How do I know if I have thyroid disease?

jaiedocere, thyroid

How do I know if I have
thyroid disease?

I have some thyroid symptoms, what now?

Because there are so many signs and symptoms of thyroid disease, and because many of those signs and symptoms overlap with other conditions, conventional medical doctors rely primarily on labwork to diagnose thyroid disorders. Let’s go back to the analogy of the thyroid as employee and the pituitary as manager. The pituitary/manager makes TSH, or thyroid stimulating hormone. This hormone travels from the pituitary to the thyroid and tells the thyroid to make more thyroid hormones. Usually medical doctors start by measuring TSH.

Image by Thomas Hawk via photopin cc

The next thing they might measure are the actual thyroid hormones, T3 and T4. These hormones travel through the body so they can tell other tissues to do something. In order to travel, they hop on a bus to carry them through the blood to where they are going. This bus is actually a protein. But when it’s on the bus it can’t do its job; and most of it is on a bus! Conventional medical doctors often measure total T3 and total T4, or ALL of the hormone both on the bus and off the bus. But I prefer looking at the hormone that is actually available to do its job, free T3 and free T4.

By conventional medical standards, if you have thyroid symptoms but “normal” labwork then you do not have thyroid disease.

  • Problem #1

    The currently defined normal range of TSH is 0.4 to 4.2 mIU/L (or even up to 5.0). Most normal lab ranges are just averages of all the samples that the lab sees. But there are so many people with diagnosed and un-diagnosed thyroid disease, that these “normal” values have been skewed. There was a study that measured TSH values in healthy adults. For these adults, TSH values ranged from 0.36 to 1.91 mIU/L. Therefore I would consider a TSH of 2.5 to be (slightly) elevated.

  • Problem #2

    You could have autoimmune hypothyroid disease, Hashimoto’s thyroiditis, without having measurable levels of thyroid antibodies.

  • Problem #3

    Signs and symptoms of Hashimoto’s thyroiditis can be present before the lab values change, including an enlarged thyroid gland.

As you can see, the diagnosis of autoimmune thyroid conditions, Hashimoto’s thyroiditis in particular, is complicated and controversial.

The first step is making sure you don’t have another condition that is causing the suspicious signs and symptoms.

The second step is getting thorough thyroid labwork , not just TSH. 

Image source: DeviantArt


Referenced by Alan Christianson, ND. Erden g, Oanzden A, Tezcan G, et al. Biological Variation and Reference Change Values of TSH, Free T3, and Free T4 Levels in Serum of Healthy Turkish Individuals. Turk J Med Sci 2008; 38 (2): 153-158.

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