It could be your thyroid!

Now stay with me here because it does get a little confusing (especially for you under-treated thyroid peeps). When we check patients for thyroid disease we do not check the thyroid directly. We instead check the levels of a hormone called Thyroid Stimulating Hormone (TSH) that is produced by the pituitary gland in the brain. Your TSH stimulates your thyroid to make thyroid hormones. When the levels of your thyroid hormones are normal your TSH will be normal or low. You feel good, energetic, keep your weight and cholesterol down easily and have great brain function because good levels of the thyroid hormones help you feel great and give you a sense of well being. When, on the other hand, your thyroid hormones are low your TSH will be high. Your brain senses the low levels and increases TSH levels to try to stimulate your thyroid to make more thyroid hormones. So (stay with me here), when we diagnose patients with low thyroid, it is because the TSH result came back high. That range of normal use to be 0.5 to 5.3. You had to have a TSH above that to be considered low thyroid. In January 2002 the AACE narrowed those parameters to 0.3 to 3.0. If you had your thyroid checked before and your TSH was over 3.0 it would have been considered normal!! When, in fact by the new standard, you would be considered abnormal (no offense). This is GREAT news! The problemo is that most primary care doctors are not aware of these new standards and the labs are still using the old parameters to flag abnormal labs. Often times if the lab is not flagged abnormal it is not looked at. For those of you already on thyroid replacement hormone you may be able to up your medication. If say your TSH was 4.0 you could get you medication increased. Maximizing your thyroid medication (getting your TSH less than 3) will maximize your sense of well being and make it easier for you to maintain a healthy weight. It is such a wonderful thing to diagnose and treat patients for a low thyroid, we see it all of the time at the clinic as most patients with a low thyroid also have weight issues. Not all patients with weight issues have a thyroid problem but most patients with thyroid problem struggle with their weight. Whether we increase their current medication (because the TSH is above 3.0) or start them on it, they most always feel so much better within 10 days. So now what do you do?

If you are feeling symptoms consistent with a low thyroid, whether you are already on thyroid medication or not, go see your primary care doctor. Ask them to check your thyroid and ask them to go to the AACE website where the new parameters for the normal range are outlined. Even better print it up yourself and bring it to them. Remember that you are your own best advocate. Knowledge is power. Most doctors are so busy trying to keep their heads above water. Between seeing patients, referrals and dealing with insurance rejections it leaves little time to keep up with reading. Help them help you.