As a thyroid hormone specialist, I want to talk about thyroid testing and the different types of tests available to assess how well your thyroid is functioning.
Conventional Thyroid Hormone Testing
The conventional test that is called TSH, or thyroid-stimulating hormone. TSH comes from the brain and stimulates the thyroid gland to tell the thyroid to make hormones. TS has been the conventional test for decades; however, it does not provide the whole picture.
Complete Thyroid Hormone Testing
Now, a few other tests are still done pretty conventionally, and they give a fuller picture of how your thyroid is functioning:
The Thyroid Hormone Production Process
Thyroid-stimulating hormones stimulate the thyroid gland to make T4 first, which can be thought of as our hormone’s storage form. T4 is a little bit less metabolically active and has to get converted into T3 to become the hormone’s active form.
So TSH stimulates -> T4 to make -> T3.
T3 then goes out into the bloodstream and stimulates metabolism in every single cell in the whole body. It stimulates your heart, gut, brain, reflexes, and mood.
So, TSH stimulates Free T4 to Free T3. When you get these tests measured, you want to look at the reference ranges and make sure that you’re not out of the conventional reference range.
Thyroid Hormone Normal and Optimal Reference Ranges
There’s a vast difference between normal reference ranges and optimal reference ranges.
Conventionally, the TSH hormone should be less than about 4.5. Now, some labs say less than 4 is best. Some say less than 4.5 is good. The American Endocrine Society generally wants this to be less than 3. We’re looking for optimal functions in the naturopathic community, so I usually like this number to be even lower, preferably less than 2.
Now, your T4 hormone ideally should be higher than 1, which would then get converted into T3. The general idea is that you want your T4 to triple or quadruple into your T3. So, I want my free T4 to be higher than a 1, and I want my free T3, ideally, to be higher than a 3. Even more ideal would be greater than 3.5.
Additional Thyroid Tests
These tests are checking for autoimmune hypothyroid or Hashimoto’s Disease. Hashimoto’s is an autoimmune condition where the body’s immune system starts making antibodies that attack one’s thyroid gland. The thyroid gland can either over-produce hormones or under-produce hormones. However, The more common situation is the under-production of hormones, and that’s hypothyroid.
So, to find out if you have an autoimmune version of hypothyroid, you want to get your thyroid antibodies measured, which are TPO (topoisomerase antibody) and TGA (thyroglobulin antibody).
Generally, I follow the conventional reference ranges when those labs get tested. As long as they’re normal, the patient does not have Hashimoto’s or autoimmune hypothyroid. If they’re elevated, you’re dealing with an autoimmune version of hypothyroid.
If you are interested in getting your thyroid more thoroughly checked, call 480-588-6856 to schedule a FREE brief meet and greet with a naturopathic doctor.