Feeling Awful with a "Normal" TSH


Your thyroid gland is responsible for a host of bodily functions; every glucose oxidation reaction in the body in fact. Hormones secreted by your thyroid control metabolic rate, body heat, blood pressure, pain response, and directly affect your mood. They govern the metabolism of carbohydrates, proteins and fats, and the secretion of digestive juices. Thyroid hormones also trigger tissue growth, skeletal and nervous system development, reproductive maturation, and reproduction.

The thyroid hormones effect virtually every cell in your body and when they get out of balance you may feel tired, bloated, heavy, have pain or a host of other issues making it hard for you to feel young and vibrant.

If your doctor has suspected a thyroid imbalance, they have likely ordered a TSH test. Thyroid-Stimulating Hormone (TSH), or thyrotropin, is a hormone that stimulates the development and secretions of the thyroid gland. It’s released from the anterior pituitary and it stimulates the thyroid gland to release thyroid hormones (TH).

However, TSH is not an ideal test to get to the root cause of disease. For example, your pituitary could be stimulating your thyroid as it’s supposed to and you could still not have enough thyroid hormones getting into your cells. TSH needs to be assessed with other endocrine hormones to help you get to your root cause.

Ok, get ready for some science. Thyroid hormone (TH) is actually two different iodine-containing hormones; Thyroxine (T4) and triiodothyronine (T3), the more cellular active form. More than 90% of the TH produced is T4 which is made with the help of thyroid peroxidase enzyme (TPO). T4 then is converted into either T3 (within your liver and digestive tract) or reverse T3 (rT3). T3 is the active form while rT3 is the inactive form and can reduce the effectiveness of T3 by competing for absorption at the receptor sites.

When in balance, and responding as designed, T4 regulates TSH. Low levels of Thyroxine (T4) trigger the release of TSH and ultimately more T4, as does increased body energy requirements. TSH is inhibited by high levels of T4 and lower body energy requirements.

Imbalance, whether under or over-activity of TSH, inability to make T4, conversion of T4 into rT3 or T3 not getting into the cells, will cause noticeable and often problematic metabolic changes. Other factors could be mineral imbalances, metabolic toxins, adrenal insufficiencies, hormone imbalances and more.

So, if my doctor or I suspect a Thyroid imbalance, what should I do?

These are the recommended minimum labs to request to get a complete enough picture to establish a root cause:
• Free and Total T3
• Free and Total T4
• rT3
• Thyroid peroxidase (TPO) antibodies
• 4 or 5-point salivary cortisol

Additionally, you may want to look for total protein, ferritin, estrogen and progesterone levels, vitamin D levels and more. You’ll need a health care professional well versed at looking at the entire endocrine system, knowledgeable of optimal levels of the above labs, and experienced enough to know what nutrients are needed to help alleviate the imbalance in question.