“I’m tired all the time, my hair is falling out, my brain feels foggy, and my weight keeps rising for no reason.”

Let me guess. Your doctor shrugs those classic signs of hypothyroidism off as normal, imaginary, related to some other medical condition, or caused by eating too much and not exercising enough.

You might get lucky and have a doctor who actually listens to those symptoms and gives you the chance to try an increase in thyroid medication dosage to see how you feel. You finally start feeling better. You have more energy, your hair stops clogging the shower drain, your brain fog lifts, and the excess weight finally starts dropping off. You go back to your doctor happy that you’re finally feeling some relief. Then BAM.

Your doctors says, “Your TSH has fallen below the normal range. We must DECREASE your thyroid medication dosage.”

And one by one your symptoms return, some symptoms even worse than they were before and some new ones out of the blue.

Sound familiar?

t’s the same TSH thyroid saga that I’ve heard about from countless Hypothyroid Mom readers over the years.

TSH IS JUST NOT RELIABLE

The standard TSH normal range is around 1.0 to 5.0. That’s TOO WIDE.

Some doctors declare a patient normal with a range of 1.0 to 10.0. And that’s WAY TOO WIDE.

There are no words to describe that wretched thyroid fatigue that falls over you when TSH rises too high, even if it does fall between those dreaded standard ranges that are as wide as the Grand Canyon. I could barely get out of bed near 10.0 yet many doctors consider that completely normal and pass you a prescription for an anti-depressant because surely that deep fatigue must be a mental health issue not your thyroid, or so they assume.

THE CASE OF SUPPRESSED TSH

When a patient is taking the proper dosage of thyroid medication with complete relief of symptoms, the TSH may fall below the lab reference range, also called a suppressed TSH. The TSH will be quite low, and this will disturb the mainstream doctor who insists the patient is taking too much thyroid medication.

Even if there are no signs of over-medication, the patient’s medication will be automatically lowered all because of this “gold standard” TSH lab result. The issue can be settled by running additional thyroid lab markers like Free T4, Free T3, Reverse T3, and thyroid antibodies and focusing on the patient symptoms. The reality is that the interrelationship between TSH, Free T4 and Free T3 is patient specific and highly individual. Our symptoms are far more reliable than standard lab reference ranges. Unfortunately, most conventional doctors do not order additional labs and they are trained to base all decisions on TSH alone. In the conventional medical model, TSH reigns supreme and automatically dominates over patient symptoms. And here I present you one of the main reasons why there are so many unhappy thyroid patients in the world.

Even a miniscule amount of thyroid medication may be sufficient to drive down the TSH, and the doctor will then consider treatment dosage too high. But it’s not too high, in many cases.

A GROUNDBREAKING THYROID STUDY

April 18, 2019 in BMC Endocrine Disorders titled “Time for a reassessment of the treatment of hypothyroidism”, researchers wrote:

In the treatment for hypothyroidism, a historically symptom-orientated approach has given way to reliance on a single biochemical parameter, thyroid stimulating hormone (TSH).

Over the years when replacement therapy aimed at complete TSH suppression a relatively low rate of persistent hypothyroid complaints was reported by patients followed at a single institution, much lower than in the subsequent years when the relaxed TSH policy came into effect.

Time and time again, I have witnessed the power of my Hypothyroid Mom community that has amassed to over one million hypothyroid people worldwide. By listening carefully to my followers over the past decade, I have found common themes running through their stories. TSH suppression is a common one, and these themes are never a coincidence. The experiences of over one million people can’t be overlooked. It will take researchers decades to arrive at what I’ve discovered at Hypothyroid Mom and it will take the mainstream medical world even longer.

We know our bodies. We know our symptoms. And we know the standard TSH lab is unreliable. Point. Blank. Period.

Thyroid Lab Tests No One Tells You About

When the pituitary gland in the brain releases TSH, TSH stimulates the butterfly-shaped thyroid gland at the base of our necks to produce the thyroid hormones T4 and T3. The majority of thyroid hormones produced by the thyroid are T4, however T3 is the most active useable form of thyroid hormone that can be used in the cells of the body. The conversion of T4 to T3 is the critical element. By testing TSH, doctors are assuming that our bodies are properly converting the T4 to active T3.

