Why is My Thyroid Still Not Normal?

January 19, 2015

Why Is My Thyroid Still Abnormal

Reference Kent Holtorf Journal of Restorative Medicine 2014 Jan 19th, 2015 

 Standard medical practice measures two simple tests with your thyroid.   Your TSH (thyroid stimulating hormone) and your T4 (the circulating precursor to the active hormone T3).   Your doctor says, “You’re fine.”   You still feel crummy.   What’s going on? Your doctor made the assumption that your blood test shows “normal” so you must be ok.   That assumption is based on the premise that if blood levels are ok, intracellular levels are also ok.   

Aha!   Therein is the glitch. Transport of T4 into cells is not a passive subject.   There is much recent evidence that insulin resistance, diabetes, depression, chronic fatigue, high blood lipids, anxiety, dieting and plain old aging all contribute to reduced T4 transport into cells, while the pituitary is unaffected. In fact, the pituitary can continue to concentrate T4 up to as much as 600 times higher than peripheral tissues. 

The pituitary/hypothalamus combination is thereby not the best indicator of peripheral tissue function.   That’s what your doctor measures when she/he draws a TSH test. The TSH is what your pitutitary thinks you need. If it’s level is higher, it’s your pituitary saying you need more. If it’s lower, your pituitary says you have enough. Transport of T4 into cells is not passive. That is the assumption your doctor made. It takes energy. Transporting T4 takes more energy than T3. If you are treated with pure T4, you might not be getting enough thyroid effect in your tissue. 

So, if you are cold, gaining weight, have muscle aches, decreased libido, weakness, water retention, depression, have low basal body temperature, all symptoms of being hypothyroid, you likely need to be treated with T3. If this sounds like you, you may need to have some unique tests done. A much better assessment of your thyroid comes from testing your REVERSE T3 and calculating a T3 / rT3 ratio.   (Reverse T3 is a mirror image of T3 and basically blocks T3 from working – giving your body a valuable tool to adjust your energy metabolism up and down.)   High levels of rT3 are more likely due to reduced transport into the cell, and not due to increased T4 to rT3 conversion. 

So, a high rT3 is simply a good marker for lousy intracellular transport of T4. If you can’t transport T4 into the cell, you can’t make T3, and you feel tired, cold and achy. Then, you should measure your Sex Hormone Binding Globulin (SHBG). SHBG is made in your liver in response to sufficient estrogen and sufficient intracellular T4 in the liver.   If women have a level above 70 nmol/L and men above 25 nmol/L, each has enough intracellular T4. 

 Read the whole article referenced above. Holtorf is one of your best thyroid educators.   The final kicker you will find is that dieting repeatedly changes the speed at which you transport T4 into the cell. It has been demonstrated that repeated dieting results in weight loss at half the rate, and weight gain at three times the normal rate unless thyroid hormone deficit is addressed. Hmmm. 

 WWW. What will work for me?   Weight loss is the holy grail of good health. But it messes up our thyroids and then we see our doctors who can’t figure out our problems. We feel cold. I’m checking rT3 and SHBG all the time now, and the light turns on when you see the results. It’s a much better set of tests than the simple TSH and T4. 

 Pop Quiz

  1. Reverse T3 is the mirror image of T3.   T or F                      Anwer:  Perfect. True
  1. Reverse T3 reverses T3.   T or F                       Answer:  Again, on the money
  1. Our body balances T3 and rT3 intracellularly to deal with stress, which boomerangs on us in a highly stressed world, filled with dangerous foods. T or F                        Answer:  That’s about the sum of it
  1. Your pituitary gland reads blood levels of T4 accurately. T or F                       Answer:  Dead wrong. It can concentrate T4 and convert it to T3 many times more efficiently than local tissues
  1. Does the pituitary make TSH which accurately reflects your body's thyroid needs? T or F.     Answer:   T if you are taking the Internal Medicine exam, false if you are a human
  1. Sex Hormone Binding Globulin is an interesting adjunct measure of the accuracy of sufficient intracellular thyroid hormone activity. T or F