How to Determine if you Have a Thyroid Problem
By Dr. Shannon Sinsheimer, N.D.

One of the most common concerns many individuals have is thyroid dysfunction. Lack of energy, weight gain, sleep issues, and hair loss often prompt the concern. Although these symptoms can be “classic” indicators of hypothyroidism, one does not always have a thyroid condition if they simply have these concerns. A medical intake, appropriate lab work, and a physical exam are necessary to determine if you have thyroid dysfunction. Treatment plans depend on a combination of findings from these procedures.

The symptoms of thyroid dysfunction are first discussed during the medical intake. Most often, individuals are affected by hypothyroidism or what is commonly called “low thyroid function.” Hyperthyroidism, or an “overactive” thyroid is less common than hypothyroid but still present in many people. Typical physical indicators of hypothyroid include weight gain, inability to lose weight, fatigue, depression, hair loss, cold extremities, constipation, and irritability. Some or all of these symptoms may be present, however even a small number of these can lead to discomfort and unhappiness with the way one feels on a daily basis. Based on the symptoms present during the intake, relevant lab work is then ordered.

The lab work for thyroid function needs to be specific to determine exactly what, if any, thyroid dysfunction is present. To be thorough, have Thyroid Stimulating Hormone (TSH), Free T3, Free T4, and Free Thyroxin Index (FTI) tested. TSH is an indicator of how well your thyroid is able to produce the active thyroid hormones T3 and T4. The measurement of Free T3 and Free T4 shows the amount of thyroid hormone that is unbound to certain proteins in the body and is therefore a more direct method of detecting hormone levels versus detecting the way in which it is able to bind to certain proteins. The amount of active hormone and TSH determine the appropriate type of treatment to consider.

Physical exams are done to assess any other physical conditions related to the symptoms mentioned and to determine if there is any thyroid enlargement or nodules. The thyroid is located in the front, midsection of the neck on either side of the esophagus. It can be easily found and palpated to determine a disruption in size or texture.

Based on the findings from the exams mentioned, an appropriate treatment plan is created. Many physicians find it unnecessary to treat a thyroid condition unless the TSH is above five. However, a more conservative analysis of TSH correlated with any physical symptoms of hypothyroidism could require medical treatment. This is called sub clinical hypothyroidism, meaning your TSH is between 1.5-5, below the “clinical” levels of low thyroid, yet still displaying symptoms of a hypothyroid condition. An appropriate medical treatment can address sub clinical hypothyroidism to relieve the symptoms without creating any long-term damage to the thyroid.

Treatments may range from natural thyroid supplementation (formerly known as armour thyroid) to supplementation of herbs, minerals, and vitamins. The treatment is based on the severity of the symptoms and ratio of thyroid hormones. For individuals with more severe symptoms, natural thyroid in addition to nutritional supplements may be necessary. However, those with less severe symptoms may only need the supplements.

In addition to assessing the thyroid itself, it is also appropriate to assess causative factors of thyroid dysfunction. Three common culprits of thyroid disease are adrenal fatigue, excessive heavy metals in the body and food intolerance, such as gluten. A heavy metal urine challenge with DMSA used as a chelating agent can determine if there are above normal levels of mercury and lead in the body. An adrenal function test, requiring four timed saliva samples will show the range of adrenal function throughout the day. A food sensitivity test will determine if there are foods aggravating the body’s systems. All of these factors are important in determining the cause as well as the treatment of thyroid dysfunction.

To determine thyroid dysfunction, you will need a medical intake, lab work and a physical exam conjunctively to evaluate the necessity of any medical treatment. To assure you have a thyroid problem you will need to thoroughly assess your lab work alongside your symptoms. If your lab work is in the borderline ranges, make sure the possibility of sub clinical hypothyroidism is addressed. Treatment options depend on the severity of the condition alongside the health goals of the patient. In addition to treatment, it is best to assess causative factors of thyroid dysfunction. Those individuals who have thyroid dysfunction can feel better within a matter of days if the correct treatment is given, so it is worthwhile to assess your thyroid function if you are not feeling optimally healthy.

Shannon Sinsheimer is a Naturopathic Doctor in…..she can be reached at….