“I have gained weight and don’t know why. I’ve have been to many doctors and they’ve checked the thyroid blood work, but found everything is normal.” Sound familiar?
There are lots of reasons for a suddenly slower metabolism and weight gain. I am sharing this so you can use the information with your doctor team and get the best results for your health!
A holistic view of a person, means examining one’s lifestyle, diet, hydration, nutrient status, energy/sleep patterns, digestion, other health conditions and often we need a physical exam. It is important to talking about the degree of recent stress, traumatic life events, work/life balance. Testing is needed to confirm suspicions about the underlying causes of the weight gain or slower metabolism. Tests including an expanded thyroid panel with TSH, free T3, free T4, reverse T3 and the autoimmune thyroid antibodies and finally red blood cell selenium which is needed for the conversion of T4 to T3, the active hormone.
Reminder, What are the symptoms of hypothyroid?
- feeling puffy
- dry skin
- hair loss
- weight gain or slow metabolism
Additional testing needed? YES!
Remember, the thyroid gland is a part of a larger system, the endocrine system. These glands all work together actually. The pituitary, hypothalamus, adrenal, pancreas, ovaries, testes, and thyroid are a team. I am not about to quickly summarize this vast system, but just know that each is not working in isolation. When one gland suffers or is overworked, the others are affected.
Sex hormones and sex hormone binding globulin tests are needed because as we age and our sex hormones change, our thyroid hormones can also change. Also, the fasting insulin and hemoglobin A1C are needed. If the blood sugar control system is out of whack, many times so is the the free T3 active thyroid hormone. When adrenal cortisol is chronically high or low, the thyroid is affected. Might need a thyroid ultrasound too, if there is any sign of swelling in the gland.
So if you have been to the doctor and they have not run all these tests, you might want to ask and see if they can do a few more tests. See the complete list below. In the blood work reports you get back from your doctor, you can see there are “normal ranges”, and most doctors say you are fine if your numbers fall within those ranges. There are ways however to optimize your thyroid function and get those numbers into the optimal range.
Thyroid tests – Optimal ranges of TSH, Free T3, Free T4
First of all, to really get a good look at your thyroid function, you have to test blood TSH, free T3 and free T4. The value for TSH should be under 2, Free T3 should be minimum 3 and better closer to 4. Free T4 should be around 1.2 to 1.5. Checking the free levels is the best representation of what is actually happening with the conversion of T4 thyroid hormone to the active T3 hormone. Click here for more on hypothyroidism.
Other thyroid tests
Checking reverse T3 (rT3), tells us if your free T3 is being converted to this non-usable form of T3 hormone. This reveals that your state of health is currently lowering your free active thyroid hormone T3. There are many causes of increase rT3 such as dieting, diabetes, inflammation, stress, pms, autoimmune, toxins, insulin resistance, and leptin resistance (a resistance to feeling full).
Testing thyroid antibodies we are looking for a possible underlying auto immune condition called Hashimotos. It’s good to always ask for these specific tests from your doctor. The presence of these antibodies can lead to a long list of possible underlying causes to investigate, including chronic infections, environmental toxins and heavy metals, all things that can negatively impact your metabolism and thyroid gland.
Fight and flight adrenal connection to the thyroid
One gland that can affect thyroid gland function, is the adrenal gland. The adrenal gland is our fight/flight gland, and helps regulate sugar and salt in our bodies as well. The adrenal is most known for its production of cortisol or the ‘stress’ hormone, and adrenaline. When the body is in a time of very high or very low production of cortisol for a prolonged amount of time, it can slow down our metabolism, slow down the thyroid hormone production. Specifically, it can interfere with conversion of T4 hormone to T3 (active) hormone. So with less T3, we have a slower metabolism and each cell does not get the signals to utilize glucose / detoxify at the same rate as it should. Interesting to note that when T3 is low, it is more difficult to conceive a child. The body’s wisdom at work, not the time when stress is so high, it says.
Morning cortisol in the blood is an okay screening test but it is only accurate if it is low. When cortisol is high in the blood we can assume there was an in the moment stress during the blood draw such as the pain of the needle, etc. It is best to test adrenal gland function via saliva or urine tests, and to do 4 tests per 24 hours to get a full pattern of how your adrenals are working throughout the day/night.
Blood sugar issues and connection to the thyroid
When the pancreas is producing insulin, it is attempting to lower the blood sugar. High blood sugar is a killer, so the pancreas has a very important job and goes all out to keep the sugar down. After long periods of having high sugar in the blood, the pancreas will increase it’s baseline production of insulin so a steady stream of a high amount of insulin can constantly be flowing in the blood to keep the body/brain safe from high sugars. This is where the trouble for the thyroid begins. And worse yet, the cells stop listening to insulin at some point and blood glucose continues to rise, this may lead to crossing the threshold into the range of blood sugar that is termed diabetes type 2. A topic for a future post…how to reverse this condition.
When one has high FASTING insulin, one is usually in a very inflamed state. Why is that? High fasting insulin means insulin resistance, which means the blood sugar is remaining higher in the body for longer than it should. Many inflammatory chemicals will be released, and this is the body’s wisdom to call in the immune system to help handle all the cell damage from high sugars. The thyroid is affected by the inflammation. The inflammation can lower the enzyme that converts T4 to T3, thereby lowering free T3 levels, an also damage the thyroid gland cells and increase the chances of autoimmune thyroid conditions.
Not everyone who has insulin resistance has hypothyroidism. But many, many have suboptimal levels of T3 hormone, the active hormone that helps one to have a faster cellular metabolism.
Bottom line is, everyone needs their thyroid, insulin and hormones tested. If suboptimal levels are found, and the causes are address the best we can, we can also use natural medicine or compounded T3 hormone replacement to increase the Free T3 to optimal levels. Often we can come off the thyroid after a period of time if it is not too severe and the causes are rightly addressed.
List of test names to take to physician:
- – CBC w/ Differential, w/ Platelet
- – Comprehensive Metabolic Panel
- – CRP, High Sensitivity
- – Ferritin
- – Vitamin D, 25-Hydroxy, Total
- – Estrogens, Fractionated, LC/MS
- – Progesterone
- – Testosterone, Free (Dialysis) and Total, MS
- – T3 Free,T4 Free, TSH
- – Thyroid Antibody Profile
- – T3 Reverse, LC/MS/MS
- – Lipid Panel
- – Hemoglobin A1c With eAG
- – Insulin, Fasting
- – Selenium, Plasma/Serum
- – Sex Hormone Binding Globulin
- – Cortisol, AM
Next blog will be on all the natural ways to support the thyroid gland.