Thyroid Dysfunction You May Not Know About

1. Hypothyroid means your gland is under active: too little thyroid hormone being produced
2. Hyperthyroid means your gland is overactive: too much thyroid being produced
3. Both hypothyroid disease and hyperthyroid disease can be primary or secondary, either the gland dysfunctions or there is another cause that has to be adjusted for the gland to be able to function well
4. There are individuals who do test borderline, and fluctuate in and out of a dysfunctional hormone level. Typically this will be due to illness or even medication. Because of this it is optimal to have a primary care provider watching you in a global or holistic way to help you optimize your health.
5. Symptoms of thyroid disease are fairly commonly known such as fatigue, hair, nail problems
6. Sexual dysfunction is not normally discussed by health care providers as a side effect of thyroid disease, but actually this is not uncommon.
7. Blood work is the only way physicians diagnose thyroid disease. There are different lab values we see in primary and secondary thyroid disease. This prevents the simplistic approach to thyroid disease of just using a value such as the TSH level which is a pituitary control hormone, and not the actual circulating active thyroid disease.
8. Understanding how a hormone, secreted remotely from a gland in our neck, can affect all cells is a critical piece of the physiologic puzzle that is us. Like with other hormones, thyroid circulates free in the blood stream, or bound. If binding proteins increase, the levels won’t test normal.
9. The correct blood work is critical. If you are on hormone therapy or oral contraceptive pills this may alter your lab values.
10. In primary underactive thyroid gland, or primary hypothyroidism your TSH should be increased, you circulating or free T3 and T4 is decreased.
11. In secondary hypothyroidism, such as in a woman on hormone therapy, you may have typical decreased TSH, or actually normal TSH levels and decreased free T4, and decreased or normal T3 levels. The result can be that some standard testing looks normal. In this type of hypothyroidism you are not optimally in balance, and don’t feel well for a reason: your thyroid is actually underactive.
12. There are actually three proteins thyroid circulates to. TBG thyroid binding globulin is one that is the best known and checked by physicians. Transthyretin and albumin are the other two. Their functions are complex, date to very primitive organisms, and are a whole topic of their own!
13. In women it is becoming clear that we need to be tested in more complex ways to really understand thyroid health as estrogen hormone affects the binding of thyroid, especially the TBG (thyroxin binding hormone).
14. Oral hormone therapy will affect the TBG levels the most and may alter your thyroid levels. And as your doc tweaks your estrogen dosage, timing, or route the effects on the thyroid gland can vary!

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