Thyroid Function in Women
Healthy Thyroid Function and Maintaining Optimal Thyroid Levels
Millions of men and women around the world suffer from thyroid dysfunction. Disorders of the thyroid affect more women than men and commonly goes undiagnosed. It is estimated that 1 in 7 Americans have a thyroid disorder, but just over 40 percent are diagnosed and seeking treatment.
Why are so many women impacted by thyroid disorder?
Eighty percent of thyroid disorders are diagnosed in women. Some statistics blame the disparity between men and women when it comes to seeking care for ailments (a 2019 survey found 72 percent of men would rather do household chores than go to the doctor.) However, thyroid function is a highly delicate feedback loop that impacts multiple body systems. Women face multiple hormonal transitions across a lifetime—such as menopause and pregnancy—making them more susceptible to dysfunction compared to men.
The thyroid impacts several aspects of everyday function in the body, including sleep-wake cycles, regulation of your metabolism, hungry and full signals, temperature regulation, and much more. An untreated thyroid issue can significantly impair your wellbeing and keep you from enjoying simple activities, but it can also put you at risk for serious diseases, like osteoporosis, heart disease, and certain cancers. If you know—or even suspect—your thyroid is dysfunctional, it is a significant health risk to avoid treatment.
The butterfly-shaped gland located in the base of the neck is the thyroid gland. This tiny organ is responsible for secreting a variety of hormones that regulate development, growth, metabolism and body temperature. The primary hormones released by the thyroid gland are thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4).
The pituitary gland in the brain sends a signal to the thyroid gland to release TSH. This signal regulates thyroid hormone levels of T3 and T4. T3 and T4 are highly involved in the amount of energy your body uses to perform basic functions, such as breathing and temperature regulation, while at rest (also known as your basal metabolic rate or BMR). Iodine is a key building block for making T3 and T4. Iodine must be consumed through the diet. In the United States, iodine was added to table salt to reduce or eliminate thyroid diseases commonly observed in developing nations. However, poor soil quality due to diminishing environmental conditions in the U.S. have increased the presence of thyroid disorders.
Calcitonin is another hormone produced by the thyroid gland that supports calcium and bone metabolism. Thyroid dysfunction can lead to severe cases of osteoporosis or contribute to falls and bone breaks later in life.
Individuals suffering from thyroid dysfunction often experience a diminished quality of life and are at risk for a number of illnesses because the hormones of the thyroid gland impact almost every cell in the body.
The Thyroid Hormones
What is thyroid stimulating hormone?
TSH or thyroid-stimulating hormone is the most renowned of the thyroid hormones. As previously noted, it is responsible for regulating the production of the other vital thyroid hormones, T3 and T4.
It is common for to test TSH levels when assessing the function of the thyroid gland. Under the standard healthcare model, if TSH levels are deemed outside of “normal” the patient will be diagnosed with one of two forms of thyroid dysfunction. The standard classifications are TSH levels that are too low, known as hypothyroidism or too high, known as hyperthyroidism. These ranges of normal are large, very non-specific and fail to account for the difference between “optimal function” and “normal.” “Normal” for you may not be “normal” for another individual making it important to look at multiple parameters to assess thyroid function and make changes to achieve optimal function.
What is T3 (triiodothyronine)?
T4 (thyroxine) is the primary thyroid hormone produced in the body. To function, T4 must be converted to T3. The conversion of T3 to T4 occurs mainly in the liver. The amount of T4 produced is controlled by TSH. Low levels of T4 trigger the production of TSH by the pituitary gland while high levels of T3 or T4 inhibit the release of TSH. Most of the thyroid hormone in the bloodstream travels around bound to proteins. Bound hormones are virtually ineffective. The portion of the T3 and T4 that are unbound are free portions that are biologically active.
If there is too much T3 circulating in the body, the condition is known as thyrotoxicosis. AN abundance of Ts is associated with hyperthyroidism, Graves’ disease and goiter (swelling of the neck due to an enlarged thyroid). An imbalance of T3 is characterized by such symptoms as heat intolerance, unexplained weight loss, irregular menstrual cycles, rapid or irregular heartbeat, fatigue, hair thinning or loss and retraction of the eyelids (bulging eyes).
