I’ve got a pop quiz for all of you women out there: In the last year, have you felt:
- Frustrated you can’t seem to lose weight? Like you’re eating the same and exercising the same but the weight isn’t coming off like it used to?
- Way more tired than usual?
- Constipated & bloated – like things aren’t moving like they should be even though you’re getting the fibre and water you need?
If you answered YES to these questions, it may be worth discussing blood tests for your thyroid gland function with your naturopathic doctor or family doctor.
You may be surprised to hear that I encourage my patients to get a copy of their test results so we can look at the actual numbers together. Sometimes even when everything is within the normal range for your thyroid gland – it’s still not functioning optimally which is often why you still feel exhausted despite your results being “normal”.
This is also something to keep in mind if you are already on thyroid medication and still experiencing these and other hypothyroid symptoms. This is an issue I’ve been seeing increasingly with my patients, especially in the past few years.
My goal is to share some info that can help you make sense of your thyroid lab tests and why you deserve optimal thyroid test results. Remember, this isn’t medical advice, but rather education to empower you to advocate for yourself and so you can understand your body and your health better.
Why you want optimal not “normal” thyroid test results
Thyroid Gland: A Review
The thyroid gland makes thyroid hormones called T3 & T4 for short and their job is to regulate our metabolism (1). Basically, this means that they help our cells make energy efficiently so that our body can function well. So when our thyroid gland doesn’t make enough thyroid hormones (T3 & T4 – which you can learn more about here), our metabolism starts to slow down which means our body’s overall ability to make energy decreases. This decrease in metabolism and energy in the body is what leads to weight gain, fatigue and the other symptoms common to hypothyroidism. If you want to know more about these hormones and the thyroid gland please make sure you watch my thyroid hormone video from May Know Your Hormone Series.
But our focus here today is testing.
Did you know that T3 & T4 aren’t typically tested right away? Often the first test your doctor will run to assess your thyroid gland function is TSH.
What’s TSH got to do with it?
TSH stands for thyroid stimulating hormone. This hormone actually comes from the pituitary gland in the brain and travels to the thyroid gland and tells it to make thyroid hormones (1). If our thyroid gland is not producing enough thyroid hormones (T3 and T4), then the pituitary gland in our brain produces more TSH to try to stimulate the thyroid gland to make more T3 & T4 (hence the name TSH!). A rise in TSH can signal that the thyroid gland is not functioning well.
Normal lab ranges for TSH are typically between 3.5- 5.0 mIU/L (2)
However, did you know…
Optimal TSH for optimal thyroid health is typically between 1 – 2.5 mIU/L
In practice, when I see women with TSH levels at 3 or 4 mIU/L and they present with common hypothyroid symptoms, I order their complete thyroid panel (keep reading below for more lab tests), and based on this information, I work with them to create a nutrition and lifestyle plan to help them optimize thyroid gland function. For a woman trying to conceive, I like to see the TSH even lower, below 2.0 mIU/L for optimal fertility. If you’re seeing a fertility specialist and your TSH was higher than 2.0, you may have been prescribed thyroid medication. Learn more about the importance for thyroid function in fertility in this video blog post. Remember, these numbers are for educational purposes only and are based on the lab I use and may not reflect your health needs so speak to your naturopathic doctor, family doctor or specialist to see what is right for you.
What about the actual thyroid hormones (T3, T4)?
When TSH is sufficiently higher than 5.0, your doctor will likely then often test free T4 and free T3 to see if they are below normal, which is what one would suspect based on a high abnormal TSH. If T3 & T4 are below normal, you officially have hypothyroidism.
- The normal range for T4 is 9-19 pmol/L (2)
- The normal range for T3 is 0.9-2.3 nmol/L (2)
But what if your TSH is in the high normal range and your T4 & T3 are on the low normal/borderline low range?
Should we just wait and do nothing?
It’s possible that TSH can return to normal on it’s own – depending on how high it is. Unfortunately, if you take that approach and nothing changes with your nutrition and lifestyle, it’s possible you may experience increased low thyroid symptoms, and if left untreated long enough the lab values may reach outside normal range, depending on what they were to start with. This is why I like to take a proactive approach when it comes to thyroid health.
The Proactive Bottom Line:
My goal with patients is always to work proactively to identify thyroid issues early when they respond best to natural treatments:
- Get a full thyroid panel with the blood tests listed above and thyroid antibodies if indicated. Determine if the results are within optimal range and understand how they relate to their symptoms
- Identify increasing levels of TSH and work on nutritional, lifestyle & as necessary, nutritional supplements and/or herbs to help improve the thyroid gland’s ability to make T3 & T4, which can help lower the TSH to the optimal range.
- Ensure they are getting the necessary nutrients to convert T4 to T3. You can find out why T4 to T3 conversion is important to your thyroid function right here.
Join me next week for our final Lab Tests Explained article where we’ll be discussing tests for blood sugar balance.
Take care until then!
References:
- Marieb, Elaine N. Essentials of Human Anatomy & Physiology, 11th Ed. 2015.
- LifeLabs Test Results. 2018.
