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Eat Yourself Healthy – Sally Joseph

Why your thyroid pathology maybe ‘normal’ but you don’t feel it

Why your thyroid pathology maybe 'normal' but you don't feel it


If you’ve been following my blog, you may recall in my previous thyroid post that when it comes to pathology testing, you only find what you look for  and this certainly applies to sufferers of thyroid disorders.  Over 40% of women suffer from an underactive thyroid,  yet the majority of them are going undiagnosed or being told by their Dr they have ‘normal’ thyroid pathology results, despite presenting with classic underactive thyroid symptoms of fatigue, weight gain, depression and brain fog.   Worse still, even the cases that are being diagnosed, are either receiving inadequate diagnosis and or treatment.

This was my experience over ten years ago, when I gained ten kilo’s in ten weeks, despite no changes to my diet or exercise routine ( at the time I was running 6 laps of Bondi beach, 5 days a week), thanks to the onset of Hashimoto’s and a pituitary adenoma.  Dr’s prescribed me T4 thyroid hormone in the form of a drug known as Thyroxine, which didn’t provide an ounce of relief from my symptoms, even though my thyroid function looked ‘pretty on paper’ – according to my pathology results.   This lead my Dr to conclude I was ‘all better’ despite the fact that I continued to feel like a giant pile of poop.

An underactive thyroid can have a devastating impact on your health,  and so many women are suffering unnecessarily due all because too many Dr’s don’t know how to adequately test and assess thyroid function effectively.  Its a little known fact that an underactive thyroid can also be the underlying cause of many other related illnesses – including depression, anxiety, chronic fatigue, cognitive dysfunction, atherosclerosis, high cholesterol and poor immune function.

I get so frustrated when I see a patient presenting with textbook classic symptoms for hypothyroidism, only to hear their Dr told them their thyroid function is completely  ‘normal’, because their TSH ( thyroid stimulating Hormone) level was within range!  Not only is the reference range for TSH outdated, (because it was developed to measure your health against a disease state vs a state of optimal health), but a patient can indeed have a ‘normal’ TSH level, yet still be suffering from an underactive thyroid.

If you have typical hypothyroid symptoms, but your lab tests are ‘normal’, your Dr may have prescribed you with an antidepressant, pain killer, or insomnia medication, rather than running the full gamut of pathology tests required for accurate diagnosis and treatment.  Many thyroid conditions are resulting from chronic nutrient deficiencies, including essential minerals like selenium, iron and iodine as well as vitamin D – ALL of which are required by the thyroid to make sufficient levels of thyroid hormones. Yet the majority of Dr’s are failing to even test these nutrient levels, let alone consider prescribing adequate doses.

There’s no doubt thyroid physiology is complex, requiring the adequate production, conversion and uptake of thyroid hormone for optimal function.  If any of these steps are skipped, you will continue to experience hypothyroid symptoms.   The tricky part is, not all of these necessary steps may show up in standard pathology tests, which is another reason so many hypothyroid sufferers fail to get diagnosed OR continue to experience hypothyroid symptoms, despite taking thyroid medication.

There are many factors that can influence your thyroid function and why you may not be responding to treatment effectively.  

  1. Elevated cortisol  (caused by chronic stress, pregnancy, acute infection, insulin resistance or diabetes ) exhausts the pituitary gland, impairing its ability to signal to the thyroid to release adequate thyroid hormone.  In this situation, the function of the thyroid gland may be perfectly fine, but its just not receiving the right messages from the pituitary gland. So in this scenario, you need to address the cause of the elevated cortisol. Meditation is one sure fire way to regulate elevated cortisol as well as taking specific herbs that support adrenal function like rhodiola.
  1. Failure to convert T4 to T3 – T4 is referred to as the ‘inactive’ form of thyroid hormone and needs to be converted to T3 before the body can use it to rev up your metabolism and energy amongst other things. Because the majority of thyroid hormone produced by the body is T4, if your body can not adequately convert it to the active form – T3 – you will continue to experience symptoms of hypothyroid.  Considering the majority of hypothyroid patients are prescribed T4 in the form of Thyroxine, there’s little wonder why so many sufferers don’t respond to this medication adequately.  The common cause of poor T4 to T3 conversion, is inflammation – usually associated with autoimmune and elevated cortisol levels. If you have your T3 levels tested in this situation, it likely to be low, despite TSH and T4 being within range.
  1. Elevated Thyroid Antibodies – seen in the case of Hashimoto’s autoimmune disease, is caused by chronic inflammation stemming from the gut, cortisol insufficiency, or elevated estrogen levels, due to taking the oral contraceptive pill or HRT for menopause which causes a condition known as oestrogen dominance.   You can read more about the causes  and effects of this condition in previous posts I’ve written here and here.  I recommend undertaking my liver detox and gut repair program to clear excess estrogen from the body and reduce systemic inflammation and elevated thyroid antibodies by healing your gut.
  1. Thyroid hormone resistance – this is usually caused by chronic stress and elevated cortisol levels, or even taking too much T3 hormone  – if you are taking a compounded form.  This is a classic scenario where more is not necessarily  a good thing!  I had one patient over dosed on her T3 thyroid hormone medication, thinking if she simply took more, it would speed up her metabolism, but instead it had the opposite effect and caused the thyroid hormone receptors to desensitise so she was unable to respond to treatment.

So as you can see there are many intricate factors that influence thyroid function and pathology results, which is why it’s essential to find a very experienced Dr or natural health practitioner to assess your case very thoroughly, and who will also take your symptoms into account, not just your pathology results and view you as more than just a number on a page.

If you have a story to share about your experiences with poor or inadequate diagnosis for an underactive thyroid, drop me a line in the comments section below and don’t forget to sign up to my newsletter to stay in the loop on my healthy tips for thyroid health.

Want to discover the secrets to losing weight and boosting your energy the natural way? Then grab a copy  of my e-book Eat Yourself Healthy In 28 Days

© All Rights Reserved Sally Joseph 2014

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  1. Hi Sally,
    I have a strong genetic history of hashimotos and graves plus all the typical hypothyroid symptoms! My nutritionist recently ordered blood work and found that my reverse T3 scores were through the roof. What are you thoughts on this measure of thyroid function?
    Best wishes, Kathy

  2. Morning Sally, I found your article an interesting read. I am 45 years old and work hard but don’t believe at this age I should be incapable of working hard, everyday I start out feeling like I am carrying lead weights. I was diagnosed with an underactive thyroid about 10 years ago. I have recently changed doctors as every time I went to my normal GP he kept telling me I just needed a holiday… I then found myself seeing a hormone spec as I thought I had started the change of life. After her running tests she said my hormones were fine it was my thyroid levels were way out. She suggested that I stay off all gluten products as she felt they were masking my thyroid ?? What are your thoughts on this… It may have helped a little but not hugely. Look forward to your reply. thanks Helen

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