What is T4 (thyroxine)?
Thyroxine, more commonly known as T4, is the principal hormone secreted into the bloodstream by the thyroid gland. Once released, the majority of T4 is converted to T3. T4 is part of the same feedback loop as T3 and TSH. Levels of each hormone support the balance of the others. An overactive thyroid may produce too much T4, which can result in a higher rate of conversion to T3 and present the same as an overabundance of T3 production—same symptoms, same diseases, but different root cause.
Here, it is important to note that thyroid function testing that limits the focus to TSH levels are dismissing the role of T3 and T4 in maintaining optimal function of the thyroid gland. These hormones work on a feedback loop—too much or too little of one or the other can result in uncomfortable symptoms and thyroid disease. The conversion of T4 to T3 means that low levels of T3 may be caused by poor production of T4 or it could be that T4 is being produced but not converted properly. Too little of either hormone will increase production of TSH. To achieve optimal outcomes, it is necessary to know which thyroid hormone is to blame for the imbalance.
What is Reverse T3?
Reverse T3 (rT3) is the inactive metabolite of T4. As an inactive component, reverse T3 is unable to complete the role of T3, which delivers oxygen and energy to the cells throughout the body. Reverse T3 is typically produced when levels of T4 are high and conversion to T3 is inadequate. In healthy patients, this scenario may occur when a patient is prescribed T4 alone, rather than a combination of both T4 and T3 for thyroid hormone therapy.
Signs and Symptoms of Thyroid Dysfunction
The signs and symptoms of a thyroid issues or thyroid disease are easy to dismiss, especially when symptoms initially appear. Feeling tired or sluggish, gaining or losing weight, and mood swings may easily be written off as side effects of everyday life. When you are busy with a job, family or social obligations, it can be hard to notice when the symptoms stack up. However, when the symptoms extend to greater, more obvious discomforts, like hair loss, heart palpitations or heat/cold intolerance, you may start ask, what is wrong with me? Ignoring these symptoms is risky since untreated thyroid disorders can develop into much more serious diseases, including osteoporosis, heart disease and thyroid cancers.
HYPOTHYROIDISM (Underactive Thyroid)
Low production of thyroid hormone is diagnosed as hypothyroidism, or an underactive thyroid gland. Elevated TSH levels are often the warning sign for this condition. Some patients, however, suffer from subclinical hypothyroidism. Subclinical hypothyroidism presents with only slightly elevated levels of TSH, but normal levels of T3 and T4. Approximately 8 percent of underactive thyroid disorders present this way.
Regardless if the hypothyroidism is subclinical or not, the condition is commonly misdiagnosed or goes completely undiagnosed. This is because nutrient deficiencies and stress can skew test results, if TSH is the only hormone tested.
For example, if T3 and T4 thyroid hormone levels are low, TSH will increase. This is a red flag that there is inadequate thyroid function. However, some things like low selenium, stress and high cortisol levels can suppress TSH. In this case, you could be in a high stress situation and have a poorly functioning thyroid, but your TSH would not increase to signify low thyroid function because it is being suppressed by high cortisol. For this reason, comprehensive thyroid testing so essential to effective treatment of a thyroid disorder.
Symptoms of hypothyroidism include:
Hyperthyroidism (Overactive Thyroid)
Overproduction of the thyroid hormone, thyroxine, is diagnosed as hyperthyroidism, or an overactive thyroid gland. This condition is typically linked to an autoimmune disorder, thyroid nodules, thyroiditis, overconsumption of iodine or excessive doses of synthetic thyroid hormone.
Symptoms of hyperthyroidism include:
Thyroid Function Testing
The most common form of thyroid function testing is a TSH test. However, this isn’t a popularity contest. As they say, what is popular may not always be right and what is right, may not always be popular. Many physicians who are not highly trained and educated in the field of hormone health or are not specialized in thyroid health may not be aware of more extensive forms of thyroid testing or even understand the vast complications of thyroid dysfunction.
In 2007, a review led by the Society of Endocrinologists was found to exclude people with borderline low thyroid function, leading the group to change the upper and lower limits for dysfunction. Despite the change in recommendation, many physicians that do specialize in endocrinology or hormone disorders still use the outdated ranges, leaving millions of patients untreated and undiagnosed.
