Has your doctor told you that your thyroid is "fine" but you know deep down that something is definitely off?
Are you losing more hair then you think you should? Have you suffered from miscarriage? Or terrible postpartum depression? Do you have uncontrollable mood swings? Mental fogginess? Are your hands and/or feet cold much of the time?
If so, then your thyroid is likely not "fine."
Most doctors only check TSH and maaaaybe T4. This does not give you the whole picture!!
First of all, the conventional range for thyroid markers is derived from blood levels from the average person that has gone in for blood-work. The average person in this country does not have an optimal functioning thyroid!
In a moment, I want to talk about functional medicine ranges for thyroid markers, but first, I'll explain functional medicine. While modern conventional medicine is excellent for injury and trauma, in other areas like chronic disease, it merely works to stop symptoms.
Got high blood pressure? Take this pill. Got high cholesterol? Take this pill. Have an inflammatory condition? Take this pill. Got acid reflux? Take this pill! Got low functioning thyroid? Take this pill!
Functional medicine seeks to get to the root cause of why the blood pressure or cholesterol is high; what’s causing the inflammation or reflux or sluggish thyroid.
When we address and target the root cause, the downstream effects usually fall into place.
Functional lab ranges are derived from optimally functioning bodies. This is a much tighter range.
Okay, back to the thyroid:
The reason only checking TSH and T4 doesn't give you the whole picture is because we want to see what's happening in the whole pathway - production, conversion and uptake.
If we only look at these one or two markers, we can't tell how well the body is using what's produced, if it's even being produced enough.
TSH is a measure of how much the pituitary is trying to stimulate the thyroid gland. If TSH is off, it may be that there's nothing wrong with the thyroid, it could be that the pituitary's messages are garbled.
T4 is the inactive form of thyroid hormone. Most of it needs to be converted to T3, the usable form.
Many things, especially this day in age, hinder T4 to T3 conversion - gut issues, stress, toxins, basically anything that creates inflammation and cortisol wonkiness.
Your T4 could look fiiiine, but that's not telling us how much the body is getting of the stuff it needs to spark the cells to do their jobs.
There are quite a few other markers that should be checked in a complete thyroid panel (like thyroid binding globulin and T3 uptake), but i'm just going to touch on ones your provider would likely oblige you with. Either way, antibodies must be part of the panel!
Antibodies are proteins that the immune system produces against something it "flags" as offensive to the body. If someone has elevated antibodies, they likely will be diagnosed with Hashimoto's, the autoimmune disease that attacks the thyroid.
This is essential to know, because it will determine if you have a true sluggish/hypothyroid issue, or if it's an immune system issue, where the immune system is seeing the thyroid as a foreign enemy and destroying it, thereby lowering it's functional ability.
Grave's disease is a less common autoimmune thyroid condition where the thyroid enlarges and becomes overactive, causing hyperthyroid symptoms.
This information is out there, hiding in plain sight on the internet and in books like Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal? by Dr. Datis Kharrazian, so I'm baffled as to why this info seems so obscure (well, not really).
So here ya go, a list of markers to ask for and what the optimal functioning range should be.
We want more than to just be within the "normal range." We want to be in the optimal functioning range.
Do you want to be "not sick" or do you want to feel like your body is optimally functioning?!
By the way, thyroid imbalance isn’t a cause of something; it is an effect of something further upstream!
How are the adrenals functioning? Do you have a viral or bacterial infection that was never fully dealt with? Is your body dealing with toxic load? Do you have nutritional deficiencies? Is your gut all jacked up?
If thyroid levels are off, we need to dig deeper into the root cause.
So whip out your past lab tests and feast your eyes on these ranges!
NOTE: If your thyroid numbers fall within functional ranges but you are still having symptoms, it could be thyroid resistance, where the thyroid hormones aren't getting into the cells where they are needed, causing hypothyroid symptoms. This could be a receptor issue (partially due to thyroid receptor genes predisposition) or caused by chronic stress/cortisol dysregulation.
While optimal functional ranges vary from practitioner to practitioner, the range is still tighter than the conventional medical range. These are the bare minimum markers you should ask for.
TSH: 1.8 - 3.0 mU/L (I've commonly seen this as 1-2 as well, especially in women trying to conceive, so I personally like to see it between 1 and 2.5). Conventional range is 0.45-4.5!
Free T4: 1.0 - 1.5 ng/dL
Free T3: 3.0 - 4.5 pg/mL
Reverse T3: 9.0 - 35 ng/dL - Reverse T3 is produced in cases of extreme or chronic stress, trauma or infection. Rather than producing T3, rT3 is created, which is an unusable form of T3. This slows down your metabolism so that the body can conserve energy. If this is elevated, it's your body's way of saying it needs to rest and repair.
Thyroid Peroxidase Antibodies and Thyroglobulin Antibodies: These vary the most between functional medicine practitioners. Some say you want them less than 20, some say less than 10, and I've even seen quite a few ranges say less than 2! I gauge my clients based on symptoms and how they react to certain substances that can indicate
Hopefully your doctor will be receptive to testing for these markers, as well as interpreting them within a functional range.
Also, I'm considering making a video about nutrients that support thyroid functioning, INCLUDING ONES YOU MIGHT WANT TO AVOID. I check nutrient levels and support them before I recommend an outright thyroid supplement like a glandular. Leave a comment if this would be of interest to you!
(If you would like scholarly references, or would like to work with me, please feel free to contact me)