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Thyroid Symptoms with Normal Labs?

With 1 in 7 women in the U.S. diagnosed with thyroid problems, this health condition is more common than you may think. Most of us are familiar with the more common symptoms of thyroid dysfunction like fatigue and difficulty losing weight – even with diet and exercise- FRUSTRATING!

Dr. Natalie Lawrence, DC

Some other common, but less know symptoms are: 

• constipation
• depression
• hair loss
• feeling cold
• anxiety
• heart palpitations

If this sounds like you, you may have asked your doctor to check your thyroid and been told “all is well” yet your health continues to decline.

I see this happen regularly in my practice. Part of the problem is that not enough testing has been done to really check thyroid function and the issue is never uncovered.

Typical testing that is ordered is TSH only or TSH, T4, and T3. 

Let’s look at what these tests mean: 

TSH – Signal from the pituitary (brain) to the thyroid to make thyroid hormone. It should be higher when you are low in hormone and normal when you have enough.

T4 – The main thyroid hormone.  Around 93% of what the thyroid makes is T4, mostly inactive until converted to T3.

T3 – The other thyroid hormone. About 7% of what thyroid makes but the hormone that activates cells and does work is T3, not T4. T3 is converted primarily in the liver, secondarily in the GI Tract and cells.

T3U – Related to your hormone status and blood sugar – carries the hormones out into the body.

TPO/TBG Antibodies – Show up when you have Autoimmune reactivity – coupled with thyroid symptoms indicate Hashimoto’s Disease

RT3 – Reverse T3-inactive and blocks actual T3 from working.

Typical screening only consists of TSH and maybe T4 or T3 – not enough to get to the bottom of things.

If you’ve been told your thyroid tests are normal, yet still suffer from the symptoms, ask your doctor to run ALL of the testings. If a problem is uncovered, you may respond positively to thyroid replacement, like Synthroid or Armour.

If you’re a woman on thyroid hormones and still not feeling well it may be time to dig a little deeper. 
• You may have a problem converting T4 to T3 which will give low thyroid symptoms with a normal TSH.
• YPositive  AB’s indicate auto-immunity, making the issue a problem with your immune system. Look for aggravating factors like infections, inflammation and blood sugar dysregulation.
• Changes in testosterone and estrogen can affect binding and create symptoms of low thyroid or high thyroid.

A functional medicine practitioner looks at the patient in a more holistic way to get the “bigger picture”. If you aren’t getting the results you’re looking for, it may be time to look at your problem through a different lens.

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