02 9011 5595 Book an appointment

Hypothyroidism—The Undiagnosed Disorder

Are you displaying the signs and symptoms of hypothyroidism?

What is hypothyroidism?

Are you feeling tired and suffering from constipation, hair loss or do you find it hard to lose weight and often have cold hands and feet? These are just some of the symptoms of hypothyroidism or an under functioning thyroid gland.

The thyroid gland makes hormones that help control your weight, heart rate, blood pressure and body temperature. Hypothyroidism occurs when the thyroid is underperforming, and is more prevalent in women. The risk of having some sort of thyroid dysfunction increases with age.

Having an under-active thyroid can cause anxiety and depression, and as such, many people who are undiagnosed may seek medical assistance. Unfortunately, although depression is a symptom of hypothyroidism, it may not be the root cause, and some end up taking unnecessary anti-depressants or anti-anxiety medication instead of addressing the cause of the problem.

Because your thyroid controls your metabolism, hypothyroidism is associated with weight gain and obesity, and has shown to increase the risk of heart disease. Unfortunately, many go undiagnosed for many years, creating a downward spiral of their health status.

The gold standard blood test controversy

So why do so many people go undiagnosed?

Hypothyroid symptoms resemble many other conditions, such as depression, ageing (menopause), or just simply feeling tired and run down.

Another reason is the way thyroid disease is tested by a GP.

Thyroid stimulating hormone (TSH) is the gold standard test for thyroid disease. At present, the reference range is 04. – 4 (not long ago it was even as high as 5 mIU/L), however, this range has been debated for years.

In 2002, researchers published an analysis of thyroid function test results from a large survey of individuals representative of the U.S. population (the National Health and Nutrition Examination Survey—NHANES III), which demonstrated that the mean TSH level in normal, healthy participants is 1.47 mIU/L.

This finding prompted organisations such as The American Association of Clinical Endocrinologists (AACE) to recommend TSH 3.0 mlU/L as the upper limit, and other groups went as low as 2.5 mIU/L.

Many naturopaths and functional doctors believe that anything above 2.0 mIU/L is a sign of a dysfunction, whereas GPs, following the standard outlined above, see a reading in between 2.0 – 4.0 mIU/L as a normal reading, and may not result in a diagnosis of hypothyroidism.

However, it has been found that people with serum TSH levels of greater than 2.0 mIU/L are more likely to have elevated thyroid antibodies, and therefore more likely to develop autoimmune hypothyroidism (Hashimoto’s).

For the above reasons we need to address thyroid issues before they become overt.

The resistance to change the TSH testing intervals is based on the argument that conventional medical treatment of hypothyroidism will not be beneficial to people with a TSH level below 4.5 mIU/L.

Herbal medicine and nutritional support may help re-balance the thyroid and prevent hypothyroidism and Hashimoto’s. In turn this will increase energy, mood, promote weight loss and prevent future health complications caused by hypothyroidism

It is also possible to have normal TSH and normal T4 and still have hypothyroid symptoms. This can be due to inadequate amounts of T3 (the active hormone) being available to the cells due to stress, inflammation or lack of certain nutrients. This can be addressed using nutritional support as well as adrenal and stress support.

If you are experiencing hypothyroid symptoms and your TSH is above 2.5 mIU/L, it would be wise to ask for a thyroid panel that includes other markers beyond TSH such as free T4, T3, and reverse T3 (rT3)—and always ask to be screened for Hashimoto’s by checking thyroid antibodies.

Take matters into your own hands

If you want to take matters into your own hands you can check your thyroid function by taking your basal body temperature. Leave the thermometer next to your bed and upon waking, before getting out of bed, take your temperature in your armpit. If you have a lot of blankets on, it’s a good idea to take some off or pull them down to avoid any overheating having an impact on the reading.

Follow this procedure for 3-4 days and then calculate the average temperature. It is best to start on the second day of menstruation, because mid-cycle there is a natural rise in temperature with ovulation. The ideal temperature should be between 36.4 (97.6 F) to 36.8 (98.2 F), and if you are outside this range, have a chat to your local practitioner to see what might be causing any abnormalities.

Do you think you might have hypothyroidism? Have a chat to one of our practitioners who will be able to assist you with your health concerns. Give us a call on 9011 5595 to speak to a qualified practitioner.

Article written by Pernille Jensen, a qualified naturopath and clinical nutritionist at Health Space Mona Vale. She is passionate about helping people heal their bodies naturally and preventing the onset of disease. For bookings, call 9011 5595.

