Are you suffering from fatigue despite eating and sleeping well? Has your primary care doctor told you that your thyroid is normal? What if I told you there are more detailed tests your primary doctor likely didn’t order, and it is possible your thyroid is low? Wouldn’t you want to be sure your thyroid is normal?
Luckily for my patient, Andrea (name changed), her thyroid story was more straightforward than most. A few years after establishing herself as a patient, she started to feel fatigued despite eating healthily and sleeping well with low stress levels. She felt very sluggish in the morning, she had always been a morning person, but now it was hard for her to get up and get going for the day. She avoided caffeine so she wasn’t able to cover up this symptoms with coffee like others tend to do. She also noticed she was feeling sluggish in the afternoon. Not tired enough to complain or take a nap, but just enough that she realized something had changed because everything else she was doing in her life had remained the same. This had been going on for a while and she didn’t think to mention it to me until I asked about her quality of life.
We did a detailed thyroid panel, and her labs came back with Free T3 at the lowest end of “normal”. I compared this to her previous labs and found there was a decrease in her numbers. We decided to start her on a low dose of bioidentical thyroid to see if that would boost her energy. Within a week, she reported that her energy levels were back up and she was feeling great. She is still living a healthy lifestyle and has maintained the same dosage of bioidentical thyroid for several years. Though Andrea’s case is simple, thyroid issues can be quite nuanced and may require a deeper look.
Many doctors will often only order two labs to check the thyroid: Thyroid Stimulating Hormone (TSH) and T4. However, T4 is the storage form of thyroid hormone which your body is unable to use until it is transformed into another version of thyroid hormone, T3. So, if your body doesn’t use it, why do doctors order it? Simply put, ordering only TSH and T4 is the “standard of care”. Ordering more detailed thyroid labs is going above and beyond the standard of care and some doctors are not willing to do this without a direct request from the patient.
At our office we order a detailed thyroid panel that consists of the storage form and active form of thyroid hormone, T4 and T3. We also order the unbound or free version of the hormones because this is the version your body can use right away. I’ve seen many patients like Andrea whose levels are on the low end of normal who feel much better when their levels are higher in the range. There are also patients who are unable to transform the storage form into the active form. These patients were told that their thyroid was normal when they are actually hypothyroid.
Many people like Andrea will write off their symptoms and think to just live with it or chalk it up to the aging process. However, quality of life is much more important than we give it credit for and factors heavily into our happiness on a day-to-day basis. Some simple tests and a supportive treatment plan can get you back on your feet and feeling better than ever.
The only way to find out if your case is similar is to get additional thyroid testing. Call our office for a detailed thyroid panel and find out where you are on the thyroid scale.