Thyroid 101 – A Guide To Your Master Glandsarapugh
In this article, I’m going to explain everything you need to know about your thyroid, why so many thyroid problems are undiagnosed or misdiagnosed and what test to ask for if you think you have an issue with your thyroid. I am a biochemist, so this is not medical advice and is for your information.
Even if you’ve had a blood test and were ‘within the normal range’, don’t rule it out just yet – your doctor might have got it wrong. Many doctors are not experts in thyroid hormones, and they could be testing for the wrong things.
If some of the symptoms I describe later sound familiar, don’t put it down to getting older just yet – there could be more going on with your body than you think.
What is the thyroid?
The thyroid is a gland in the neck that produces hormones. Put simply, those hormones run your metabolism by allowing oxygen to enter cells so they can make energy. Think of it like the accelerator (or gas pedal) in a car – the thyroid drives your metabolism.
So many functions depend on a good thyroid gland that the thyroid is considered one of the master glands in your body.
And yet, so many medical professionals have a lack of understanding around how it works, which is why over 20 million people in the US alone have thyroid issues and many are undiagnosed.
How does it work?
The thyroid gland is under the control of the hypothalamus and the pituitary gland, so thyroid problems can begin here.
When the pituitary gland in the brain senses low thyroid hormones in the blood, it releases a thyroid-stimulating hormone (TSH) which then tells the thyroid gland to make thyroid hormones.
Two of the main thyroid hormones in the body are thyroxine (T4) and the metabolically active triiodothyronine (T3).
Think of the T4 like a coffee bean and the T3 like ground coffee.
The thyroid is fundamental to healing and health. If there is something wrong with your thyroid hormones, it will hinder many other processes in the body, even if you do everything else right.
Thyroid glands are very sensitive and can be affected by mercury, industrial chemicals, some anti-depressants, estrogen imbalances, inflammation, and unstable blood sugar. Chronic calorie restriction (over dieting) and overtraining also lower thyroid function.
What happens when the thyroid doesn’t work correctly?
Thyroid function is key in weight management, but this is often overlooked by many doctors who just tell their patients to ‘exercise more and eat healthily’. But many people who work out for an hour a day and eat a sensible diet are still overweight because they have an undiagnosed thyroid issue.
Now I’m not saying that all weight problems are down to thyroid issues, but it could well be the cause for a lot of people.
Untreated or chronically low thyroid leads on to or is linked to other illnesses and other hormone imbalances such as insulin resistance and adrenal fatigue.
As well as physical issues, having a non-functioning thyroid can be a giant good mood hoover, leaving you feeling low and depressed. As a result, low thyroid function can cost people their jobs, relationships and happiness. People with thyroid problems are not fun to be around, but it is not their fault.
Symptoms of low thyroid an include:
• Being cold
• Feeling bloated
• Weight gain
• Brittle hair and nails
• Brain fog
• Slow to process words
• Slow to think of what to say
• Dyslexia like symptoms
• Poor coordination
• Being tearful
• Slow healing
Other thyroid imbalances can occur too, such as Hashimoto’s syndrome – an autoimmune condition where the body attacks the thyroid gland. This often goes undiagnosed even though a large proportion of thyroid issues are a result of ‘autoimmunity’.
T3 is the hormone that cells need to ‘make and use energy’ in the body, so T3 has to be able to communicate with the cells. If the target cell membranes are damaged or weak, then T3 can’t do its job. This damage can be from oxidative stress, free radicals or too many polyunsaturated fats in your cell membrane.
I worked in a laboratory where someone used radioactive iodine. They were not careful with it, and it affected their co-worker’s thyroid glands. That was when I got interested in the thyroid and started to research the subject more closely.
Why do so many thyroid problems go undiagnosed?
When TSH tells the thyroid gland to make hormones, it makes about 90% T4 & 10% T3. T4 has to be transported out of the thyroid gland into the bloodstream and carried in special transportation molecules.
T3 is made by enzymes, which convert T4 into T3 by clipping off iodine. Both the conversion and the transportation process can and do go wrong.
The liver converts about 60% of the T4 into active T3, and the gut converts about 20%. This means that gut issues like leaky gut or IBS, and/or a liver burdened with toxins are going to affect your T3 levels, and thus your metabolism.