References

1 Hypothyroidism (Dr Emma Roe)

InnovAiT: Education and inspiration for general practice February 2015 8: 75-82, doi:10.1177/1755738014561892

2 Goolsby, M. J. and Blackwell, J. (2004), Evaluation and Treatment of Hyperthyroidism and Hypothyroidism. Journal of the American Academy of Nurse Practitioners, 16: 422–425. doi: 10.1111/j.1745-7599.2004.tb00418.x

3 Kvetny J. Nuclear thyroxine and triiodothyronine binding in mononuclear cells in dependence of age. Horm Metab Res. 1985 Jan;17(1):35-8Nurse Practitioners, 16: 422–425. doi: 10.1111/j.1745-7599.2004.tb00418.x

4 Gregerman RI, Gaffney GW, Shock NW, Crowder SE. Thyroxine turnover in euthyroid man with special reference to changes with age. J Clin Invest. 1962 Nov;41:2065-74

5 Katzeff HL. Increasing age impairs the thyroid hormone response to overfeeding. Proc Soc Exp Biol Med. 1990 Jul;194(3):198-203

6 Ruhla S, Weickert MO, Arafat AM, Osterhoff M, Isken F, Spranger J, Schöfl C, Pfeiffer AF, Möhlig M. A high normal TSH is associated with the metabolic syndrome. Clin Endocrinol (Oxf). 2010;72(5):696-701

7 Lauberg, P., et. Al Thyroid Function and Obesity. Eur Thyroid J 2012;1:159–167. DOI: 10.1159/000342994

8 Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116:1725–1735.

9 Danzi S, Klein I. Thyroid hormone and the cardiovascular system. Minerva Endocrinologica. 2004;29:139 –150. 4.

10 Whybrow PC, Bauer M. Behavioral and psychiatric aspects of hypothyroidism. In: Braverman LE, Utiger D, eds. The Thyroid: A Fundamental and Clinical Text. Philadelphia: Lippincott Williams & Wilkins;2000. pp. 837–842

11 Gulseren, S., et al. Depression, Anxiety, Health-Related Quality of Life, and Disability in Patients with Overt and Subclinical Thyroid Dysfunction. Archives of Medical Research. 2006; 37(1):133–139

12 http://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/symptoms/con-20021179

13 Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE: Serum TSH, T4, and Thyroid Antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002;87:489-499.

14 Spencer CA, Hollowell JG, Kazarosvan M, Braverman, LE. National Health and Nutrition Examination Survey III thyroid-stimulating hormone (TSH)-thyroperoxidase antibody relationships demonstrate that TSH upper reference limits may be skewed by occult thyroid dysfunction. J Clin Endocrinol Metab. 2007;92(11):4236-40.

15 Demers LM, Spencer CA. Laboratory medicine practice guidelines: laboratory support for the diagnosis and monitoring of thyroid disease. Clin Endocrinol (Oxf). 2003;58:138–40

16 https://www.aacc.org/publications/cln/articles/2013/may/tsh-harmonization#ref

17 https://www.aace.com/files/hypothyroidism_guidelines.pdf

18 Lambrinoudaki, Irene, et al. “High Normal Thyroid-Stimulating Hormone is Associated with Arterial Stiffness in Healthy Postmenopausal Women.” Journal of hypertension 30.3 (2012): 592-9.

19 Roef GL, Taes YE, Kaufman J-M, et al. Thyroid Hormone Levels Within Reference Range Are Associated with Heart Rate, Cardiac Structure, and Function in Middle-Aged Men and Women. Thyroid. 2013;23(8):947-954. doi:10.1089/thy.2012.0471.

20 Vanderpump, M. P et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin. Endocrinol. (Oxf.) 43, 55-68 (1995). 14

Receive our NEW health tips ebook for FREE - Health Space Clinics

Sign up today to receive our NEW ebook and monthly newsletter for FREE!

Receive the latest in Health news, articles and recipes via email plus the "Gut Healing Recipes & Health Tips" ebook from our Naturopathy and Nutrition team.

Not sure what treatment you need?
Click here to ask a health practitioner

Not sure what treatment you need?

Do you have particular pain or symptoms but are not sure which health treatment or practitioner is right for you? Please get in touch and one of our practitioner team will respond to you with personalised assistance.

  • This field is for validation purposes and should be left unchanged.