Suspect You Have a Thyroid Issue but Your Bloods Are in Range?

Hypothyroidism is often diagnosed through blood tests that measure Thyroid-Stimulating Hormone (TSH), and sometimes Free T3 and Free T4. However, many women experience hypothyroid symptoms despite their lab results falling within the "normal" ranges. This discrepancy can be attributed to factors that traditional tests may overlook, such as intracellular utilization of Free T3 and elevated Reverse T3 (RT3) levels. Understanding RT3 and its role in thyroid function is crucial for addressing the underlying issues of hypothyroidism.

What is a Full Thyroid Panel?

Often, when a woman gets a script for blood work to test thyroid levels, the script only checks TSH, T3, and T4, which is not a full thyroid panel. A full thyroid panel tests seven levels which are important for getting a more complete picture of an individual's thyroid health. A full thyroid panel includes:

1. TSH (Thyroid Stimulating Hormone)

2. Free T3

3. Free T4

4. Reverse T3

5. Anti-TG Antibody (anti-thyroglobulin)

6. Anti-TPO (Anti-thyroid Peroxidase)

7. TSH receptor-stimulating antibody

Sometimes when TSH, T3, and T4 are within normal ranges, we are told that there is nothing wrong. However, upon deeper inspection, there could be underlying issues. The ratio of these hormones in relation to each other might be off, or cellular energy which supports Thyroid Binding Globulin (TBG) might be low due to poor mitochondrial health. Elevated levels of RT3, indicative of stress, might be hindering T3 function, or poor liver and gut health might be hindering the conversion of T4 into active T3. These deeper issues can cause symptoms of hypothyroidism which can be missed or dismissed when simply looking at TSH, T3, and T4 alone.

The Role of Reverse T3 (RT3)

RT3 is a thyroid hormone that acts as a regulator, preventing the body from becoming hyperthyroid by balancing out the effects of active thyroid hormones. It counteracts active T3 and creates equilibrium in a healthy body. When the body faces stress—whether from illness, trauma, or chronic emotional stress—it produces more RT3. This increase is meant to conserve energy, allowing the body to better focus on dealing with the immediate stressor, which should be only temporary.

In cases of prolonged or chronic stress, consistently elevated RT3 levels can inhibit the function of T3, the active form of thyroid hormone responsible for energy metabolism, body temperature regulation, and overall vitality. This blockage can lead to hypothyroid symptoms even when TSH, T3, and T4 levels appear normal.

The Importance of Liver and Gut Health

The thyroid gland produces T4, which is stored predominantly in the liver (80%) and the gut (20%). When the body requires T3, T4 is released from these stores and converted into T3. This conversion is crucial for maintaining a range of bodily functions that the thyroid is responsible for. Poor digestive health and/or liver function can hinder this conversion, leading to insufficient T3 availability when needed and consequently, hypothyroid symptoms.

Maintaining a healthy liver and gut is essential for optimal thyroid function. A sluggish liver or compromised digestive system can disrupt the delicate balance of thyroid hormones, further exacerbating hypothyroid symptoms.

Free T3 and Thyroid Binding Globulin (TBG)

Elevated levels of free T3 can indicate that Thyroid Binding Globulin (TBG) is not effectively transporting thyroid hormones to the cells. This inefficiency is often a result of stress, which depletes the body’s energy and affects the mitochondria—the cell's powerhouse responsible for energy production.

When the mitochondria are fatigued, the transportation of thyroid hormones becomes less efficient, leading to symptoms of hypothyroidism despite normal blood test results. This underscores the importance of addressing stress and supporting mitochondrial health to ensure proper thyroid hormone function.

Addressing Hypothyroidism Holistically

Understanding the nuances of thyroid function and the potential pitfalls of standard blood tests is essential for managing hypothyroidism effectively. Here are some steps women can take to support their thyroid health:

1. Comprehensive Testing: Request a Full Thyroid Panel from your doctor. This can provide a clearer picture of thyroid health.

2. Stress Management: Implement stress-reduction techniques such as mindfulness, yoga, or breathwork to reduce the production of RT3 and support overall thyroid function. Engage in oxytocin-boosting activities such as hugging a loved one, spending time with friends, listening to music, or getting a massage. Oxytocin directly counteracts cortisol—the stress hormone.

3. Support Liver and Gut Health: Adopt a diet rich in nutrients that support liver and gut health, including plenty of fiber, antioxidants, and anti-inflammatory foods. Consider supplements like probiotics or milk thistle if recommended by a healthcare provider.

4. Support Mitochondrial Health: Ensure adequate intake of nutrients that support mitochondrial function, such as CoQ10, magnesium, and B vitamins.

5. Regular Monitoring: Work with a healthcare provider to regularly monitor thyroid function, especially if symptoms persist despite normal blood test results.

Conclusion

Hypothyroidism is a complex condition that requires a comprehensive approach to diagnosis and treatment. By understanding the role of RT3, the importance of liver and gut health, and the impact of stress on thyroid function, women can take proactive steps to manage their symptoms and improve their overall well-being. Always consult with a healthcare provider for personalised advice and treatment options.