For many hypothyroid sufferers like me, our bodies don’t convert T4 to T3 properly. In the care of doctors who only tested for TSH, my symptoms did not improve. They got much worse. It wasn’t until I found a doctor open to full thyroid testing including Free T3 that my symptoms improved. I personally feel my best when my Free T3 is in the top quarter of the normal range. As soon as my Free T3 falls to the middle or low in the so-called “normal” range I feel like a truck ran over me. My warning signs are clear as day waving a big red flag at me to tell me that my Free T3 is too low. I don’t even need a lab test to know it is too low, now that I know my body so well. For me, and everyone’s red flags will be different, but for me my very first warning signs that my Free T3 has fallen too low are major pounding relentless headaches, difficulty staying awake, fat collecting on my belly, and an overall achy feeling.

Since T3 is the most active useable form of thyroid hormone that can be used in the cells of the body, Free T3 is critically important. Unfortunately most mainstream doctors do NOT test for Free T3 levels. I’ve heard from hundreds of thousands of Hypothyroid Mom readers over the last ten years complaining that their doctors refuse to test Free T3 even though they are suffering terrible symptoms on their traditional treatment.

T4 must be converted into a usable form of T3 before the body can use it. In times of stress, such as major emotional or physical trauma, surgery, extreme dieting, chronic stress or illness, the body will convert T4 into inactive Reverse T3, also known as rT3, instead of the active Free T3 that our bodies require. Your TSH and T4 scores may look ‘normal’ however the person suffers hypothyroid symptoms due to the high levels of reverse T3. Few mainstream doctors test for reverse T3, declaring a patient’s thyroid lab tests completely ‘normal’ all the while their patient suffers debilitating symptoms because their reverse T3 was not tested. One of the main reasons that hypothyroid people still feel sick is that elevated Reverse T3 is on a rampage in such stressful times that we have especially experienced over the last few years and no one is testing Reverse T3 but they should.

Hashimoto’s disease is an autoimmune disease where the body has turned on itself and attacks and destroys its own thyroid gland. It is a leading cause of hypothyroidism, yet the mainstream medical model does not include two thyroid antibodies – Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies(TgAb).

A full thyroid panel for hypothyroidism should include these 6 key thyroid lab tests. Request a copy of your thyroid lab results. Check them. Yes check them carefully one by one. Keep a file of them. You will be surprised the themes that you will notice begin to emerge. The “optimal” ranges for your body are specific to your body and that’s part of what makes thyroid treatment so darn tricky for doctors to figure out. They are  missing the point of bio-individuality. It was by carefully going over my lab results one by one and watching the patterns of where my lab results fell when I felt okay, when I felt awful, and when I felt great that I finally figured out my body’s particular optimal ranges.

If you find that some or many of these markers have not been taken for you, your first step is to request them by name. And remember to always keep a copy of your lab results and compare.

Here are the “optimal” ranges listed below based on all the many doctors that I’ve had the opportunity to meet over my ten years as Hypothyroid Mom. You will notice they are much narrower ranges than the “normal” ranges provided by the lab companies that you will find on your lab results. The “normal” ranges are far too wide which is why it is so frustrating to hear our thyroid is “fine” because it falls within these broad ranges but you know that you are far from “fine”. We know our bodies. Also your lab may use different units of measurement than what I list below. Please remember that bio-individuality plays such a big role in thyroid disease that they too are just guidelines. The goal is to find a doctor who will help you find the precise ranges that are right for you that make you feel wonderful with elimination of your symptoms.

Need help finding a great thyroid doctor? Let’s talk.

TSH               0.5-1.5 μIU/mL

Free T4         1.4-1.8 ng/dL

Free T3         3.7-4.4 pg/mL

Reverse T3   <15 ng/dL  

Thyroid Peroxidase Antibodies (TPOAb)     <2 IU/mL

Thyroglobulin Antibodies (TgAb)                   <2 IU/mL

On the traditional TSH and T4-only levothyroxine protocol, I was scared. I was slipping downhill fast and I knew it.

I know that I’m not alone.

Wishing you all the very best in health,
Dana Trentini

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