Testing for Thyroid Health Properly

January 02, 2017

Thyroid Testing

 Assessing or Testing for thyroid health properly is essential in determining a true thyroid condition. To do this, we must first understand what the thyroid is and what it does for our bodies.

The thyroid is an important gland located within our necks.  Its purpose is to produce thyroid hormones, which are responsible for a number of different functions (to be discussed later in this article).   Unfortunately, the thyroid can become diseased like any other gland in your body.  When this occurs, it can cause a lot of health issues.  Here are some important facts with regard to Assessing Thyroid Health:


1) Thyroid dysfunction affects approximately 20 million  Americans. 

2) It is estimated that approximately 60% of those with thyroid disease are unaware of it. 

3) Women are 5 times more likely to develop a thyroid condition as compared to men. 

4) Nutritional deficiencies can contribute to thyroid dysfunction. 


Even after knowing some of the facts stated above, thyroid conditions are still under-diagnosed.  This can happen for a number of reasons, which I will cover in more detail later in this article.  Let’s take a closer look at how thyroid conditions can go unnoticed by health care practitioners, as well as how to properly assess thyroid disease in a more effective way.


The Thyroid’s Purpose


The thyroid is responsible for producing thyroid hormones (triiodothyronine or T3), thyroxine (T4) and calcitonin.  T3 is the active form of thyroid hormone, and its purpose is to maintain metabolic rate (your metabolism), growth and development.


What Tests are used to Determine Thyroid Function?


The standard tests that most conventional doctors use to determine your thyroid health are the following: TSH, Total T4, and some doctors measure Total T3 as well.  These are very limiting tests, and this will be explained later in this article. 

Each of these markers have their own purpose. Thyroid Stimulating Hormone (TSH), is a signaling hormone that is stored in the pituitary gland within your brain.  It is released under the control of the hypothalamus (the regulatory or control center), which is also part of your brain.  When your body needs more thyroid hormone, the hypothalamus signals the pituitary to release TSH. TSH circulates in the blood until it reaches the thyroid gland.  Once there, it signals the thyroid to produce the following hormones: T4, T3, T2 and T1.

Currently, most doctors only measured TSH, Total T4 and Total T3 to determine thyroid function.  As for T1’s and T2’s purposes, they are still yet to be determined.  The majority of hormone, approximately 80%,  produced in the thyroid is Thyroxine, (T4). Triiodothyronine (T3) (active form of thyroid hormone) is also generated in the thyroid, but only consists of approximately 20% of all hormones that it produces. Most T3 is formed outside the thyroid gland through the conversion of T4 hormone.  It is used in each cell in your body.

Once again, most of the T3 that your body needs is formed through the conversion of T4.  This conversion mainly takes place in the liver and kidneys, although it also happens in the rest of your body’s cells as well.  T4’s conversion to the active form of thyroid, T3, is accomplished through an enzyme called 5 ‘ Deiodinase, as well as through various nutrients, which I will list later.  

These three markers (TSH, T4, and T3) do have some use when testing for thyroid health, but their use is very limited.


Why Standard Tests Fail When Assess Thyroid Health


Even with science’s medical advancements, knowledge and testing, thyroid conditions are very much underdiagnosed.  There are various reasons for this occurrence. To start, most doctors test only a limited number of blood test markers when screening for thyroid health. For example, most doctors only test TSH, Total T4 and possibly Total T3, as stated earlier. Unfortunately, these tests do not illustrate a true picture of thyroid function.


To explain this as simply as possible, Total T4 is a measurement of all the T4 hormone in your body, which includes T4 that is both bound and unbound to proteins (free-T4). Total T4 hormone is mostly made up of protein bound thyroid. Bound hormone is not readily available to use in your body. Your body needs thyroid hormone that is readily available, or in its free (unbound) form. This is why it is most important to test free-T4 (FT4) and free-T3 (FT3).


A doctor should measure both of these hormones (FT3 and FT4) to properly assess thyroid hormone conversion and function.  Let’s say that your doctor only tests TSH and free-T4 and finds that they are both normal, but you still have symptoms that all match a thyroid condition, such as in hypothyroid (underactive thyroid). Without testing the free-T3, you would be missing the bigger picture.


There have been quite a few instances where patients of mine have had an issue with the 5’Deiodinase converting enzyme (a very important enzyme you body that converts T4 to the active form of thyroid, T3), and had a low FT3 level. In this instance, if FT3 isn’t tested, your condition may go undiagnosed for a long time leading to worsening symptoms or possible inappropriate treatment of a wrong diagnosis.


In addition to a conversion issue, the levels of T3 in your brain can be different from that in the rest of the body’s tissues (peripherally). Furthermore, T3 levels in your body’s tissues can be different than that in your blood. This means you can have normal T3 levels in your brain, and even your blood, while other parts of your body are experiencing deficiencies. And, if T3 is responsible for metabolic function (your metabolism), these deficient T3 areas will cause you to experience signs and symptoms of hypothyroidism (see Signs and Symptoms of Hypothyroidism below).


Another issue to consider is that your body could be deficient in particular minerals, such as selenium, zinc, B-vitamins, iodine, and amino acids.  All additionally contribute in some way to the formation of thyroid hormone, and/or the conversion of T4 to T3 (active form).  Deficiencies in any of these substances could lead to deficient free-T3, while T4 and TSH appear to be normal or even increased.


