevated Reverse T3 may be an indicator of hypothyroidism at a cellular level.
Reverse T3 reference range: 9.2 to 24.1 ng/dL.
Quest Diagnostics Example
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S To A Proper Thyroid Diagnosis
1. Do you know your TSH and other thyroid levels or just was informed by your doctor that your labs are normal? Ask your doctor what tests does s/he order to check your thyroid.
It is especially important to make sure that an extended thyroid panel was ordered for those who experience hypothyroid symptoms but have TSH in normal range and they have difficulties to get diagnosed.
If you cannot go to the lab you can get a comprehensive thyroid and other testing without visiting the lab. Here is the easiest way to get your thyroid tested now.
2. Check what values your doctor and lab are using for normal thyroid levels. Make sure to follow new updated guidelines that recommends TSH normal range between 0.3 and 3.0.
3. Work with your doctor to optimize your thyroid levels for optimal health. Optimal TSH is around 1.0 and free T4 and T3 high normal. This approach is especially useful if you are looking to lose some weight, stop thyroid related hair loss, increase your energy and improve fertility.
4. Measure your body temperature first thing in the morning to evaluate your Basal Metabolic Rate and/or use Dr. Rinds approach to establish the pattern by using a combination of markers:
If your results fit a certain pattern you will get an idea what additional testing you may need to ask your doctor to get a proper diagnosis.
5. Consider additional testing that can include:
|Most people have a mixture of symptoms of hypothyroidism and adrenal function|
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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