Have You Had a Complete Thyroid Panel Done?
Have you had a complete thyroid panel done?

There are 5 important pieces when it comes to the thyroid puzzle. TSH, FT4, FT3, Thyroid Antibodies and Reverse T3. Unfortunately, it isn't uncommon for only TSH to be tested...and if you are lucky, FT4. I encourage you to be your own health advocate and ask for a full thyroid panel to be tested.

Let me explain these in a bit more detail.

TSH stands for thyroid stimulating hormone. This basically tells us if your brain - the pituitary gland, specifically - is telling your thyroid to make thyroid hormone. If you are not getting enough of this signal, then you will not make sufficient levels of thyroid hormone (hypothyroidism). On the other hand, if you are getting a big signal, then you can make too much thyroid hormone (hyperthyroidism). From a functional perspective this should be between 1 and 2. Anything over two can indicate hypothyroidism.

When your thyroid gets the signal from your brain to make thyroid hormone, it makes FT4. However, this is the inactive form of thyroid hormone. That is not to say it is not important though. We need to have sufficient levels of the inactive thyroid hormone to be able to be converted to the active form, which is the FT3. 

From a functional perspective, FT4 should be at least in the middle of the reference range, if not in the upper 3/4 of the range.

The process of converting FT4 to FT3 mostly takes place in the liver. It is the FT3 that should enter the cells and do the thyroid hormone job. If this conversion doesn't happen, then there can be hypothyroid symptoms occurring.  Again, from a functional perspective, FT3 should be at least in the middle of the reference range, if not in the upper 3/4 of the range. 

The other issue is that Reverse T3 can stop FT3 from entering the cell. The reason being, it binds to the receptor sites on the cells, essentially blocking the FT3 from being able to do so.

Reverse T3 is produced when we are stressed, so it is important to have stress management techniques in place. From a functional perspective this should be no higher than middle of the reference range. Any higher than that, and the FT3 will be impaired from getting into the cells and doing its job.

The last piece of the thyroid puzzle to test for are Thyroid Antibodies. If there is a known thyroid problem, it is beneficial to know if it is the autoimmune type. The autoimmune type of hypothyroidism is Hashimoto's thyroiditis. The autoimmune type of hyperthyroidism is Grave's disease.

Knowing exactly what is going on with each piece of the thyroid puzzle will give a much better guideline for further investigation and/or how to specifically tailor your treatment.


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