Struggling with fatigue, brain fog, weight gain, constipation, mood imbalances, or cold hands? And have you seen your doctor just to tell you that everything is fine with you? After seeing many doctors and even years passing, this is the reason why the doctors did not know how to diagnose your hashimoto thyroiditis .
Unfortunately, this is very common in conventional medicine. And, as I explain in my book, The Thyroid Connection , it is often an undiagnosed thyroid condition called, Hashimoto, that is behind your symptoms. Let me tell you a story that may sound familiar to you.
When Susannah first came into my office with complaints of exhaustion, depression, and weight gain, she had already seen three different doctors who were unable to accurately diagnose or treat her condition. “They kept telling me I was fine because my tests were normal,” Susannah told me. “But I can’t be okay if I feel like this!”
I have seen countless patients in Susannah’s situation whose doctors ignored their symptoms such as stress, age-related, or simply “woman issues,” and after diving deep into their medical history and running a full thyroid panel, I was able to determine that it was, in fact, Hashimoto that they were dealing with.
After reviewing Susannah’s medical records, I could see the problem. Each of his doctors had only analyzed part of his condition. Their blood tests showed Susannah’s thyroid hormone levels were within the normal range, but those tests don’t tell the whole story. She had a thyroid dysfunction; her doctors just couldn’t see her in the tests they ordered. So even if your doctor tells you that your thyroid levels are normal, chances are you have Hashimoto’s.
In this article, we are going to look at the signs that you are dealing with Hashimoto’s thyroiditis , and the reasons why your doctor may have missed your diagnosis.
What is Hashimoto?
Your thyroid produces hormones that help regulate almost all of your bodily functions, including metabolism, heart rate, body temperature, menstrual cycles, and cholesterol levels. Hashimoto is an autoimmune disorder in which your immune system creates antibodies that attack your thyroid gland, causing hypothyroidism , which is when the thyroid produces less hormones.
When this happens, all metabolic processes slow down, leading to a whole range of symptoms, including:
- Fatigue and feeling of exhaustion even after 8-10 hours of sleep
- Brain fog, trouble concentrating, poor memory
- Weight gain or inability to lose weight
- Cold hands or feet, low body temperature
- Hair loss or thinning, brittle hair
- Constipation
- Hormonal imbalances including PMS, irregular periods and low sex drive, infertility
- Dry skin or brittle nails
- Mood imbalances such as anxiety, depression, and mood swings
- Decreased heart rate
- Neck swelling, snoring, or a hoarse voice
Hashimoto is the leading cause of hypothyroidism in the US alone As I explain in my book The Thyroid Connection , we are currently in the midst of a thyroid epidemic, with about 27 million Americans facing some form of thyroid dysfunction. Women are up to eight times more likely to develop a thyroid condition than men, and 60% of people living with thyroid dysfunction are unaware that they have a problem.
The development of thyroid dysfunction is much more likely for those who already have a pre-existing autoimmune condition, so it is important to get tested if you have this risk factor or any of the other signs that you have Hashimoto’s thyroiditis .
Why Your Doctor Couldn’t Diagnose Hashimoto’s Thyroiditis
If you are one of the millions of patients who have yet to receive an accurate diagnosis of underlying thyroid dysfunction, your doctor may simply not have performed the proper tests. Here are 3 reasons why.
1. They didn’t check your thyroid levels
The symptoms of Hashimoto’s thyroiditis can be vague , causing doctors to dismiss them as “women’s problems,” stress, aging, or some other illness. Conventional doctors usually don’t start checking your thyroid levels until you’re in your 40s and 50s, so if you’re in your 20s and 30s, they probably assume your symptoms are part of another condition (such as fatigue caused by lack of iron). If you are a man, your thyroid levels may not be checked as men are considered to be at low risk for thyroid dysfunction. And if you have another autoimmune disease, your doctor might focus on that condition as the source of your symptoms and not bother to check your thyroid levels as a result.
2. They didn’t run a full panel
Perhaps your doctor performed a thyroid test and declared that your thyroid levels were normal, even though your symptoms continue to persist. Chances are, your doctor didn’t run a full panel. Most conventional doctors only monitor your thyroid stimulating hormone (TSH), which is considered the initial test for the diagnosis and treatment of thyroid dysfunction. However, measuring this hormone alone doesn’t tell the whole story, and the results can often be counterintuitive and confusing. For a more accurate diagnosis, you will also want to check your levels of free T4, free T3, and reverse T3 hormones.
Here’s an overview of what each measures:
Free T4: The Storage Form : T4 is the primary outlet of the thyroid. It is an inactive form of thyroid hormone that is stored in your body’s tissues so that it is ready to use when needed. Measuring free T4 (FT4) shows how much T4 is still circulating in the bloodstream and available to act in the body.
Free T3 – Gas : Free T3 (FT3) is the active form of thyroid hormone. When each local area of your body determines that it needs more energy, it converts the storage form of T4 into FT3. These hormones bind to receptors within your cells to drive their metabolic processes, so they act like gas. It is vital to measure your FT3 levels because your body may not be converting T4 to FT3 very well. This is one of the most common causes of hypothyroid symptoms .
Reverse T3 – The Brakes : Your body uses a portion of T4 to create reverse T3 (RT3), which connects to receptors for FT3 in order to slow down your metabolic processes. For that reason, RT3 are like brakes. If the RT3 levels are high, you are likely converting too much T4 to RT3 and not enough to FT3. This can cause hypothyroid symptoms even if your TSH and T4 levels are optimal.
TPOAb and TgAb – Antibodies: In addition to controlling thyroid hormone levels, there are also two main types of thyroid antibodies that your doctor should check. Thyroid peroxidase antibodies (TPOAb) attack the enzyme responsible for the synthesis of thyroid hormones and thyroglobulin antibodies (TgAb) attack thyroglobulin, which the thyroid uses to make its hormones. In patients with Hashimoto’s disease , TPOAb and TgAb levels are elevated. Determining if you have Hashimoto’s, as opposed to an underactive thyroid, is key because once you have an autoimmune condition, you are three times more likely to develop another.
It is recommended to order all of the thyroid tests listed below to get a complete picture of a patient’s thyroid health.
- TSH
- Free T4
- Free T3
- Reverse T3
- Thyroid peroxidase antibodies (TPOAb)
- Thyroglobulin antibodies (TgAb)
For a complete description of what these tests measure and how to interpret the results, see my book The Thyroid Connection.
3. They did not use optimal reference ranges
Okay, you finally got your doctor to order the full range of thyroid tests, and your results still don’t indicate Hashimoto’s or thyroid dysfunction. This is because many physicians rely on “normal” reference ranges, which are too wide and often lead to unreliable results. When they created the laboratory reference ranges for a healthy thyroid, it was later found that they had included people who already had thyroid dysfunction! In 2003, the American Association of Clinical Endocrinologists (American Association of Clinical Endocrinologists) recommended reference intervals narrower laboratory, but still many doctors and laboratories have not updated their practices.
In my experience, I have found the following reference ranges to be optimal for my patients:
- TSH 1-2 IU / ML or lower (Armor or compound T3 can artificially suppress TSH)
- FT4> 1.1 NG / DL
- FT3> 3.2 PG / ML
- RT3 less than 10: 1 ratio RT3: FT3
- TPOab y TgAb – <4 IU / ML o negativo
By using these guidelines and listening to your body, you can be sure that you are getting the most accurate information about your thyroid health and medication needs.