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“I’M TIRED. IT MUST BE MY THYROID! I CAN’T LOSE WEIGHT. IT MUST BE MY THYROID!”

By: Clifford Sonnie, M.D., M.P.H.

I hear this time and again in my clinic so I thought I’d write a bit about the thyroid. It is an endocrine organ (it makes hormones) in your neck. It has two lobes located on each side of the lower part of the neck and a piece of tissue connecting the two together. It collects iodine and forms a thyroid hormone. I’ll get into the names later. Basically, it is the gas pedal of the body. If you are running too slow it produces its hormone and the body’s metabolism (engine) speeds up and vise versa. It keeps us running as fast as we need it to, to give us energy and allow the body to burn off fuel so we can control weight. Running too slow can result in fatigue and weight gain and running too fast, blood pressure and heart problems.

That makes sense, so what’s the problem. Well the problem is that it is just not that easy. Yes, the thyroid makes thyroid hormone. The issue is what affects that production. Now is the time for definitions. Ready? The pituitary is an endocrine gland in your brain and one of its jobs (with the help of a gland called the hypothalamus) is to watch how fast the body is running. If it is too slow it produces something called TSH (thyroid stimulating hormone). This kicks the thyroid in the butt and tells it to start producing more Tetraiodothyronine (T4). T4 is like Clark Kent. It’s big and strong but doesn’t do much. T4 goes to the body (the liver is the phone booth) and takes off an iodine and comes back as triiodothyronine (T3). T3 is the Superman, as it is responsible to speed up your engine. Couple of problems! First there are many things (including other hormones) that affect how well T3 works and second those same things can mess up T4 from becoming T3. Lastly your body can also sometimes produce something called reverseT3 instead of T3. Reverse T3 is measured together with the T3 and it can give you a false reading. It also has no power whatsoever and blocks the “good” T3 (works like kryptonite). Ok, it’s over you can wake up now.

What can affect T4 and T3? Well like I said, one answer is other hormones. Estrogen, for example, works against T3 and allows calories to be turned into fat. T3 wants to burn them off. Progesterone helps control the amount of estrogen. So if you have too little progesterone or too much estrogen, your thyroid won’t work as well. (Where you get too much estrogen or too little progesterone is the subject for another article and it will surprise you). Likewise, the adrenal gland produces cortisol which stops T4 from becoming T3. Too little iodine in your diet will also affect thyroid function and today I believe we do not get anywhere near enough iodine in our diet, especially if you live in the “rust belt” and we do. Your immune system sometimes goes bonkers and looks at the thyroid and doesn’t recognize it. So it begins to attack it. This is called autoimmune disease and can be caused by toxins, heavy toxic metals, genetics and many other things. (Wow that’s three more things I can write about in future articles). These same toxins also are believed to be the cause of your body producing kryptonite, I mean reverse T3. Ok I was wrong. Now it’s over. WAKE UP!!

How do you test to see if the thyroid is ok? A blood test will show you T3, T4 and TSH but there are a couple problems. First reverse T3 is measured as “good” T3 so it can be confusing. (You can actually order a reverse T3 but not many labs do it and it’s expensive). Second there are different opinions between MDs as to whether the high range of normal for TSH is too high. As for me I look at the blood tests but I also like to rely on waking temperatures. Too low you are too slow, just that simple. There are ultrasounds and CT scans done of the thyroid but that is in case a lump was felt in your thyroid by your doctor.

Treatment as you can see is not as simple as just giving you iodine, synthetic thyroid (Synthroid) or natural desiccated thyroid (Armour Thyroid). Even with “normal” numbers the problem could still be the thyroid. Too many times these patients are mislabeled with things like fibromyalgia, chronic fatigue syndrome or depression. Likewise with abnormal numbers the issue can be so much more involved than just the thyroid. Therefore make sure you see someone who has been trained in this area of medicine namely your family MD or DO. Or you can also call us at The Balance of Life Clinic and we can sit down with you and determine if your concerns are coming from your thyroid or elsewhere and along with your family medical physician develop a game plan to correct it. Remember a smart health care consumer is informed and aware.

Clifford Sonnie, M.D., M.P.H. is a physician at The Balance of Life Clinic.