5 August 2019 | Jennifer May (BHSc (Nut Med), Adv.Dip.Nut.Med, ATMS, MINDD)

What your doctor hasn't told you about thyroid testing

What you need to know about thyroid testing

Do you struggle to lose weight? Are you constipated? Do you often feel flat, fatigued and depressed? Do you feel more sensitive to cold than your friends? Or is it the opposite of all of the above, feeling wired, anxious, hyperactive, struggling to gain weight, hair falling out, insomnia and diarrhoea.

If the answer is yes to any of the above, it might be time to get your thyroid checked.

For those who've answered yes and think you've already had it checked with your GP I have bad news... The sad truth is unless you have a diagnosed thyroid disorder, or unless you have paid for a specific and comprehensive test like the Advanced Thyroid Check through i-screen, then it's highly unlikely that you have had a full, accurate and complete assessment. Yes, even if your doctor says they've checked your thyroid, you've only had a partial assessment.

The test available free of charge through your GP is not complete and therefore not reliable. It is not a thorough assessment and it is possible to get an “all clear” from the doctor while still having issues under the surface.

It's not your doctor's fault!

You see under the MBS (Medicare benefits scheme) there is only one test permitted which is your TSH - thyroid stimulating hormone. Without any abnormal TSH measurement, the lab simply cannot reclaim their benefit from Medicare for any further thyroid assessment - so they cannot test the other important markers.

It is possible to have a TSH within normal range whilst also having elevated antibodies or severely imbalanced thyroid hormones. I see it all the time!

Introducing private pathology…

Private pathology means that you’ve been referred by your health professional with a different type of referral slip that states that you’ll be paying for the lab fees yourself, rather than claiming a medicare rebate. At i-screen this service is simplified further by allowing you to order the test direct - the referral is provided by the i-screen medical team. This allows you to have any test you request immediately, rather than having to comply with what Medicare determines is significant or not. The lab we use at i-screen for private pathology testing is the same lab your GP uses for the ones Medicare pays for, however the referral you get from iScreen is like a permission slip to authorise a complete assessment.

Let’s discuss the thyroid a little more so that you have a better understanding of what it is and why comprehensive testing is a highly beneficial and often necessary step..

What is the thyroid?

The thyroid is a gland in the throat which secretes the hormones which regulate your growth and metabolism. This effects both mental and physical growth, your energy, brain function, mood and of course metabolism. The thyroid also regulates many other systems in the body.

What effects does the thyroid have on my health?

The direct and indirect effects of the thyroid hormones include your immune balance, stress tolerance, mood, bowel function, digestion, energy and metabolism.

If I am overweight, does this mean I have a thyroid issue?

Thyroid dysfunction is a common cause of weight issues. Hypothyroidism (under-functioning thyroid) may lead to obesity and/or difficulty losing weight. Hyperthyroidism (over-functioning thyroid) commonly causes weight loss, hair loss and anxiety. In this blog we are focusing mostly on Hypothyroidism.

However, while an important factor to rule out, and one which can significantly impair weight loss, it is important to know that thyroid dysfunction is not the only cause of weight gain. Testing will help to determine if this is the cause for you.

How can I test my thyroid?

There are a few markers which must be assessed together for a complete and thorough assessment of the Thyroid. Let’s discuss each of them now:

TSH: Thyroid Stimulating Hormone – this hormone is produced by the pituitary gland. It’s job is to “crack the whip” to tell the thyroid to work a little harder.

T3: Your active thyroid hormone - this is the hormone which is metabolically active, responsible for all of the thyroid’s influence in the body (discussed above) including the metabolic rate, stimulating weight loss, improving appetite and digestion.

T4: Your storage thyroid hormone – we produce T3 from this in times of need by removing one iodine molecule. An adequate supply of this hormone means we are well nourished and have well stocked reserves. This hormone can be broken down and recycled over and over to create T3.

rT3: Reverse T3, the dummy hormone - one which is used to reduce appetite and metabolism in times of famine or malnutrition. This is the hormone which binds up the receptors, preventing T3 from doing it’s job. Remember T3 is responsible for a healthy appetite and metabolism, therefore elevated rT3 generally means slower metabolism, fatigue, difficulty losing weight.

Thyroid Autoantibodies- Antibodies which are produced due to autoimmune conditions such as hashimotos thyroiditis, or in the instance of nutrient deficiencies. Acceptable levels vary per the sensitivity of the lab conducting the test. Ideal levels would be zero.

