The most common cause of hypothyroidism in the U.S. is Hashimoto's disease (an autoimmune condition) in which the immune system mistakes the thyroid for a foreign invader and starts to attack it.
The thyroid gland located in the throat produces the thyroid hormone T4 (Thyroxin)
Fig 1. When T4 levels reach a certain level they cause the brain to stop producing TSH (thyroid stimulating hormone) so that it stops stimulating the thyroid to release T4 (similar to the way the the toilet stops filling after flushing once the float rises back up again). That is why when your MD wants to check your Thyroid function they will usually order T4 & TSH when they run a blood test. If the T4 is low and the TSH is high then they know you have hypothyroidism, and they prescribe thyroid replacement medication in an attempt to bring up the levels of T4 to within the laboratory range.
Unfortuantely, very often these are the only thyroid tests they order. According to the work of Datis Kharrizian, there are at least 8 different patterns of thyroid diease and only one of them is found by the standard lab reference ranges.
In addition there are 22 sites of thyroid metabolic defects possible that could be responsible for the patient's low thyroid symptoms that cannot be assessed by just these two tests alone. To assess thyroid function I recommend a full thyroid pannel which includes: TSH, Total T4 (TT4), Free T4 (FT4) (unbound), Free Thyroxine Index (FTI), Tesin T3 Uptake (T3U), Total T3 (TT3), Free T3 (FT3) (Unbound), TGA, TPO-Ab, and in some cases a Reverse T3 (rT3). Thyroid hormone functional reference range
WE CAN ORDER YOUR THYROID TESTS ON THIS WEBSITE TO FIND OUT WHICH PATTERN YOU MAY HAVE (the blood draw & testing is done at your local LabCorp).
Here a common scenario, the patient has been experiencing symptoms of hypothyroidism (fatigue, depression, cold hypersensitivity, hair loss, weight gain, dry/itchy skin, facial swelling, or constipation) but, when they happened to have their blood tested their immune system had attacked their thyroid releasing stored T4 which resulted in normal T4 & TSH levels. The MD sees these results and dismisses a diagnosis of hypothyroid. Instead they prescribe individual medications to alleviate all of the symptoms. They prescribe antidepressants, recommend that you increase your exercise, change your diet and lose some weight, and fiber or stool softeners to treat the constipation.
When the immune system attacks and destroys thyroid tissue stored thyroid hormone T4 (thyroxin) can be released into the bloodstream. If this happens then this can cause an increase in metabolism and result in hyperthyroid symptoms (anxiety, palpations, increased blood pressure, or increased heart rate). However, this would only show up on a blood test when the thyroid is under attack. Since the attacks come intermittently, if the blood test was done in between attacks, the T4 would be normal or elevated and the TSH would be normal or low. Your MD would think that the thyroid is normal and would probably prescribe anti-anxiety medication or refer you to a psychologist.
The patient reports occasional relief but, eventually has tried several medications and even changed their doctors to try and get some relief to no avail. This is because the underlying autoimmune component was never addressed. Add to this the fact that ~90-98% of all Hashimoto's patients have a sensitivity, intollerance or allergy (Celia disease) to
Gluten (glaidin protein) and that when they eat foods that contain gluten (breads, pasta, grains) that they are going to flare-up their autoimmune Hashimoto's attack on their thyroid. Even an accidental exposure can rev up the immune system destruction on the tyroid and last for up to 3 months later. If you want to get better then eliminating Gluten is a wise choice!!!
An enlarged thyroid can lead to the appearance of a Goiter.
FORTUNATELY, YOU CAN GET HELP HERE!
All the consultation services, diagnostic testing, and therapeutic products are available here! There are two tests for Hashimoto's hypothyroidism:
TGA (Thyroglobulin binding Antibody)
TPO-Ab (Thyroid Peroxidase enzyme Antibody)
If either one of these is positive that means you have Hashimoto's.
The reason the MD is hesitant to order these two tests, is that even if you tested positive it wouldn't change their treatment protocol, they would still give thyroid replacement medication to try and balance the T4 levels. Whenever the autoimmune attack flares-up or receeds the levels of T4 change and so the MD is constantly trying to change the dose or even the type of thyroid medication in order to keep up with the patient's symptom complaints. Treating this conditions without modulating the immune system is like a dog trying to catch his tail.
Even if they do get somewhat stabilized with their medication the two most common symptoms that still persist are Low energy & Depression. This is because even if the T4 levels are adjusted, the TSH levels & Thyroid Releasing Hormone (TRH) levels are suppressed.
"BRAIN FOG" IS QUITE COMMON.
Both TSH & TRH act on the brain chemical (neurotransmitter) production as well as the sensitivity of the receptor for the brain chemical. When these are low the patient will still feel fatigued and depressed even if they are on their thyroid replacement medication. In a desperate attempt some patients will even dangerously try and increase their dose on their own, to get some relief from these symptoms (please do not try this).
It is not uncommon for the patient to become so depressed & lethargic that they experience a lack of will to survive and even experience self-destructive thoughts. These can be a result of low Serotonin &/or Dopamine neurotransmitter levels. Functional integrative medicine works well with these conditions. Hashimoto's hypothyrodism can be an extremely debilitating disorder, do not get discouraged.
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