Normal Thyroid Levels But Still Have Hypothyroid Symptoms:
An abnormally high TSH will catch low thyroid function in about 95% of cases. The other 5% of cases can be detected with a TSH test and a test of free thyroxine (T4). Thyroid stimulating hormone (TSH) is produced and released by the pituitary gland, found at the base of your brain. It acts as a messenger to the thyroid gland to produce thyroid hormone T4 (thyroxine), which converts to T3 (triiodothyronine) in the body.
Most importantly, building muscles help you preserve your metabolism, making it easier to lose fat. In Thyroid Strong, I’ve guided thousands of women with Hashimoto’s through safely exercising and building muscles. Some women don’t only have autoimmune attacks on their thyroid but also the inability to activate thyroid hormones [8]. So, it’s a good idea to ask your doctor about checking for free T3 and adding a T3 medication. If your thyroid hormone levels are low, a simple treatment could greatly improve your quality of life.
Symptoms of hypothyroidism may include being tired, slow, sluggish, gaining weight, cold, dry skin and constipation. In the vast majority of patients with overt hypothyroidism, symptoms either improve or resolve when thyroid hormone levels are returned to the normal range with thyroid hormone therapy. In patients with subclinical hypothyroidism, results are not as clear. Indeed, in both overt and subclinical hypothyroidism, some patients might still have some symptoms despite thyroid levels being normalized.
Generally, high TSH can indicate hypothyroidism, while low TSH can indicate hyperthyroidism, though the levels and severities of these can vary. Things like blood sugar imbalance, gut dysfunction, food intolerances, chronic infections, environmental toxins, and inflammation can cause the adrenal glands to produce more stress hormones. Like many hypothyroid symptoms, adrenal stress symptoms are often nonspecific and can affect virtually every system in the body. Subclinical hypothyroidism is a mildly elevated TSH level in the presence of normal free T4. It is challenging to determine which symptoms, if any, are related to subclinical hypothyroidism as the symptoms are often nonspecific and could be related to any number of other things.
Levothyroxine typically causes no side effects when used in the correct dose. If you change brands of the medicine, tell your health care provider, as the dosage may need to change. From that database, the Rush researchers identified 469 adults who were taking levothyroxine monotherapy and compared them to 469 individuals who were not on levothyroxine. Both groups were matched for age, sex, race, and serum TSH levels. One is that the thyroid mostly produces T4, which turns into T3 as it travels through the body.
They can do this by affecting other hormone systems (such as cortisol), reducing inflammation, and providing your thyroid with nutrients that it may directly be in need of. I find this type of deficiency to be very common among people in the United States. I am referring more info to the combination of TSH, free T3, free T4, and reverse T3 (total T3 can be included here but it doesn’t necessarily have to be). So even though you were right that you have a thyroid problem, it will go unnoticed unless the CORRECT tests were ordered.
Despite starting patients on levothyroxine, around 40% of the patients still had laboratory numbers indicating subclinical hypothyroidism, even during the follow-up period. Measurement of TSH by immunoassay is used by endocrinologists to screen for and diagnose thyroid disorders. Based solely on TSH levels, the three see patients identified in this and a previous study [21] appeared to be euthyroid. Importantly, treatment with thyroid hormones alleviated symptoms and lowered total cholesterol in the case report of the 76-year-old male presented above. The body releases TSH to signal the thyroid gland to release thyroid hormones.
“The important thing to understand is that T4 is not the active hormone,” Bianco said. “T4 must be converted to T3 by our bodies with an enzyme called deiodinase.” However, this test can often time be misleading, as levels of circulating hormones may fluctuate at different times, such as in Hashimoto’s, the person affected may fluctuate between highs and lows. Most conventional physicians use the TSH test to determine if one has a thyroid disorder and to dose thyroid medications. It is important to take thyroid hormone at a different time of day than one does other vitamins, especially iron supplements, since they can interfere with the body’s ability to absorb treatment. If TSH rises above 10 mU/l, doctors usually treat it as hypothyroidism, and a person will likely have symptoms.
In most cases, a doctor will recommend a dosage of 1.6 micrograms per kilogram of body weight per day. It is possible, however, to adjust this if a person needs less or more. Most laboratories consider TSH levels of 10 mU/l or above to be high enough to start treatment. Researchers recommend treatment when TSH levels rise above 2.5 mU/l in pregnancy. Similarly, insulin resistance, diabetes, or metabolic syndrome may also impact the conversion of T4 to T3. Insulin is a hormone produced in the pancreas that regulates the amount of glucose in the blood.
To start, your hypothalamus releases thyroid-releasing hormone (TRH) to trigger the release of thyroid-stimulating hormone (TSH) by your pituitary gland. Most of the time, subclinical hypothyroidism doesn’t cause any symptoms (it’s asymptomatic). Based on TSH and FT4 measurements by IA, all patients appear to be euthyroid. However, when total and free thyroid hormone concentrations were measured by LC-MS/MS, all patients were diagnosed as having biochemical hypothyroidism. Cholesterol, TSH, and thyroid hormones were measured using the Roche Cobas 6000 (Indianapolis, IN).
T3 hormones can also interfere with T4 blood test results and complicate the monitoring of your disease. The combination of Cytomel and levothyroxine may improve symptoms without any additional side effects compared to levothyroxine alone. There are many healthcare providers who consider the addition of a T3 hormone, in the form of Cytomel (liothyronine or LT3), wholly unnecessary and problematic.
Thus, it’s important to notify your healthcare provider of any history of thyroid disease in addition to active thyroid disease. Various prescription medications can do this by either inhibiting the release of thyroid hormone directly, reducing peripheral T4 to T3 conversion, or directly damaging your thyroid gland. And these antibody levels can be ELEVATED even in the face of normal thyroid lab tests which includes a normal TSH. One study identified LT4 use for subclinical hypothyroidism as one of four commonly overprescribed medications, especially in older adults. When assessing your response to treatment, many healthcare providers will aim to get your TSH level to around 1 to 2 mU/L’the lower end of the normal range.
All of your clinical symptoms point to hypothyroidism so you go to your doctor to get checked. Over time this will lead to the complete destruction of your gland and reliance upon thyroid medication for life. Consider it ‘good medicine’ to have yourself checked for and evaluated for these conditions if you have thyroid disease.
TSH is also not necessarily sufficient to monitor hypothyroidism during pregnancy; T4 and free T4 are often recommended. Likewise, if the TSH is normal, but a person still has symptoms of being hyperthyroid or hypothyroid, free source T4 may be checked. In some cases, however, the dose is okay, but the medication is not being fully absorbed. For example, many foods and medications can affect the absorption of Synthroid (levothyroxine) in your system.