Written By: Randi Miller for The Balanced Nut
What Does A Thyroid Do?
Your thyroid is a butterfly-shaped gland that’s part of your endocrine system. It sits at the base of your throat and produces hormones including T4 and T3, which play important roles in your metabolism. Think of your thyroid as the cruise control on a car whose job it is to keep your system moving at the right speed. Too much thyroid hormone (hyperthyroidism) is like lead-footing the gas—causing symptoms that speed up your system—like diarrhea, anxiety, weight loss, and heart palpitations. Too little thyroid hormone (called hypothyroidism) is like slamming on the brakes—causing symptoms that slow down your system—like constipation, weight gain, and depression.
When Should I Test My Thyroid?
You should ask your doctor for a full thyroid panel if you are experiencing any symptoms that can be thyroid-related, such as:
· Difficulty losing weight
· Difficulty keeping weight on
· Chronic constipation or diarrhea (or oscillation between the two)
· Anxiety or irritability
· Depression
· Diffuse hair loss
· Fatigue (or wake feeling tired)
· Palpitations
· Dry skin and nails
· Poor concentration, memory, or motivation
· Joint pain and stiffness
· Body aches
· Bloating
· Cold extremities (like cold hands and feet)
That said, given the number of undiagnosed thyroid problems out there, as well as the statistic that it often takes an average of 7 years for a person with thyroid problems to receive a diagnosis, I recommend that everyone asks their doctor for a full thyroid panel at least once as part of a regular checkup. The sooner the better. Having these results, at the very least, provides good benchmark numbers for the future.
Which Tests Do I Ask For?
If you ask your doctor to test your thyroid, chances are s/he will perform 2 tests. They are:
- TSH Ultrasensitive
-
T4
Until recently, it was thought that these two tests were conclusive enough to indicate whether the thyroid was experiencing a problem. If either of those metrics were out of range, your doctor would then likely follow up with a full thyroid panel.
I recommend you ask your doctor for a full thyroid panel, which usually includes all these:
- TSH Ultrasensitive
- T4
- Free T4
- T3
- Free T3
- Reverse T3
- TPO Antibodies (thyroid peroxidase)
- TG Antibodies (thyroglobulin)
Why Ask for A Full Thyroid Panel if My Doctor Says TSH and T4 Are Enough?
Because the information you get from only 2 tests is lacking. Here’s how:
Reason 1: T3 Levels are Important
One of the more important things to know is how much T3 your body has available, because in order to USE most of your thyroid hormone, your body has to convert a large percentage of your T4 into T3. Some people make a good amount of T4, but lack the required nutrients (like selenium and zinc) to convert T4 into T3. So, just because a standard panel says your T4 is in range, doesn’t mean your body is necessarily getting enough T3.
Reason 2: Free T3 Levels are Important
Once T4 gets converted into T3, that T3 has to become unbound and turned into Free T3 in order to be used by the cells. Think of T3 as that special someone you want to marry, but who is already married. Free T3 is single and available.
Reason 3: TPO and TG Antibodies Tell an Important Story
Most doctors don’t test for antibodies, probably because if they did find antibodies, it wouldn’t change their treatment plan (hint: you’d likely get a prescription for Synthroid (levothyroxine)— a synthetic T4). But knowing if you have antibodies will tell you if your thyroid issue is autoimmune or not. If it is autoimmune, there are many lifestyle interventions you can try to reverse your thyroid condition and reduce systemic inflammation. Also, people with one autoimmune condition can often accumulate others as time goes on. Implementing anti-inflammatory lifestyle choices early can dramatically turn things around and prevent other autoimmune conditions (and their symptoms) from piling on.
Reason 4: Reverse T3 Tells Another Important Story
When your body is under intense stress, be it physiological (eg. you just had an operation or a virus) or psychological (eg. you’re extremely stressed about work), instead of converting T4 into T3, the body “battens down the hatches” and conserves energy by converting T4 into Reverse T3, an inactive form of T3 that is incapable of delivering oxygen and energy to the cells. If your RT3 is high, you may want to look for physiological stress factors (eg. infections) as well as seriously investigate stress reduction techniques (eg. abdominal breathing or meditation).