Fresno Chiropractor and Natural Health Doctor Comments:
A very common problem is patients suffering with a laundry list of thyroid symptoms, but when the basic thyroid panel is ran the two main markers for hypothyroidism (TSH and T4) are normal. Often times these patients are sent away and told it's "all in your head." Even worse these people are often put on a regimen of antidepressant drugs when the real problem is lying just beneath the surface. Even though the two primary markers that indicate whether a person has primary hypothyroidism are normal, this is truly a thyroid problem.
How is it possible to have a thyroid condition and still have normal lab values?
Let me explain.
There is two forms of thyroid hormone. Thyroxine, commonly called T4, and triiodothyroxine, commonly called T3. T4 is the inactive form of thyroid hormone, meaning it does not have the ability to bind to cells and create a metabolic response. T3 is the active form of thyroid hormone, responsible for binding to cells and creating metabolic responses.
Your thyroid gland produces predominantly inactive T4. This means that we must convert T4 to T3, called thyroid conversion, in order to have normal thyroid responses. This conversion takes place primarily in the liver and gut mucosa.
So what does this have to do with thyroid symptoms and normal looking labs?
The negative feedback loop between the thyroid and the pituitary gland is with TSH and inactive T4. When T4 levels drop then TSH is elevated to tell the thyroid to produce more hormone. If T4 is elevated then TSH is suppressed. It works both ways.
So if T4 and TSH look normal on the lab panels, the true problem may never be investigated and the person may go on suffering indefinitely.
When there is underconversion of T4 to T3 we don't have normal thyroid responses. T4 is the inactive form of thyroid hromone, and does us no good if we can't convert itinto an active form. This thyroid underconversion issue is one of the many reasons why patients with hypothyroid symptoms go undiagnosed and mismanaged.
So What Causes Thyroid Underconversion?
Certain inflammatory cytokines involved in the stress response have been shown to down-regulate the enzyme responsible for peripheral conversion of T4 to T3. Fixing this problem requires lab testing to determine the source of the inflammation. It is necessary to also test the hypothalamus-pituitary-adrenal-axis since abnormal adrenal stress control has been shown to down-regulate thyroid conversion enzymes.
By using natural interventions to normalize the faulty physiology we can normalize the T4 to T3 conversion. In this case we have to deal with the specific things that are causing thyroid conversion enzymes to function abnormally. There is nothing that needs to be done to support the thyroid directly, nor is it appropriate to give replacement hormones. Many women will still receive replacement in the scenario we just laid out, and as you can see now, this will not help because we still have to convert the replacement to the active form of the hormone.
Another source of thyroid peripheral underconversion is increased gastrointestinal lipopolysaccharides, an endotoxin produced from bacterial overgrowth. The primary cause of this is intestinal dysbiosis, or a shift in the good vs. bad bacteria in your gastrointestinal system. This problem is fixed by doing advanced gastrointestinal lab panels and normalizing the findings, with natural interventions.
I see people everyday that have medical histories that scream that they have a thyroid problem, yet they continue to suffer because no one ever looked at the whole picture. T3 levels are rarely ever used in thyroid screening panels, so the T4 to T3 underconversion pattern is rarely detected. When it is found, proper testing to determine the source of the underconversion is not investigated. It's a big problem, since this is such a common thyroid dysfunctional pattern.
If you suffer with a thyroid problem and you would like to become a patient at the Boydston Institute, then read the pages about becoming a patient, located on the left navigation bar. If you have a question then Contact Us.
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