She sat there on a summer day in a wool coat, her face haggard and drawn from exhaustion, telling me how she had no energy, was steadily getting fatter, and felt cold no matter how many layers of clothes she wore. Karen retired early because she had difficulty functioning on the job.
She couldn’t remember things and her brain worked so slowly that she felt like she was under water slogging her way through each day. She had seen 8 doctors over 5 years without relief. I knew what the problem was before any lab results were back. When I told her, she started to cry.
This is a story I have heard over and over since starting my restorative medicine practice. Why does this happen? There are an estimated 20 million Americans with thyroid problems. They occur far more frequently in women than in men. Yet, this is one of the most commonly misdiagnosed and mistreated health problems in America.
Women often think that they must have low thyroid function because of symptoms like weight gain, fatigue, dry skin, dry hair, hair loss, brittle nails, constipation, and cold hands and feet. They’ll go to the doctor and explain that they have these symptoms. A blood test is done and almost all of the time they are then told their thyroid is normal, it must be something else. But no one knows what.
Karen’s doctor ordered a thyroid stimulating hormone test (TSH). This is one of the tests that’s like asking your mother how your father feels instead of asking her directly. It is a test that asks your brain how your thyroid is doing. It’s an indirect measure. The pituitary gland in the front of the brain produces TSH in response to the levels of hormones made by the thyroid gland. It is the regulator of thyroid gland function. When thyroid hormone levels are low, the pituitary gland swings into action and sends messages (TSH) to the thyroid gland to tell it to make more hormones. It is, however, a poor indicator of when the thyroid gland is making too few hormones. When doctors depend on TSH measurements to tell whether your thyroid is functioning well, they are missing many instances of low thyroid function.
The other problem with using the TSH test is that the reference range established by almost every lab is too high, missing many cases of low thyroid function. Since it is an indirect measure, it is high when your thyroid is underfunctioning (hypothyroid) and low when your thyroid is overfunctioning (hyperthyroid). Like a see saw. Most labs say that 05-4.5 is the normal reference range. However, by the time your TSH is over 1 or 2 your gland is significantly under functioning. So your goal for your TSH is less than 1-2. At this level, chances are better that your thyroid gland is working well for you.
Well, I’m here to tell you that if you have the above symptoms, you probably have low thyroid function. And the tests that were done? Either they were incomplete or incorrectly interpreted.