Thyroid Labs Not Enough

Thyroid Hormone affects every cell internally while blood tests alone only measure hormone levels outside the cells making most thyroid tests incomplete. One study suggests that over 16 million adults in the U.S. have low functioning thyroids that are undiagnosed.

Thyroid Function is a Big Deal

The thyroid affects every cell in the body. Problems with metabolism, dyslipidemia (e.g. elevated cholesterol), sex hormone regulation, immune system function, aches and pains, fatigue, hair loss, and skin health are just a few aspects directly connected with thyroid function. If labs are normal but symptoms are high, a patient might end up on a handful of drugs chasing symptoms without relief and without an exit plan (stay on harmful drugs long term without addressing the cause of the symptoms).

Signs of Poor Thyroid Function

  • changes in blood pressure

  • difficulty with pregnancies

  • foggy thinking

  • fatigue

  • poor strength

  • periorbital edema (swollen eyes)

  • anxious or depressed feelings

  • heart palpitations or changes in heart rate

  • dry or itchy skin

  • brittle hair and nails/hair loss

  • cold extremities

  • changes in weight (loss or gain)

  • changes in bowel function (e.g. constipation)

  • low or high blood cholesterol levels

  • irregular menstrual cycle or painful cycle

TSH Not Enough

Most physicians will only test TSH which stands for Thyroid Stimulating Hormone. This hormone is produced by the brain (pituitary) and is a message to the thyroid to take action. The assumption is that if TSH elevates then your brain is having to yell at the thyroid because it is not doing its job (hypothyroidism - the opposite is also assumed; low TSH = hyperthyroid). This is a very narrow window from which to assess the state of the entire hormone system (which affects thyroid function) as well as a very limited and one dimensional approach to assessing thyroid health. It is also important to note that the reference ranges for TSH are not based on optimal function and allow for many patients with abnormal TSH levels to fall through the cracks.

Better Labs

  • TSH - thyroid stimulating hormone

  • T3 - free triiodothyronine

  • T4 - free thyroxine

  • Reverse T3 - thyroid hormone metabolism

  • Thyroid Peroxidase - autoimmune condition

However, labs do not take the place of a good intake interview with a doctor that is trained in connecting signs and symptoms to root cause problems in the physiology. Never trust a doctor that only treats the number even if they advertise holistic, integrative, or functional medicine. Physiology first, labs only if there are missing pieces or to confirm diagnosis. If it's an MD they use labs first (and treat the number) because they're forced to manage liability which does not allow for patient centered care (not their fault - it's a broken system they're stuck in).

Clinical Experience

The reality is that most of my "thyroid" patients (even with clear related symptoms plus confirmatory labs) are not actually thyroid patients at all. For example, issues with liver function can negatively affect thyroid function. If the thyroid is treated with this type of patient their thyroid numbers may improve but the root cause was not addressed. This means there is no exit program from whatever they're taking (they are not actually getting better) and new symptoms will show up related to the root cause (in this cause the liver) which was not treated. Dysglycemia and adrenal gland abnormalities are two other major pieces of the puzzle when treating the hormone system (and ultimately the thyroid).

Natural Doesn't Mean Root Cause

Although the majority of people are becoming aware of the toxic effects of drug medications the pursuit of natural treatments leaves people vulnerable to random one-size-fits-all approaches and scams. "What's the natural thing for thyroid," must be replaced with "What's the cause of my hormone system problems?"

The pursuit of clinical nutrition and herbal medicine must always start with a firm grasp of physiology. What's in the way of function and how to improve function? When the body is functioning normally (as designed) there are no symptoms. It is my goal to teach health concepts that educate and empower people for a higher quality of life.

Dr. Cassone

Holistic Medicine

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