Feeling down? Feeling tired and worn down? Can’t lose that last 20 pounds, despite your best efforts? Love life not what it was a few years ago? All of your labs keep coming back to normal while you feel far from normal? I hear this story all the time, “My medical doctor said nothing is wrong with me. So why do I still feel this way?” There are good reasons, and it isn’t all in your head!
Protocols and flowchart medicine
Now don’t get me wrong, I’m not saying your MD, or anyone else for that matter, is incompetent. These are very smart, very well trained professionals. The trouble stems from, well… Their training and intellect. When you combine these two things together you end up with protocols. Lots of them! And these protocols are what makes the US hospital system the model for the rest of the world.
Every profession, every industry has standards and protocols, and they’re there for good reasons: they protect people, eliminate unnecessary steps and costs. In healthcare these protocols are often referred to as the “standards of care”. The issue here isn’t with the doctors but rather it’s with the protocols and those protocols going on unquestioned. We have this in Chiropractic too; patient symptoms are put into a flowchart and through a series of exams and outcomes it leads us to a proper diagnosis. This is great for clinical reasoning, but may not always be appropriate for delivering care.
The thyroid paradigm
We’ve all had the test before: TSH, or Thyroid Stimulating Hormone. It’s the one blood lab that is considered the standard for checking thyroid function in the body. It basically tells the thyroid to start or stop making thyroid hormones. TSH does not actually come from the thyroid at all but rather from the pituitary in the brain. The reference range is pretty broad, and varies depending on the lab doing the testing; the clinical range for TSH is somewhere between 0.45-4.50 ulU/L. the thyroid itself makes T3 and T4, and very little of it. So why do we keep testing TSH on normal laboratory screenings?
Let’s take a look at the research
A study published in 2000 examined 25,862 random people at the Colorado State Fair. Each of these volunteer had blood taken and a thyroid panel ran. The results were not what the examiners were expecting; 10% or 2586 people approximately had subclinical abnormal thyroid findings. If we extrapolate these results, we can project 13 million people with undiagnosed thyroid problems. (Archives of Int. Med. Vol 160, No. 4, 2/28/2000)
I know what you’re saying, why is important to me? Subclinical thyroid problems are associated with quite a few many things.
- Candida infections
- Chronic fatigue syndrome
- Coronary artery disease and heart disease
- Cystic breast and ovaries
- Blood pressure changes
- Mental disorders
- Multiple sclerosis
The scariest statistic was the associated risk of heart disease goes up 260% with subclinical hypothyroid (SCH) (J. Clin. Endocrin. Metab. 2004; 89: 3365-3370). Another study compared people with SCH and healthy thyroids over a 20 year period. There was a 76% increase in heart disease, and 79% increase in mortality from heart disease in the SCH group. BUT… when the SCH subjects were treated with thyroid medicine, the results were that same as the healthy group (J. Clin. Endocrin. Metab. April 2010; 95: (4) 1734-40).
So what do we have to do?
One is demand better testing, and expect a reflex if the results are not optimal. (I say it all the time, we look at OPTIMAL LAB RANGES, not clinical). A reflex is a test that will run automatically if the results are not perfect. In the case of thyroid, it should be for antibodies that attack the thyroid – Most of the time, thyroid issues are autoimmune in nature. The other thing you can do is be observant of the food you’re eating.
Most importantly have your labs read by a doctor who has been trained in functional medicine and understands the thyroid. Our training not only helps us identify subclinical thyroid problems but also allows us to develop safe and effective treatment plans. Plans aimed at optimizing thyroid functions, not just managing all the symptoms.
I would love to Hear your story!
Please use the comments area to tell us your thyroid story!
Have you been experiencing any of the above mentioned symptoms? Have you been misdiagnosed? Have you found help that actually worked?
I can’t wait to hear from you!