Hashimoto’s Disease: What you need to know

We're going to start this new year off with a four-part educational series.

Part 1: Is your thyroid making you miserable?

Could you have a thyroid problem? If you do, how do you talk to your doctor about it?
How do you speak to your doctor and get the answers that you need? What kind of labs do you order?

I want to start out first by saying that there are a lot of different causes for low thyroid or underactive thyroid. Hashimoto's thyroiditis is just one of those. And as you can, no, I've struggled with this problem.

In 2009, I tried to conceive my second child but was unsuccessful. At that time, a fertility doctor that I had seen suggested that I get tested. But not surprising, my thyroid tests were normal. But I decided to dive a little deeper at that time because I knew something was wrong. I mean, it took over a year and I couldn't get pregnant. So we actually ordered thyroid antibody tests. And the antibody tests came back very abnormal.

So despite my labs being normal, my thyroid antibodies indicated I had subclinical hypothyroidism, but I clearly had a problem.
I was placed on Synthroid and lo and behold, I was able to conceive my second son. This is a common story among my clients and patients that struggle with infertility until their thyroid is optimized.

What are the symptoms of hypothyroidism?

-Fatigue

-Weight gain

-Hair loss

-Acne

-Poor digestion

-Temperature issues, hot or cold all the time

-Anxiety, depression or brain fog

-Muscle or joint pain

-Numbness in toes/hands

If you think this sounds like you, then what do you do next?

Find a healthcare provider, MD, DO, naturopathic dr, functional medicine provider, whoever you are comfortable with and get tested. But get the full panel of tests. Bring your list of symptoms and ask for the full panel of tests which include TSH, free t4, free T3, and reverse T3.

TSH is produced by the pituitary and tells your thyroid to make hormones. It is the most common test ordered by your doctor to screen for either low functioning gland (hypothyroidism) or high functioning gland (hyperthyroidism).

Free T4 is a test to assess how much T4 is circulating in your body. T4 can be bound to proteins and not used so it is better to get a free t4 test to better gauge the amount of useable t4. T4 is the predominant hormone made by the thyroid. Some of it is converted to T3 in the bloodstream.

Free T3 is a test that assess how much T3 is circulating in your body. Like T4, the free T3 test is a better measurement of the amount available for the body to use.

Reverse T3 is a controversial test. It assess the whether the body is properly converting T4 to the active form T3. But it isn't reliable in that there is no established perfect range and knowing how to interpret the test can be difficult. It can be altered by stress. Most providers do not think it is necessary to order. I feel it is necessary to get this test when the medication you are taking is not working. If the medication that has been started works great then this test will not add any value.

Summary points:

Bring a list of symptoms, list them all out, just write them down. Sometimes you don't think that they're important, but they're important to help your provider find the answer.

If you want to see the full video series now, check it out on my YT channel.

 

About the Author
Dr. Jennifer Roelands is a physician specializing in hormone health, longevity medicine, and metabolic optimization at Precision Health MD in Fullerton, California. Her clinical focus includes perimenopause, testosterone therapy, metabolic health, and preventive medicine for patients seeking long-term health optimization.