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Endocrine System

Thyroid Thicket - Part Three of Three

How do I get to GOOD?

Or, in other words, if my tests suggest something is amiss, what do I do? Let's just talk about hypothyroidism, which raises the possibility of replacing, by prescription, thyroid hormone. Hypothyroidism, whether overt or subclinical, takes a toll on normal physiology and will generally get worse if treatment is delayed. You have many options for treatment, starting with two special considerations:

Thyroid Thicket - Part Two of Three

Here’s the million dollar question, because most large medical clinics have switched to “efficient” thyroid testing, which I would call perhaps efficient but in the long term, absolutely insufficient. Bare bones testing checks just the TSH (the messenger from the brain’s control center, turning on thyroid hormone production) with a “reflex to T4”, the free T4 only ordered if the TSH crosses a worrisome threshold, usually set too high, in my opinion. Such testing will identify “overt” hypothyroidism, namely when there is an elevated TSH and a sub-normal T4 level.

Hashimoto's Thyroiditis

Something is not quite right, but it’s not necessarily dramatic. Some feature of your vitality is, well, just a little bit under the weather. It could be a sinking of mood or energy, a little extra hair loss, a change in the quality of your sleep. Your mind doesn’t seem quite so sharp, you’ve gained a little weight, your voice is hoarse; perhaps you’ve become constipated.