We talked about how thyroid should work. We talked about how common low thyroid is, with tens of millions of people treated for it. In the last lecture we talked about common symptoms of low thyroid - low energy, feeling sluggish and tired, gaining weight, dry skin, hair loss, cold intolerance, depression, brain fog, constipation. There are dozens of other symptoms, but these are the most common.
Today we’ll talk about how doctors are taught to diagnose hypothyroidism.
I mentioned that in the US, the number one reason for low thyroid is Hashimoto’s thyroiditis. About 90% of people with low thyroid have Hashimoto’s. It’s an autoimmune disease, where the immune system starts making antibodies against the thyroid gland. These antibodies slowly destroy the thyroid.
This is not supposed to happen, the body is not supposed to attack itself, but it does happen. The immune system starts attacking an organ, in this case the thyroid. That’s why Hashimoto’s is called an auto-immune disease. We’ll have plenty to say about Hashimoto’s in the future lectures.
I mentioned before that in the case of Hashimoto’s there is nothing wrong with the thyroid gland. Thyroid is fine, it is just a victim of the malfunctioning and overactive immune system.
The other 10% of hypothyroidism have different causes, like having thyroid removed, by a scalpel or by radiation, getting older, or getting pregnant, or going through menopause, or taking certain medications.
Whatever the cause, a typical patient notices some or all of the common symptoms, she suspects that she may have low thyroid and goes to see her doctor. The doctor, having heard her symptoms, agrees that she may have low thyroid and orders a blood test. The test is the level of TSH.
You remember TSH, thyroid stimulating hormone. It is produced by the pituitary gland. Its job Is to stimulate thyroid gland into action, into making more thyroid hormones. TSH is controlled by another hormone called TRH and by the level of thyroid hormones.
When there are plenty of thyroid hormones, TSH level will go down, but when thyroid hormones are low, TSH level goes up. That’s why we use TSH levels to diagnose low thyroid. If your TSH is higher than what the lab says it should be, then you are diagnosed with low thyroid and get a prescription. But if your TSH is not high enough, if it’s in the “normal range” then your doctor will say that you don’t have low thyroid. You are normal.
And it does not matter what symptoms you may have or how bad they are, they simply don’t matter. Only TSH matters, and if it’s not high enough then you are normal. You do not have any thyroid problems and any symptoms you have are all in your head, not real, end of story.
This is how doctors are taught; this is how I’ve been taught. TSH rules. If you have the symptoms and high TSH, then you have low thyroid, and we’ll treat you. If you have the symptoms, but your TSH is not high enough, then you are normal, nothing is wrong with you, and we will not treat you.
If you think about it, it doesn’t make much sense. We are looking for low thyroid, but we measure a pituitary hormone.
In the next lecture, we will talk about what blood tests your doctor should be checking and how blood tests can be normal when you really have a problem. For now, I’ll just tell you that this approach is wrong, and this is why there are tens of millions of people who have low thyroid, and you may be one of them, but their doctors refuse to treat them. Or even if you are being treated with thyroid medications, doctors decide what dose to give you based on TSH. If TSH is fine, then the dose you are taking is fine, even if your symptoms have not improved completely or at all.
Just think about it. Doctors have been treating patients with low thyroid for a few hundred years. There was no TSH test or any other blood tests. If you had the symptoms of low thyroid, the doctor would treat you. You know, if it looks like a duck and quacks like a duck, it’s most likely a duck.
But not today. Today it’s not a duck unless you have high TSH. If you don’t, tt does not matter what symptoms you might have, doctors will not treat you.
If you are in this situation, you need to find another doctor. Most of my thyroid patients came to me because they could not get treatment from their own doctors. The other patients came because the synthetic drugs they were given (Synthroid, Levothyroxine) did not work and they wanted to try something more natural. Of course, many came because they were recommended by other patients.
Next time we’ll talk about what blood test a doctor should order in a patient suspected of low thyroid.
If you know someone who might be interested in low thyroid, please refer them to LowThyroidDoctor.com so they can download this ebook. Also, if you have questions or comments, please email to DrTeplisky@gmail.com.
As an additional bonus, while available, you can get a free, no obligation 30 min phone consultation with me to see if I can help you figure out if you have low thyroid and what I can do to help you. Just book it online or call my office at 718-769-0997.