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We used to think blaming the thyroid for fatigue, poor energy, and lackluster focus was overrated. Maybe the thyroid was even being used as an excuse.

Tired schoolgirl sleeping in classroom

Many of our fellow health seekers already knew the real scoop. It took us a little longer to catch up. Thyroid lab values are only a birds-eye view of how your thyroid functions.  AND – they don’t always give you a clue as to WHY you have symptoms of low thyroid.  Before we get started, here’s a little background info…

Thyroid Anatomy – Pictures don’t do it justice.

The thyroid is butterfly-shaped and found in the front of your neck. It’s below your larynx (voice box) and surrounds your trachea (windpipe). It’s made of two lobes that are connected by a bridge in the middle.

When your thyroid is normal in size, you can’t really feel it.  Try to feel in the front of your neck. Put your fingers on your voice box, and as you move lower, notice that your windpipe gradually becomes less distinct. Now you’re feeling your thyroid. It’s flattened over top of your windpipe. Even the lobes on the sides aren’t so obvious.  Isn’t it surprising that It doesn’t feel like much, for a gland that’s so crucial to your well-being?

Your thyroid is an endocrine (hormonal) gland.

The thyroid gland belongs to the endocrine system, one of many glands that regulate metabolism, sexual reproduction, sleep, and mood. The endocrine glands make hormones (chemical messengers) that circulate throughout your body to communicate with organs and tissues.

Let’s make some thyroid hormone.  It’s always easiest to start at the top.

Your thyroid is under the direction of your brain.  Deep in your brain is an area called the hypothalamus. Its job is to connect your mind with your body because it coordinates your thoughts, emotions, and memories with physical responses. It directs the master gland, the pituitary.

Your pituitary is a pea-sized structure that makes needed hormones, which are then sent throughout your body to target organs.

In the case of the thyroid, the pituitary makes thyroid-stimulating hormone (TSH). As its name implies, TSH is carried in the blood to the thyroid, telling it to step up its production of thyroid hormone.

Now you’ve made it to the thyroid gland, where the work really begins.

Your thyroid is both the factory and warehouse for thyroid hormones.  It stores thyroid hormone and releases it as your body demands.

Your thyroid makes T4, the weak or inactive form of thyroid hormone. (Many people take thyroid medication which is mainly T4).

T4 then converts to T3 in tissues outside your thyroid. This conversion is required since T3 is the active form of the hormone, which means it’s the form that does most of the work.

T3 finally enters every cell of your body to control metabolism specific to the function of each brain and body cell.

***Reminder – thyroid medications are mainly T4.  This may explain why many people don’t feel better on thyroid medications. Though they increase levels of T4 (thyroxine), they may not necessarily convert to T3.

 Let’s look more closely at each of the players in the thyroid pathway. Each conversion in the pathway is necessary. If there’s a glitch in the system, the process can pause, causing you to experience symptoms of low thyroid.

Thyroid players in your blood

TSH (thyroid-stimulating hormone):  Remember that it’s made by your pituitary gland and stimulates the production and release of thyroid hormone from your gland.  Traditional medicine teaches us that the level of TSH should be below 4.0 for the best thyroid function. We now know that (for optimal health), the ideal level of TSH should be below 2. If it isn’t, underlying causes should be considered before starting medications. These include nutritional deficiencies, digestion problems, interference from environmental substances, or stress.

If the underlying causes are not corrected, thyroid medication is unlikely to correct all your symptoms of low thyroid.

T4 (tetraiodothyronine, thyroxine):

Most of the hormone leaving the thyroid is in the form of T4. This is the form commonly found in thyroid medications.   It has low activity in your tissues. Therefore, it’s commonly called “inactive.”

T3 (triiodothyronine):

T3 is about 4X more potent than T4 but is present in much smaller quantities. T4 converts to T3 outside your thyroid gland, mainly in your liver and kidney. It’s vital to have good kidney and liver function so that the T3 can be made. The enzyme for this conversion requires adequate levels of specific nutrients. A quality diet rich in nutrients is a must!

Lab values don’t always tell the whole story

The approach to accurately diagnosing a low thyroid is tricky. The production of T4, conversion to T3, and uptake of thyroid hormone by your body cells involve many steps. When any one of the steps is compromised, you may develop symptoms, but your labs can be in the normal range. That’s because each step requires different enzymes and different nutrients and may be affected by different outside forces. All cases of hypothyroidism do not share the same cause.

Here’s an example of how low thyroid can be missed

Sometimes T4 has difficulty converting to T3. The result is a low level of T3, even though the thyroid gland could be functioning adequately. This can happen when your body is busy fighting illnesses, like infections, diabetes, low kidney, and liver function, stress, or a low-calorie, nutrient-poor diet.  It puts on the metabolic brakes to concentrate on more crucial issues instead of converting the inactive T4 to the active T3.

Your lab pattern can indicate normal levels of TSH and T4, which are the lab values that are traditionally ordered. If T3 levels are not also assessed, it’s easy to assume that your poor concentration, fatigue, weight gain, and hair loss are from something other than low thyroid function.

The bottom line is that each step of the pathway for thyroid hormone production must be carefully considered. External negative forces (like toxins, poor diet, too much stress) must be lowered and replaced by a high-quality diet rich in vitamins, minerals, and healthy fats and proteins.