The standard NHS test for thyroid dysfunction measures TSH (thyroid stimulating hormone), and Free T4 (circulating levels of thyroxine). If you’re on medication for thyroid dysfunction, you’re probably getting these tested every three to four months and the results are probably within the normal ranges, while you feel anything but normal!

What’s missing in your test results are all the other factors that can contribute towards thyroid problems and need to be checked…

1. Thyroid antibodies
The body produces antibodies as part of a normal immune system response to invaders such as viruses, bacteria. In some people, the immune system overreacts and starts to produce antibodies to their very own thyroid as part of what is called an autoimmune disease. There are two autoimmune diseases that can affect thyroid function and without testing for thyroid antibodies, it is not possible to say that you do/don’t have them.

Hashimoto’s thyroiditis, or Hashimoto’s disease, is one of the thyroid autoimmune diseases and finding raised levels of these antibodies is a sign that the cells of the thyroid itself are slowly but surely being destroyed, leading to an underactive thyroid. That’s a permanent destruction – those cells won’t ever come back and the thyroid will never work at 100% again.

In some cases, my clients have had these tested and the results show raised levels of the Hashimoto’s antibodies, but as they show no symptoms of an underactive thyroid they are told to wait until they do show symptoms before any action will be taken. This is the equivalent of watching someone walking into the road and watching them get hit by a car, instead of doing something to stop them walking into the road….

If you’ve been diagnosed with an underactive thyroid, or have symptoms of an underactive thyroid, ask your GP to test for:

  • Antithyroid Peroxidase Antibody (TPO Ab)
  • Antithyroglobulin Antibody (TG Ab)
  • Thyroid Stimulating Immunoglobulin (TSI Ab)

2. Free T3
Free T4, or Thyroxine, is a relatively inactive hormone secreted by the thyroid that circulates in the body. Patients diagnosed with thyroid dysfunction are given T4 in dosages between 25mcg and 200mcg in their thyroid medications.

But more important than knowing how much Free T4 is present, is knowing the level of Free T3 or Triiodothyronine which is the active form of T4. This isn’t included in the thyroid medications, and the conversion process is dependant upon the presence of selenium. Selenium is found in abundance in brazil nuts (just 3 a day is plenty!) and eggs, but there are many people who don’t eat either on a weekly, let alone daily basis which means you might be at risk of selenium deficiency, and therefore not be able to convert T4 to T3.

Whether you eat eggs and brazil nuts or not, ask your GP to test for:

  • Free T3

3. Full iron panel
Insufficient levels of iron in the body can result in the thyroid not being able to form the thyroid hormones T3 and T4. Iron deficiency is becoming more common, particularly in women. But it’s often overlooked when a client has thyroid dysfunction since the symptoms of insufficient iron (and indeed those of excess iron) such as fatigue and hair loss are also symptoms of thyroid dysfunction!

If you’re feeling tired, breathless, and have aches and pains, or you’re experiencing hairloss, ask your GP to test for:

  • Serum Ferritin
  • Total Iron
  • Saturation %
  • Total Iron Binding Capacity (TIBC)

Similar symptoms of fatigue can also be experienced with low B12 or low folate levels, so it can also be worth asking your GP to test for serum B12, and serum folate to rule out insufficiencies.

4. Reproductive Hormones
A lot of research appears to show that thyroid dysfunction can be one driver of infertility. Indeed, excess oestrogen can inhibit the action of thyroid hormones, by competing with them in the body. This could result in you seeing normal levels of thyroid hormones in your blood results, but feeling the symptoms of thyroid dysfunction.

If you have any menstrual abnormalities, from irregular periods to symptoms of pre-menstrual syndrome, ask your GP to test for:

  • Oestrogen
  • Progesterone
  • FSH
  • LH
  • Total Testosterone
  • Free Testosterone
  • SHBG

Once you have all your results, it’s time to book your appointment with me (or another nutritional therapist!) and start taking control!

Good luck!