Hypothyroidism is caused by a deficiency in T3 hormone. Usually this leads to high TSH levels, which is often the sole basis for diagnosis. However, TSH can be normal despite low T3. The standard treatment - T4 hormone supplements - will not work for those whose cells have trouble converting T4 to T3. Such patients tend to get misdiagnosed and treated for fatigue, depression, obesity, etc. without success.
What Is Hashimoto’s Thyroiditis?
It is an autoimmune disease of the thyroid that has been increasing over time and is still largely undiagnosed and undertreated. The reason for this is that most primary care physicians only test for TSH (Thyroid Stimulating Hormone) so they miss a lot of pathologies when it comes to the thyroid gland, especially hypothyroidism and Hashimoto’s.
Hyperthyroidism is more easily detected through TSH and the patient’s symptoms are specific to hyperthyroidism.
Patients with an underactive thyroid (Hypothyroidism) and Hashimoto’s have symptoms that are common for many other disease processes such as chronic fatigue syndrome, fibromyalgia, depression, anxiety, obesity, etc. These patients get missed for the proper diagnoses and instead, get treated for depression, told to lose weight, etc.
Causes And Symptoms Of Hashimoto’s Thyroiditis
The thyroid gland produces T4 which is largely inactive. This hormone is transported to the nucleus of every cell in the body. Here it is converted to T3. This transportation process into the nucleus and the actual conversion to T3 depends on the presence of plenty of ATP (cellular energy), trace minerals, and iodine. Most Americans have poor cellular energy and deficient trace minerals due to long-standing undernourishment. It is no wonder that Hypothyroidism and Hashimoto’s are on the rise. In addition, the presence of heavy metals creates an autoimmune process in the body which can lead to Hashimoto’s disease (antibodies against the thyroid).
The symptoms of Hashimoto’s and Hypothyroidism (with or without normal blood work) include chronic fatigue, depression, anxiety, thinning hair, inability to lose weight, high cholesterol, low sex drive, irregular periods, joint and muscle aches. By looking at this list, one can see how Hashimoto’s and subclinical hypothyroidism get missed.
Why Measuring Only TSH Doesn’t Work
Typically the physicians that regularly see their patients test for TSH only and not the thyroid markers themselves which are T4 and T3.
TSH is secreted by the pituitary gland when it detects low levels of T3 inside the hypothalamus. Therefore, when TSH is elevated the patient is low on thyroid hormone. However, just measuring TSH without T4 and T3 is an inaccurate measure for the rest of the body as the hypothalamus lacks a regulatory protein that is present everywhere else. Because this inhibitory protein is not there, the hypothalamus has higher levels of T3 than anywhere else in the body. Therefore, patients who have under-active thyroid glands often have normal TSH and so the doctor does not prescribe thyroid hormone.
The increasing amount of misdiagnosed patients who desperately need T3 is attributed to ordering the wrong blood tests. These patients are commonly misdiagnosed with something else like depression and chronic fatigue and forced to live in mystery as to why the doctor’s treatment isn’t working and why their blood tests are “normal”.
When TSH levels are elevated on a blood test, the conventional treatment is Synthroid which is T4, the inactive hormone. Recall that the inactive T4 is converted to the active T3 and that this conversion is rate dependent on nutrients and cellular energy. Unfortunately, this conversion process is assumed to be perfect in all patients, therefore, even with the proper diagnosis of Hypothyroidism or Hashimoto’s, the treatment is ineffective, and once again the patients question why the symptoms persist in spite of the prescribed treatment.
The answer to all of this is simple. Order a full thyroid panel and prescribe T3 more often than not for most patients.