TSI: A more recent introduction to thyroid testing is Thyroid Stimulating Immunoglobulin. This is a protein produced in the instance of Graves disease (the most common cause of hyperthyroidism) which mimicks TSH - causing overstimulation of the thyroid. TSI is a much more sensitive and accurate marker for Graves and is the best choice for those suffering with symptoms of Hyperthyroidism (hair loss, anxiety, overheating, difficulty losing weight etc).

Let's talk a little more about the available testing now..

What tests are available free of charge?

The standard process is that your GP will request a TSH assessment. He or she may also tick the boxes to include T3 or T4 but unless the TSH falls outside of the reference ranges, these assessments will not be carried out. Therefore, even if your GP has requested them, you have likely not had a complete assessment.

What is a reference range?

A reference range should be called the “Average range” as this is what it really means. It is the variation in numbers that is seen following an assessment of many tests, the range within which 95% of the population falls becomes the reference range. An example of this is TSH which has a range of 0.5 to 4.

What is a healthy range?

A healthy range is the ideal variation in test numbers that you would see in a healthy person. Using TSH as the example again, the ideal range is 1-2 – vastly different to the reference range. Outside of the healthy range, you may be unable to be clinically or formally “diagnosed” as having a condition yet would often be experiencing the associated symptoms.

For example, I have patients who have experienced hair loss, extreme weight loss and chronic anxiety at TSH of 0.6, I have patients with obesity with thyroid levels at 2.7. They are all under the care of a GP, due to their TSH sitting inside the reference ranges they did not qualify for further testing.

I referred them to the laboratory for private pathology for a full assessment. Severely imbalanced hormones were being produced by the thyroid in the majority of cases. From assessing these imbalances, we could determine the appropriate nutritional support.

You’ll be pleased to know that all patient’s symptoms improve quickly with the right support and the TSH begins to normalise over time.

What is the ideal?

The ideal range is where we all should aim to be, this is our optimum or preferred level. Ideal TSH is 1.5. At 1.5 we have the perfect amount of stimulation, not so much that it over-stimulates and causes severe weight loss, diarrhoea, anxiety etc, and not so little that we have lazy thyroids making us feel exhausted, constipated, depressed and struggling to lose weight. The ideal range is the gold medal – a reward for a commitment to your health and one that feels incredible once achieved.

Who should get their thyroid checked?

I would recommend that everyone who is trying, unsuccessfully to lose weight, or is experiencing any of the symptoms below, has their thyroid checked. Once the imbalances have been picked up it can be treated very effectively with the right balance of nutrients and will also allow accurate personalisation of your diet. Specific foods may be more therapeutic than others for you and some healthy foods may even need to be avoided – this is a highly valuable assessment that changes my patients lives, creating clarity and direction.

If you have been struggling for a while, particularly if you suffer from any of the following symptoms, we would love to help you. For the optimum testing package, combine your Thyroid assessment with a Nutrition Assessment. In a Nutrition Assessment for Thyroid health I'll be analysing your test results and provide dietary, supplemental and lifestyle advice for improving your Thyroid hormone balance and, as a result, your overall health.

Symptoms of thyroid dysfunction:

  • Constipation
  • Excessive hair loss
  • Dry brittle nails and hair
  • Weight gain despite eating healthy
  • Excessive weight loss
  • Anxiety
  • Depression
  • Sensitivity to cold
  • Chronic colds and/or flu
  • Chronic diarrhoea
  • Poor digestion
  • PMS
  • Infertility
  • Muscle weakness
  • Persistent fatigue
  • Joint or muscle pain
  • Pale dry skin
  • Hoarse and/or deep voice
  • Puffy face

Pass this article around to those who you think may benefit most from the information. It's time we took charge of our own health and used the tools we have available to us. Too often I see people who have struggled for years unnecessarily, the help was there all along - they just didn't know it.

__Until next time, stay deliciously healthy.

Try i-screen's Advanced Thyroid Check
Jennifer May author
Jennifer May (BHSc (Nut Med), Adv.Dip.Nut.Med, ATMS, MINDD)
Hi there! I am a Nutritionist and Lifestyle Medicine practitioner with more than 6 years experience, and run a successful practice in Sydney CBD. In 2014 I developed an industry-first internship program for students and new graduates of Nutritional Medicine and have mentored more than 30 students of Nutrition, Naturopathy and Dietetics to date. My passion is helping people feel younger, stronger, healthier. I look forward to working with you.
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