Why Thyroid tests need updating

If you've struggled to get your hypothyroid diagnosed then you know all to well the battle it can take to get your doctor to pay attention to your symptoms, even when your lab tests are showing up normal.

It's estimated that 60% of thyroid disorders are undiagnosed. This is horrifying, especially when you go beyond the number and look at the women who are included in this number (thyroid disorders afflict women 5+ times more than men). It's horrifying because untreated hypothyroid issues are not easy to navigate.

Issues like extreme fatigue (can't get out of bed in the morning despite sleeping 8 full hours tired), weight gain despite an hour busting your butt on the elliptical everyday, hair falling out, not being able to remember where you put your keys (every.single.time). It's a hard world to navigate when your thyroid is sluggish. Not to mention most of us with low thyroid are moms. And guess what, being a mom doesn't end at 5 pm!

Learning you have low thyroid issues is the first step to healing. 

But the standard testing process is missing a whole lot of cases. Here's why...

The standard test doctors will run to check for thyroid issues is to check Thyroid Stimulating Hormone, or TSH, levels. If these levels are in the 'normal' range then doctors will often send you on your way and chalk your symptoms up to standard complaints.

There are 2 things wrong with this:

  1. TSH levels tell only one part of the story. A basic overview of how our thyroid system works:
    The Pituitary Gland stimulates TSH --> TSH stimulates the thyroid gland to then release thyroid hormones T4 and T3 --> When the thyroid hormones are low, more TSH released and the cycle continues. So if the thyroid hormones are low more TSH is needed, elevating TSH levels. This is what the TSH test is checking.

    The problem is the difference between T4 and T3. There is more T4 produced than T3, but T3 is the more active form (does the work within the cells). Most of T4 is converted to T3 when needed. But for some of us the conversion can't happen. There are a number of factors that cause this, I'll go into that in a different post. 

    When T4 isn't being converted to T3 we don't have enough active thyroid hormone to work in the cells. But the T4 levels don't drop so TSH isn't effected, thus the levels look normal!
     
  2. The range is too wide. These ranges were set based on an average of thyroid tests. Researchers determined that the range 0.5 - 4.5 mlU/L is normal based on reviewing a whole gammit of thyroid TSH tests. The thing is these tests weren't from 'healthy' individuals. These tests were mostly from those with probable thyroid issues. Somehow this detail was missed, and the range was still passed through. 

    Many believe a better range to use is 0.5 - 2.0 mlU/L. Anything above 2.0 indicates thyroid issues (or the beginning of thyroid issues). 

    I should note, hyperthyroid TSH levels are lower, indicating underproduction of TSH and overproduction of the thyroid hormones.

Thankfully many doctors are updating their standard protocols. But it's important to bring in your own information and request further testing and review the numbers yourself, especially when your symptoms are matching up with thyroid issues.