Even if all the appropriate testing markers are measured, most doctors are still trained only to read the so-called “normal ranges” when evaluating your blood test results. Unfortunately, the normal ranges are based on an average of what’s thought to be a large group of healthy people. This group includes everyone from young adults to the elderly. Unless your results fall outside of the “normal range,” your doctor may believe that everything is normal.


Recent scientific studies have demonstrated the “normal” range for TSH (0.45 – 4.5) is in fact outdated and has too great of a range to effectively assess proper thyroid function. This holds true for FT4 and FT3 as well.  Unfortunately, the medical community is usually very slow to adapt to change.

Once again, in some cases, you can have symptoms of thyroid dysfunction even when your blood test markers/levels are within normal range. This is why it is so important for a practitioner to understand and to record all your signs and symptoms. A clinical diagnosis (by interpreting signs and symptoms), in some cases, may be the only way to determine thyroid dysfunction.


Some Signs and Symptoms of Hypothyroidism (low thyroid function):


High cholesterol
Heart palpitations
Muscle cramping, joint pain
Panic attacks
Slow or decreased heart rate
Your voice sounds hoarse
Slow reflexes
Difficulty getting pregnant
Carpel tunnel syndrome
Brittle nails
Poor circulation
Fluid retention
Yellowing of skin and palms
Neck feels swollen
Puffy face
Muscle stiffness
Cancer (in extreme hypothyroidism)
Change in sleep patterns

Low body temperature (over a period of time)
Weight gain
You feel cold when others don’t
Feeling jittery or anxious
Appetite or taste buds altered
Brain fog (can’t think clearly)
Poor memory and/or concentration
Low interest in sex (decreased libido)
Thin and/or coarse or dry hair
Loss of hair, especially the outer 1/3 of your eyebrows
Dry skin
Constipation (bowel movement every 2 or more days)
Change in menses (periods)
Pain in extremities (arms, legs, hands, feet)
High blood pressure


You don’t need all of the above symptoms to have a thyroid condition. Any of the symptoms, whether having one or in combination, can indicate a thyroid condition.

Some Causes of Thyroid Dysfunction:


There are various reasons for thyroid dysfunction. These range from nutritional deficiencies (including diet, vitamins, minerals), to environmental toxins, as well as infections. Even medications that you may be taking can possibly affect your thyroid. In addition, women who are in menopause and who are post-menopausal can experience thyroid dysfunction. See below for more information on possible causes of hypothyroidism (underactive thyroid).

Nutritional Deficiencies:


  • Fasting, Starvation, Anorexia, Protein or Calorie Malnutrition

    Vitamin Deficiency:

    A, E, B12, B2, B3

    Mineral Deficiency:

    Selenium, Iodine, Iron, Zinc

    Amino Acids Deficiency:

    Cysteine, Tyrosine (with Iodine forms Thyroid Hormone)

    Also, excess consumption of goitrogens in food disrupt the production of thyroid hormones by interfering with iodine uptake in the thyroid gland. Examples of goitrogens are: cabbage, kale, Brussels sprouts, and others. That’s not to say that you should avoid these vegetables. You would have to eat a lot of RAW vegetables that contain goitrogens for it to affect your thyroid. In addition, these goitrogen containing vegetables can be eaten in large amounts if you cook them, which weakens the goitrogens.

Hormone Deficiencies:


  • Cortisol, Testosterone, and Estrogen imbalance (in excess)


Environmental Toxins:


  • Halogens: (Perchlorate, Chlorine, Fluorine, and Bromine)
    • All are found in our environment, and are in common substances such as household products (drinking water, beverages, toothpastes, and cleaning supplies)

  • Heavy Metals:  (Mercury, Cadmium, Lead)
    • Mercury can reduce or prevent the formation and conversion of thyroid hormone (exposure is usually from amalgam fillings/silver dental filling, eating fish, vaccinations and other injections,  certain cosmetics, old paints, from handling old broken thermometers incorrectly, and others)

    • Bromine displaces iodine and inhibits thyroid activity

    • Chlorine inhibits iodine uptake

    • Perchlorates inhibit iodine uptake

  • Pesticides:
    • Decrease TSH, FT3 and FT4

  • Radiation:
    • X-rays, CT-Scans

  • Excesses of:
    • Calcium, Lithium, Copper (impair conversion of T4 to T3)

    • Soy (impairs conversion of T4 to T3)

    • Estrogen

  • Medications:
    • For example:  amiodarone, carbamazepine, lithium, phenobarbitone, phenytoin, rifampin, and others.

    • These medications can induce goiters (abnormal enlargement of your thyroid gland) and suppress thyroid function.

Assessing or testing for thyroid health properly can be a bit tricky, and it’s not just determined by a blood test alone. Additionally, there can be many other factors that can either directly or indirectly affect your thyroid health. And sometimes, what may seem like a thyroid condition many not be at all. I have personally worked with a number of people who developed thyroid disease due to a variety of reasons, especially from infections like Lyme disease and from heavy metal toxicity, such as from mercury containing amalgam or silver fillings, as well as following amalgam fillings removed improperly.


This is why it is essential to have your thyroid assessed properly.  If you suspect that you have a thyroid condition, it’s important to seek out the advice of a licensed physician and never try to treat yourself alone. And remember, even though thyroid conditions may not always be obvious through conventional testing, with proper training, good listening skills (practitioner), and sometimes through the use of specialized labs, a properly trained health care provider can better determine thyroid health and function. If you need help, please feel free to contact me.