You could sense some depression, have dry skin, puffiness, and elevated cholesterol. Constipation and irregular periods. Or maybe it’s anxiety, palpitations, and sweating. Perhaps the doctor said “thyroid’s OK” but your research still points to thyroid. Accordingly, you may want more thorough thyroid testing, to look deeper into your thyroid system’s functioning. After all, your thyroid function could still be partly to blame. This regulator of mind and body metabolism can go haywire, particularly in women. Addressing this is critical to feel your best and avoid serious health problems developing down the line.
Thyroid function is influenced by a lot of things, most of which are under our control, if we take the time to figure them out! Traditional medical offices don’t normally do that, unless perhaps you have something pretty unusual going on, and insurance carriers may not pay for broader testing, either. Because Peak Health LLC works outside of the insurance industry, we do not face these limitations and can LOOK DEEPER ™ into your thyroid health.
Our Thyroid function evaluation goes beyond “usual” TSH and T4 bloodwork. Some of the tests we use are TSH, free T4, free T3, and reverse T3. Nutritional testing finds suboptimal Iodine, Zinc, Selenium, and vitamin availability due to nutrient-poor food sources or intestinal losses. Inflammation from various sources, such as gut dysbiosis, is often a key contributor to poor thyroid function, so a Stool test is ordered too. Hashimoto’s Autoimmune Thyroiditis is the most common cause of a low thyroid in America, so we look for that. Adrenal evaluations and Toxin testing from specialty labs are often revealing. If you’ve already tried a thyroid-friendly diet, and still feel poorly, it may be time to get checked out.
Together with a dietitian & health coach on your support team, we can tailor a plan to support your thyroid nutritionally and help you implement thyroid-supportive lifestyle changes. If your thyroid function is suboptimal and you need thyroid replacement, then a natural thyroid Rx or custom-compounded T4 + T3 capsule can be implemented. Inflammation sources will be addressed with diet, detox if indicated, and lifestyle items such as toxin avoidance and stress mitigation techniques. If you are ready to test your thyroid now, see the New Patients & FAQ’s page for details on how to get started.
TSH is Thyroid Stimulating Hormone, secreted by the Pituitary in the brain; it signals the thyroid gland to produce more Thyroid Hormone (T4). T4 is released by the thyroid, and some is then converted throughout the body, into the active hormone called T3. T3 goes into the nucleus of the cell and helps instruct which areas of DNA that are activated, resulting in regulation of metabolism and energy.
To conventionally evaluate thyroid function, American doctors check a TSH test, believing it to be the most sensitive initial test of thyroid function. If TSH is very low (“suppressed”), then Free T4 and Total T3 are ordered to investigate. If the TSH is elevated, however, only a Free T4 will follow. For anyone about to get their thyroid labs checked, by the way, don’t forget to stop any supplements containing Biotin (Vitamin B7), as it interferes with the test reagents.
Limited testing with TSH and T4 levels cannot tell the whole thyroid story. Production of the hormones, Transport of the hormones, cellular Sensitivity (response) to the hormones, and Degradation of the used hormones can affect how you feel; these 4 functions can be influenced by diet and lifestyle factors that are within your control! Stress, suboptimal adrenal function, and inflammation (from any source) affect the thyroid system’s function. Again, all of these are within reach in a personalized plan to address them through appropriate lifestyle changes in nutrition, stress mitigation, rest & recovery, and movement.
Production of thyroid hormone requires sufficient nutritional building blocks as well as sufficient nutrient co-factors for the enzymes that make them, so production can be limited due to suboptimal nutritional status. For example, iron, iodine, selenium, zinc, tyrosine, and multiple vitamins are required to make thyroid hormone. Other factors that inhibit production of T4 thyroid hormone are stress (emotional or physical), infection, trauma, radiation, medications, fluoride (antagonist to iodine), toxins (such as pesticides, mercury, cadmium, lead), and Autoimmune diseases like Celiac and Hashimoto’s thyroiditis.
Once T4 is produced and released by the thyroid, it gets converted into the active form (T3) or an inactive form (reverse T3). T3 and reverse T3 are further converted into T2, which also is inactive. This is accomplished by a small family of enzymes called DeIodinases, and there are 3 of them (DIO1, DIO2, & DIO3). The DIO enzymes function in different locations (such as in the bloodstream or within cells) and are influenced by many factors. Genetic variations in a DIO enzyme can change it’s function without your stated permission! The main way to get T3 is from within the cell, via DIO2. It can get pretty complex: DIO2 is responsible for converting approximately 80% of free T4 (fT4) to free T3 (fT3) in the brain (or other cells). DIO1 in the bloodstream is responsible for changing T4 into T3, producing most of the circulating T3, where blood tests measure, but DIO1 does not act in the brain (or other cells). This is one reason blood tests can be “normal” but mood and brain fog can still be suboptimal due to thyroid system dysfunction. Higher doses of Alpha Lipoic Acid, a common supplement, can decrease conversion of T4 to T3 due to DIO2 inhibition, so don’t take it near the same time as you take thyroid replacement rx. Conversion of T4 into reverse T3 by DIO3 can be increased by low-calorie diets, stress/hi cortisol, trauma, infections, toxins, inflammatory cytokines, and liver/kidney dysfunction.
Thyroid hormones T4 & T3 circulate in the blood. Like other hormones, they are bound to a special transporter protein in the blood, called Thyroxin Binding Globulin (TBG). Levels of TBG can be affected by physiologic changes (like pregnancy), diseases (like nephrotic syndrome), and other hormones (like estrogen). Differing levels of TBG results in changes in the measured levels of Total T3 and Total T4, but those levels do not reflect actual thyroid hormone production and effect. This is the reason that getting “free” (unbound) thyroid hormone levels can be a better representation of thyroid functional status. Free T3 is the active thyroid hormone, and it can be measured at LabCorp for example.
Sensitivity to thyroid hormones inside the cell is influenced by factors such as vitamin A, exercise, and zinc, so you’ll want optimal amounts of those. T3 and reverse T3 compete for binding sites on cellular membranes, so if your reverse T3 levels are elevated, it will block more of the T3 that is trying to work hard for you. The good news is that mitigation strategies to modulate formation of reverse T3 will frequently act to also support production of T3. This is empowering!
Finally, medications can affect thyroid function or Rx thyroid by several mechanisms. Some decrease the absorption or re-absorption of T4 (calcium, Iron, Psyllium, Proton pump inhibitors, aluminum antacids, soybean oil, sucralfate). Others increase the metabolism/destruction of T4 (Phenytoin, carbamazepine, rifampin, phenobarbital, sertraline). Thyroidits, or inflammation of the thyroid gland, can be caused by Amiodarone, Lithium, Interferon, Interleukin-2, and newer Cancer drugs such as Checkpoint inhibitors and Tyrosine kinase inhibitors. Development of antibodies against the thyroid, which is autoimmunity, can be induced by Interferon-alpha treatment. TSH is normally made and secreted by the Pituitary, and those control processes can be hijacked by Steroids, Dopamine, Dobutamine, and Octreotide. The amount of TBG in the blood can be changed by Methadone, Tamoxifen, Estrogen, Androgens, Steroids, and even Niacin.
The body is too complex for just a TSH. Go to the New Patients & FAQ’s page for details on how to get started on your journey to feeling better!
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We highly recommend purchasing medical grade supplements that support thyroid function, from a reputable source such as Fullscript. 
Our clients receive a discount at FullScript.