The All Important First Step
How well this part goes is going to depend a lot on your doctor. Unfortunately there is a surprisingly large percentage of doctors that aren't very well informed when it comes to thyroid diagnosis and treatment.
To be fair, according to our research, it seems that their training is a bit lacking. To avoid being sued for slander or put on a hit list, I'll not lay specific blame, although my personal opinion isn't at all confused.
So, to get to the point, I'll just skip to the nitty gritty:
Most docs, when screening for thyroid disorders, will run just one test, and if the results fall 'within normal range' they will look no further.
That test is TSH. It checks for the level of thyroid stimulating hormone. This hormone is release by the pituitary gland as a signal to the thyroid gland to increase or decrease production. The higher this number the louder your pituitary is screaming for your thyroid to put out more hormone.
Someone decided decades ago that it was okay for this level to go has high as 5.0 before you have to wonder if you have a problem. In January of 2003 the range for 'normal' TSH level was changed, it's now .3 to 3.04 (used to be .3 to 5.0). Too bad that for many folks that means that they are running around with insufficient levels of thyroid hormone to feel well and lead a normal life. Why do I say that?
Well...... Most folks with normal thyroid hormone function have a TSH of 1.25. If TSH is above that, the 'red flag' point is now considered to be 2.0, there is something 'off'. That's when it becomes time to check the thyroid hormone levels cuz the TSH level can't determine what is wrong, it can only tell us that there is something wrong if the symptoms are there and the TSH is over 2.0.
Docs that were trained to do no more than make sure that the levels don't go outside of normal range won't look any further, no matter how awful you feel, no matter how long your list of symptoms, they'll simply pat you on the head and say that it's all your imagination, fill this prescription for anti-depressants and while you're there, here's another one for your weight. But, if you just spent less time sitting on your butt eating chocolates and watching soap operas you probably wouldn't be so fat.....
Then there is the other side of the thyroid coin, hyperthyroidism... here the doc will spout that you need to lose weight, that maybe you should just relax more and things wouldn't seem so profound and, the winner, if you'd exercise a bit more you'd be in better shape and your heart wouldn't have to beat so hard. Just stop by the pharmacy after you leave here and fill this one for anti-depressants, and this one to calm your heart rate a bit, and I'd like you to follow this plan, we'll get you eating a little healthier and have you eat regular meals and you won't be dropping so much weight.
In both cases you end up filling the prescriptions and popping the pills and still feel like recycled dog food, wishing it was over. In both cases the doc didn't (or chose not to) check the other things that you need to know to determine the cause for your symptoms.
First, TSH is a valid test when first screening for thyroid disorder, when it is grossly out of range it a clear signal that something is wrong... but just because it's 'within normal range' does NOT mean that your thyroid is functioning as it should, your symptoms are the 'tell'. If the symptoms are there and the TSH is moving toward the high end of it's range (remember that range was changed in 2003 and there are far too many docs, labs, and/or insurance carriers that are still using old ranges) it's time to get serious and find out what is going on.
What do you do if your TSH is high in it's range, but still in range, and you have hypo symptoms?
It's time to dig further and find out what is going on.......
The next two test that need to be done are Free T4 (the thyroid storage hormone) and Free T3 (the active thyroid hormone). These two levels will give a much clearer picture of what is going on by showing you the levels of free hormone in your blood stream, ready and available for use by your body. With these too merely having levels 'in normal range' isn't good enough. It's where the two numbers fall within those ranges that tell what is going on. If Free T4 is high in it's range and Free T3 is low in it's range there are problems in how the body is converting hormone that will need to be addressed for you to be able to clear up those symptoms and regain a quality of life again.
** Remember -- TSH is not a thyroid hormone, it's a pituitary hormone, it can only be used as rough guide. If TSH is 'in normal range' and you have symptoms of hypo, you need to look further, checking the thyroid hormones, to find out why**
Next is thyroid anti-bodies: Antithyroglobulin and Antithyroidperoxidase. The results of these tests are going to give you a heads up to whether or not you are suffering from an Immune Disorder which causes your body to attack your thyroid gland as if it's an invader.
What if all the thyroid testing stuff is shows all is well yet I have sooo many symptoms?
There is another ailment that shares many of the symptoms of both hyper and hypo thyroidism, that is adrenal fatigue. It is VERY common for folks that have border-line thyroid function, as well as significant low thyroid function to have fatigued/stressed adrenals. So it's very wise to check their condition and function.
What else could be contributing all the symptoms I'm experiencing?
Here again, long term low thyroid function, even at a very mild stage, can cause the body to have difficulty in other areas. One of those is in how it's able to process nutrients. Two that seem to come up are anemia (low iron) and pernicious anemia (low B-12) so having your Ferritin (storage iron) and B vitamin levels checked is also wise. These components of our systems are often found to be low, causing symptoms similar to thyroid malfunction and/or found to be in addition to thyroid malfunction.
If there are lumps, bumps, visible enlargement or difficulty in swallowing, they can, and in my opinion should, scan the thyroid to check for nodules, enlargement or other physical abnormalities.
A personal plea from both of us
If you know, deep inside of you, that something is wrong.
If your doctor ignores what you have said about how you feel, dismisses your symptoms, fails to test, or takes all the necessary tests and sends you home. Please remember this:
You are the customer, the doctor is a service provider, you are paying him or her for their service (it does not matter if you are paying out of your pocket, paying a co-pay, or if your insurance is paying all of it). If that doctor does not perform the service that you have requested - FIRE THEM!!!
Find another doctor that is concerned with your health and well being and listens to what you have to say, you deserve no less that that.
Do not, PLEASE DO NOT make the mistake that so many of us have, believing the doc when they say you are fine, go home...
If you KNOW there is something wrong keep looking to find the answers, do not settle for second best.
Demand what you deserve:
Proper medical care!!!
Having a hard time with that concept? Still think doctors should be put on pedestals and admired?
Let me ask you this... if your car was misfiring and stalling out and you brought it in to the repair shop to have them check it out and the next day they called up and said that it's all fixed and to come in to pick up your car. You get there and your car is sitting out in the lot and you go in to settle the bill. They tell you the amount, less than you expected, and as you write out the check you ask them what it was....
"Well, ma'am, your left front tire was a little low, that puts a strain on your engine. We filled it up to the proper pressure and checked the other tires and they were just a touch low so we pumped them up a bit more. That's all it was."
Would you pay the bill? Would you get in your car with full confidence that all was well? If the car stalled on the way home and you were stranded, would you take it back to the same guy?
If you know there is something wrong, and the doc says that all is fine.. Are you gonna go home feeling great?
Something you might want to think about...