Some people have enough thyroxine to pass a thyroid test, but are still only functioning at 70%, so they still feel crap and still have an underperforming thyroid gland.
Other people pass the standard TSH T4 test so they are told their thyroid is normal, but their bodies can’t convert T4 into the active T3, so they still get symptoms and feel dreadful.
This is because some doctors do not fully understand how the thyroid and its hormones work, exactly which tests to do or how to treat it. Sometimes they do know what to do, but it is just too complicated, and they don’t have time.
Modern medicine works on the 2 standard deviations model, so you need to have really really low levels in blood tests for your doctor to flag the result.
Imagine a child at school who has to get Es and Fs in test results before the teacher will offer help – they should have offered help when the child was getting Cs and Ds. Blood tests are a bit like that – you need to be sicker than the average sick person. This is why you must look up the ‘optimum range’ for any lab test, to avoid being fobbed off.
What tests should you ask for?
If you think you have a thyroid problem or have Hashimoto’s, the very first step is to take a thyroid panel blood test.
• Free T4
• Free T3
• TPO antibody
• TG antibody
• TBG Thyroid Binding Globulin (Transporter)
• Reverse T3
These are the blood tests you need for a better understanding of what has gone wrong and possible ways to fix your thyroid problems.
These cost about $150 in the US, £130 in the UK and less in other countries. I once asked for these blood tests, and the doctor looked at me like I had three heads – this is why I’m sharing this information with you
With any blood test result, you want to make sure your levels of whatever you are testing are optimal, not ‘within normal range’, as they are not the same thing.
You can be ‘within normal range’ and still have a problem, as the size of this ‘range’ is pretty big.
What do these tests show?
Free T4 & T3. It is important to measure free T3/4 because if the thyroid hormones are bound to other molecules, then they aren’t able to do their jobs.
TSH is the signal to the thyroid gland to make hormones. High TSH means the brain is shouting for thyroid, but for some reason, it is not being made.
High TSH is also a sign inflammation is high. Low TSH can be the result of starvation (very low-calorie diet) or too much exercise, so the body is preserving energy. About 0.4-2.5 is a suitable range.
TPO and TG antibodies are to look and see if you have Hashimoto’s or autoimmunity, so the lower the better. Below about 15.
TBG Thyroid Binding Globulin is what the thyroid hormones ride around the body on, a bit like a boat. If there is a shortage of transporters, then this means the thyroid hormones can’t get to their destinations.
Reverse T3 or RT3 is an isomer of T3, so it has the same atoms but a slightly different shape, and it acts like an inactive form of T3.
RT3 binds to the same receptors as T3, sits there, and nothing happens. So, it blocks the thyroid effect. It is like an antibody to T3, halting your metabolism.
Reducing stress will help reduce Reverse T3.
Stress is not just caused by relationships and finances, but also environmental toxins, pesticides, heavy metals (like mercury), food intolerance, antibiotic residues and unstable blood sugar.
Many doctors are not experts in thyroid hormones, so it requires some persuading to get an RT3 test, but it provides useful information.
Below are the results you need for the ratio of T3 to RT3 – the ratio of useful T3 to useless T3.
Free T3/RT3 = 0.2 and above is ok
Total T3/RT3 = 10 and above is ok
Testing just T4 and TSH alone does not give satisfactory answers, which is why hundreds of millions of people in the world have undiagnosed thyroid problems and just put it down to ‘getting older’ or ‘chronic fatigue’ or ‘slow metabolism’ or ‘moody’ when there is a real hormone imbalance going on.
Just giving patients thyroxine or T4 alone doesn’t work a lot of the time as so many things can go wrong in the thyroid pathway.
This is why you need to understand a little about the potential problems and what to ask doctors for.
To make all this more complicated, thyroid problems are intertwined with adrenal fatigue, so that means there is cortisol, insulin, glucose and steroid hormones all in the mix. Chronic fatigue, pain, depression and fibromyalgia are all linked to the adrenals and thyroid too. I can’t cover everything in this post as it would start to get too confusing.
If you would like to know more, then check out my video on thyroid hormones and keep checking my blog for new posts about hormones and biochemistry.
I will be writing other blogs on hormones and biochemistry so keep a look out if you are interested.