The 11 Markers of Healthy Thyroid Function

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November 19, 2019
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Thyroid problems are seen more and more in clinic and there is not enough testing done to establish thyroid function. There are two things I’d like to share today.

  1. Lab testing and what each marker actually measures
  2. A check list of all the symptoms experienced by those who have thyroid disease.

The 11 Markers of Healthy Thyroid Function and what they are measuring. 

I want to share with you the most important thyroid markers that your doctor should be running on you to evaluate your thyroid hormone metabolism.
These markers will give you a much better sense of what is actually going on with your thyroid gland, your pituitary gland, adrenal glands and how well your hormones are being converted in the liver, kidneys and gut.  These markers will also rule out the possibility of an autoimmune condition that is affecting your thyroid health.

Print out this information and arm yourself with information for your next doctor’s appointment.

TSH – The most common marker used to assess 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.

Reverse T3 – This version of T3 is metabolically inactive. Reverse T3 is only typically produced in cases of extreme stress such as surgery or trauma. Chronic stress can also cause the production of Reverse T3, thereby masking the adrenal issue and looking like a dysfunctional thyroid.

T3 Uptake – This measures the number of sites for T3 to bind to for carrier proteins. These are the sites that allow T3 to be transported throughout the body to be used by cells that need it. This marker is influenced by sex hormones such as testosterone and estrogen.

Thyroxine-Binding Globulin (TBG) – This is the amount of proteins in the blood that carry thyroid hormones to the cells. This marker can be influenced by infections, liver dysfunction, HRT, birth control, steroids, prednisone, aspirin, and pregnancy.

TPO Antibodies – Most common marker elevated with autoimmune thyroid.  90% of thyroid issues are autoimmune related.  This marker is rarely tested since there is no pharmaceutical drug to fix the problem, only lifestyle.

Anti-Thyroglobulin Antibodies – Not as commonly elevated with an autoimmune thyroid condition. During thyroid cancer treatment, this marker is routinely evaluated.

Thyroid Stimulating Immunoglobulin – These antibodies are elevated with an autoimmune thyroid condition called Grave’s disease. This marker indicates a hyperthyroid state.

If you have a hard time getting these markers run by your healthcare provider, please contact us to discuss your case in more detail.

If you can identify with these symptoms then despite having so called “normal” lab ranges you have a thyroid problem.

My risk factors for Hypothyroidism despite ” Normal” lab tests include:

____ I have a family history of thyroid disease
____ I have had my thyroid “monitored” in the past to watch for changes
____ I have had a previous diagnosis of goiters/nodules
____ I currently have a goiter
____ I was treated for hypothyroidism in the past
____ I had post-partum thyroiditis in the past
____ I had a temporary thyroiditis in the past
____ I have another autoimmune disease
____ I have had a baby in the past nine months
____ I have a history of miscarriage
____ I have had part/all of my thyroid removed due to cancer
____ I have had part/all of my thyroid removed due to nodules
____ I have had part/all of my thyroid removed due to
Graves’ Disease/hyperthyroidism
____ I have had radioactive iodine due to Graves’ Disease/hyperthyroidism
____ I have had anti-thyroid drugs due to Graves’ Disease/hyperthyroidism

I have the following symptoms of hypothyroidism, as detailed by the Merck Manual

____ I am gaining weight inappropriately
____ I am unable to lose weight with diet/exercise
____ I am constipated, sometimes severely
____ I have hypothermia/low body temperature (I feel cold when others
feel hot, I need extra sweaters, etc.)
____ I feel fatigued, exhausted
____ I feel run down, sluggish, lethargic
____ My hair is coarse and dry, breaking, brittle, falling out
____ My skin is coarse, dry, scaly, and thick
____ I have a hoarse or gravelly voice
____ I have puffiness and swelling around the eyes and face
____ I have pains, aches in joints, hands and feet
____ I have developed carpal-tunnel syndrome, or it’s getting worse
____ I am having irregular menstrual cycles (longer, or heavier, or
more frequent)
____ I am having trouble conceiving a baby
____ I feel depressed
____ I feel restless
____ My moods change easily
____ I have feelings of worthlessness
____ I have difficulty concentrating
____ I have more feelings of sadness
____ I seem to be losing interest in normal daily activities
____ I am more forgetful lately

I also have the following additional symptoms, which have been reported more frequently in people with hypothyroidism:

____ My hair is falling out
____ I can’t seem to remember things
____ I have no sex drive
____ I am getting more frequent infections, that last longer
____ I am snoring more lately
____ I have/may have sleep apnea
____ I feel shortness of breath and tightness in the chest
____ I feel the need to yawn to get oxygen
____ My eyes feel gritty and dry
____ My eyes feel sensitive to light
____ My eyes get jumpy/tics in eyes, which makes me dizzy/vertigo
and have headaches
____ I have strange feelings in neck or throat
____ I have tinnitus (ringing in ears)
____ I get recurrent sinus infections
____ I have vertigo
____ I feel some light-headedness
____ I have severe menstrual cramps

So as you can see, there is more to Thyroid testing than just TSH readings. A comprehensive Thyroid panel will uncover issues more so than a single common marker.

At Vital Health and Natural Medicine, I encourage my patients to get a full panel tested if warranted and if there is resistance, I use Nutripath Labs that will do a comprehensive check.

Caring for you naturally,

Domenic Pisanelli

If you would like to know more and interested in Energy Boost Program and you would like to know more about fatigue and hormones and how it’s related to chronic inflammation or pain, insulin resistance and or weight gain, just call the clinic for your FREE Discovery Call.

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To find out more, and to learn if fatigue symptoms are causing you to have chronic inflammation or pain, insulin resistance and or weight gain, you can book a naturopathic consultation with Domenic Pisanelli Functional Medicine Naturopath.

Yours in Health

From the Team at Vital Health and Natural Medicine

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