Thyroid Testing: How to Make Sure Your Doctor is Ordering the Complete Panel of Tests

THYROID AND METABOLISM: A SYNOPSIS

BASIC NOTES: 1. ANTICONVULSANTS CAN AFFECT THYROID 2. SEE ALSO SENSITIVE THYROTROPIN ARRAY/ASSAY TEST REGARDING: O.1 m u/l = thyrotoxicosis.

1. Thyroid a. Produces hormones that affect the function of all cells in the body b. T3:
   c. T4: most common culprit in thyroid disorders. Too much produced, the body will burn too much energy and client will lose weight. Hyperthyroidism. Too little produced, the body’s metabolism will slow down to where it will not burn enough energy in the body. This is known as Hypothyroidism.

In 2002, physicians were unsure why thyroid doesn’t work properly. No sure way to know how much medication to prescribe, so doctors and patients work together usually over several months to get the right dosage.

If weight is gained due to medication and the patient cannot exercise it off, have hormone levels checked again to regulate amount of meds given.

Also, to help thyroid out naturally, as in gaining weight due to hypothyroidism, then split food consumption into small meals throughout the day. Here is a breakdown: 1. Eat 5-6 small meals/day. 2. Every time you eat, it fires up the metabolism and stokes it. 3. Exercise two times a day; example – one hour cardio, ten-minute walk later in the day. 4. Eliminate caffeine intake – drink more water and do not use any artificial thermogenics.

Here are some of the thyroid tests:

1. T4
2. T3
3. Anti-thyroid Antibodies test
4. TRH Testing
5. 3rd-generation TSH test
6. TSH test
7. Free T3 test
8. Free T4 test
9. Highly-sensitive TSH test
10. Sensitive TSH test

Note: Doing only T3 or T4 tests alone will sometimes miss a sub-clinical thyroid dysfunction. If TSH is abnormal, a Free T4 test is done. When TSH is low, a Free T3 test or assay is done.

Thyroid affects the following: 1. Heart rate 2. Cholesterol levels 3. Body weight 4. Energy levels 5. Muscle strength 6. Condition of the skin 7. Vision 8. Menstrual Regularity 9. Mental state

The thyroid is located at the front part of the windpipe below the Adam’s Apple. The thyroid affects every organ, tissue and cell in the body. How does it function? It is a feedback mechanism involving the hypothalamus and the pituitary gland. It functions in this order: 1. Hypothalamus sends a signal to the pituitary gland via a hormone called TRH (thyrotropin-releasing hormone). Once the pit gland gets this signal, it releases TSH (thyroid-stimulating hormone) to the thyroid gland. 2. Upon receiving TSH, the thyroid responds by releasing two of its own hormones, T4 and T3, which then enter the bloodstream and affect the metabolism of the heart, liver, muscle and other organs.
3. T4 is the main hormone released by the thyroid. 4. T3 is made in the tissue after the T4 to T3 conversion. 5. The pit gland “monitors” the level of thyroid hormone in the blood and increases or decreases the amount of TSH released, which then changes the amount of thyroid hormone in the blood.

HYPOTHYROIDISM: It affects over 11 million Americans. The most common is Hashimoto’s Disease – this is caused when immune system produces killer lymphocytes that destroy the thyroid. As the damaged thyroid gland produces less thyroid hormones, the pit gland secretes more TSH to encourage the thyroid to work harder. This increased demand on the thyroid may cause it to enlarge, resulting in a “goiter”. Antibodies are produced that serve as a Diagnostic Test for Autoimmune Disease. Here are some symptoms of hypothyroidism: 1. Fatigue 2. Dry skin 3. Forgetfulness 4. Difficulty swallowing 5. Coarse voice 6. Mood swings 7. Intolerance to cold

THE TEST: Sensitive TSH Test which enables physicians to detect the disorder much earlier. What is usually prescribed then? Levothyroxine Sodium. This is taken for life – periodic tests need to be done in order to prevent overreplacement, which can then turn into HYPERTHYROIDISM. As well, the same brand of Levothyroxine Sodium should be prescribed – brands should not be changed. Wilson’s Disease is not an agreed-upon diagnosis of this!

HYPERTHYROIDISM: Here are some of the symptoms: 1. Weight loss 2. Vision problems 3. Irregular menstrual periods 4. Nervous/irritable 5. Muscle weakness/tremors 6. Sleep disturbances 7. Goiter 8. Heat intolerance Treatment for this condition may include the following: 1. Antithyroid drug therapy – blocks thyroid hormone production. 2. Radioactive iodine treatment – overactive thyroid is disabled and reduced in size. 3. Thyroid surgery – Removes all/part of gland. Normally used in very young patients with Graves Disease OR very old w/ diseased thyroid glands.

Treatment of choice? Radioactive iodine treatment. Patients are given a dose of radioactive iodine that essentially “shuts donw” thyroid hormone production. Normal hormone levels must then be restored via Levothyroxine Sodium tablets.

Testing? Best test according to Johns Hopkins as of 2006: Sensitive TSH Testing – can detect even mild thyroid failure, even at its early stages, sometimes even before patient experiences any symptoms. Some of the older testing methods: Standard T4 and T3 tests. Even these tests could be within the normal range when the thyroid was not functioning.ho

TSH identifies the amount of thyroid –stimulating hormone produced by the pit gland. TSH provides an even more exact measure of thyroid failure – normal range is euthyroid, below normal is hyper.

TESTS:

1. TSH test alone can be misleading when hypothyroidism is caused by pit disease (TSH is in the normal range); hypothyroidism develops within the first twelve months of treatment for thyrotoxicosis (TSH value remains suppressed); thyrotoxicosis is caused by a TSH-secreting pit tumor normal TSH OR individuals are thyroid-hormone resistant normal TSH. In these cases, Free Thyroid Hormone testing is recommended in addition to the TSH Assay of tests. Likewise, sometimes a small number of cases of secondary hypothyroidism with undiagnosed secondary hypoadrenalism will still be missed ( 1 in 20,000). Therefore, another test would be the Anti-TPO Test. This test was previously referred to as thyroid antimicrosomal antibodies, but now known as tests enabling measurement of antithyroid peroxidase autoantibodies to determine thyroid disturbance.