Thyroid dysfunction can occur at any age. If your level of production of this important hormone is too low, you gain weight. Any imbalance of your thyroid hormone can affect every metabolic function in your body. Your thyroid gland is your body’s regulator. It regulates energy and heat production, growth, tissue repair and development, and stimulates protein synthesis. Furthermore, thyroid hormone modulates carbohydrate, protein and fat metabolism, vitamin use, digestion, muscle and nerve action, blood flow, hormone excretion, oxygen utilization, and sexual function to list just some of its uses.
The following excerpt from the recently released E-book: The Weight Loss Puzzle, Finally Solved! written by myself, Dr. Frank Aieta and Dr. Diane Hayden arms the reader with information on which essential lab tests should be run to evaluate how well their thyroid is functioning as well as typical signs and symptoms that one may exhibit if they are experiencing hypothyroidism (low thyroid hormone production.)
We will look at 5 tests total in conjunction with assessing some clinical signs and symptoms to determine just how well your thyroid gland is functioning…..so let’s get started!
TSH – TSH stands for thyroid stimulating hormone. It’s actually not a thyroid hormone but a pi-tuitary hormone that does exactly what the name implies; it stimulates the thyroid gland to produce thyroid hormones. Most doctors will simply look at this number by itself and if the patient falls with¬in the large reference range of .27-4.5 mIU/L, they are considered “normal.” In my practice I use the person’s clinical signs and symptoms first and foremost and the lab values second to determine the status of a person’s thyroid function. The problem with just looking at lab values, especially one like TSH by itself, is that many times it can take a while before blood results catch up to the clinical signs and symptoms. This is typically the case when using the standard reference ranges that are actually based upon what we consider to be a population of mostly unhealthy people. When looking at the TSH number you need to know that the higher that number is, the more sluggish the thyroid is working and the lower the number the more optimal. The standard range will vary from lab to lab but typically is .27-4.5 mIU/L . The optimal range that I see in healthy patients is .27-1.5 mIU/L.
Free T4 and Free T3 – These are 2 separate tests but we will discuss both together. T4 is the dom¬inant form of thyroid hormone produced by the thyroid gland but it’s actually considered to be a storage form of thyroid hormone and is inactive until it gets converted in our tissues to T3. Looking at both of these values together is important in determining how well your thyroid hormones are functioning at the level of the cell. Our TSH level, as discussed above, is a pituitary hormone and its secretion is determined by how much actual thyroid hormone is floating around in the blood. The problem is that a person may have adequate amounts of T4 in their blood but may not be converting it over appropriately to the active form of T3. Once again, simply checking TSH levels in the absence of T4 and T3 can lead to improper assessment of your thyroid status. Ideal range for Free T4 is in the middle of the reference range and up, and ideal range for Free T3 is within the upper 75th percentile of the reference range.
Reverse T3 – This thyroid hormone needs to be analyzed along with Free T3. Reverse T3 is a block¬ing hormone that is produced from T4 and actually slows down the metabolism. I tell my patients that T3 is like the body’s gas pedal and reverse T3 is like the brake pedal. We need to have a proper balance between these two hormones in order for our metabolism to function optimally. There are many fac¬tors that can contribute to elevated reverse T3 ranging from nutrient deficiencies to increased levels of stress hormones, inflammation and leptin. We will be discussing strategies throughout this book to address all of these potential factors that can lead to an inability to lose weight due to a compromised metabolism. Ideal range for reverse T3 is to look at the ratio between free T3 and reverse T3. The reference range that most labs give for reverse T3 is 8-25 ng/dl and 2.3-4.2 pg/ml for free T3. As you can see both are in different units of measure so what I do is move the decimal point of the free T3 ranges and make them 23-42 then assess the ratio between free T3/reverse T3. The ideal ratio is 2:1 or greater. This ratio tends to correlate very closely to the person’s clinical signs and symptoms which we will cover shortly.
Thyroid antibodies (thyroid peroxidase and thyroglobulin antibodies) – This is the last of the thy¬roid tests that I typically recommend. The presence of either antibody in the blood is an indication of an autoimmune disease affecting the thyroid called Hashimoto’s disease. If antibodies are being made to the thyroid, they can stop thyroid hormone from attaching to your thyroid receptors. Consequently, you can get symptoms of decreased thyroid function even when your blood levels are adequate. Thy¬roid antibodies can be elevated due to trauma, poor digestive function, infection, inflammation, nutri¬tional deficiencies, and thyroid degeneration. Once we get into the diet and supplements section, we will discuss strategies to help lower or even eliminate the presence of these antibodies. Optimal range for both should be zero.
As I stated above, it’s important to run the proper lab testing to assess your thyroid function to determine your metabolism, but identifying clinical signs and symptoms of hypothyroidism takes precedence since they may present far sooner than it would in the blood.
Identifying and properly treating thyroid dysfunction is just another piece of the weight loss puzzle that needs to be solved. The rest of the E-book has chapters on diet, exercise, dietary supplements, mindset, sleep and stress management that will guide the reader along the rest of their journey in solving their own weight loss puzzle.
Dr. Frank Aieta is a board-certified and licensed Naturopathic Physician with a private practice in West Hartford, Conn. He specializes in the treatment of disease, using natural therapies such as acupunc ture, homeopathy, spinal manipulation, clini-cal nutrition, herbal medicine and natural hormone balancing. For more information please visit: www.draieta.com.