At EVEXIAS Health Solutions, each practitioner is highly trained in hormone balance and thyroid health and is supported with continuing education in the advancements in hormone therapy and the latest research on hormonal health topics, including thyroid function. Theses updates are taken into consideration when testing patients for thyroid disorders.
What are Normal Thyroid Levels?
“Normal” is one of those ambiguous terms that attempts to classify things without construct or definition. It has become well-known that every individual is unique. The same is true when examining your thyroid hormone levels. “Normal” levels for one person may be not-so-normal for another. This is why it is a mistake to use broad ranges to characterize and diagnose thyroid disorders.
What do you hope to accomplish when you seek medical treatment? Restored function, right? However, if you have a choice between just functional or optimally functional, which would you choose? Of course, you want the very best.
Comprehensive lab testing and face-to-face consultations are vital to accurate diagnosis and treatment of thyroid disorders. If you are having symptoms of a thyroid disorder, your doctor must test TSH, T3, T4, reverse T3 and even look at your cortisol levels. He or she should take the time to chat with you about how life has changed since your symptoms began. Your medical history and lifestyle are also important factors in treatment and diagnosis. The most effective treatment will ideally fit your needs and not some poorly defined version of “normal.” When each factor is examined, your physician can develop a treatment strategy that will ensure the result is an optimally functional thyroid gland.
Hormone Therapy for Thyroid Disorders
The most common form of hormone therapy for the treatment of thyroid disorders is the synthetic version of T4, known as levothyroxine. Most consumers know the drug by its brand names, such as Synthroid, Levoxyl, and Tirosint. Patients taking these drugs do not always express satisfaction with the outcomes. The problem with using these medications alone is that they exclusively restore T4. For many patients, T4 may be inadequate therapy because if the problem is poor conversion of T4 to T3, adding more T4 will not solve the problem.
Prescriptions for synthetic hormones to treat thyroid disorders are often inaccurate or ineffective because the lab testing to reach a diagnosis and treatment plan was highly limited. When a practitioner only tests TSH levels rather than all the hormones involved in thyroid disorder—TSH, T3, T4, reverse, T3, and cortisol—the picture is incomplete.
Balancing Thyroid Levels
Bioidentical hormone therapy is a highly effective solution to thyroid disorders and often works best when paired with high-quality nutraceuticals or medicinal herbs designed to support healthy thyroid function.
Nutritional deficiencies and stress have significant impact on optimal thyroid function. Low levels of the mineral selenium often contribute to thyroid dysfunction for many patients. In these cases, an effective treatment plan would include selenium supplements and accompanying supplements or herbs to promote absorption.
When stress plays a role in thyroid dysfunction, levels of cortisol often help tell the story. For patients with unbalanced cortisol levels, and effective treatment plan may include meditation, mindfulness exercises, or recommendations for a peaceful night’s sleep. Stress triggers the release of cortisol, as does poor quality sleep, too little sleep and being unable to relax.
Achieve optimal function and balance with thyroid disorder is challenging and takes times. The thyroid hormones operate on delicate, highly dependent feedback loop which pinpointing makes pinpointing the precise treatment an art. The appropriate lab testing, patient to doctor conversations and analysis must occur to arrive at the best treatment plan.
The practitioners of the EVEXIAS Health Solutions begin every consultation with thorough lab testing to ensure they get a complete picture of what is happening inside the body. Testing includes assessment of all the thyroid hormones, plus reverse T3 and cortisol. After reviewing your lab results and medical history, your provider will chat with you about your lifestyle and how things have changes with the onset of symptoms.
With a clear understanding of your condition, your provider will partner with you to develop a treatment plan to suite your lifestyle and restore hormonal balance, wellbeing, and optimal function.
Thyroid disorders should not be ignored. Untreated thyroid issues worsen and compile symptoms, as well as increase your risk of certain diseases. Seeking help is the first step to reclaiming your life. Although healing won’t happen overnight, if you take this first step on your journey today, you can start feeling better much sooner.
Stop suffering from low energy, sleepless nights, and inexplicable changes to your weight, contact a partner practitioner of EVEXIAS Health Solutions. Begin your journey to feeling better, living healthier, and enjoying the highest quality of life.