Two thyroid facts worth knowing:
- The diagnosis of mild (also called “subclinical”) hypothyroidism (low levels of thyroid hormone) is overlooked by many physicians.
- When you actually are diagnosed with hypothyroidism, you might be prescribed the medicine that won’t work best for you.
You’ve shown up for your usual ten minute, quick glance billed to your insurer as an in-depth primary care office visit. You’re allowed to talk about one problem only, and so you present the symptoms of hypothyroidism every doctor and nurse practitioner should be able to recite in their sleep. She listens, sometimes attentively, and orders the insurance approved blood test, a TSH (Thyroid Stimulating Hormone).
Be aware this is not measuring anything produced by your thyroid but rather a second hormone from a different gland a few inches away, the pituitary gland. It’s an indirect measurement, sort of like determining how fast your car is moving by looking at your fuel gauge rather than at the speedometer.
Does the TSH give you an accurate picture of your thyroid status? Sometimes, sometimes not. But if the lab reports your TSH as between 1.0 and 5.0, you’re told your thyroid is ‘normal’, and that, as they say, is that. Oh, by the way, a high TSH means your pituitary is encouraging your thyroid to make more hormone. High TSH = under-active thyroid (get it?).
So, if your TSH is between 1.0 and 5.0, you’re sent on your (less than) merry way, tired, cold, sluggish and depressed, thinking “I thought it was my thyroid”.
Well, it still can be your thyroid. You need more in depth testing. So it’s time to be a pro-active patient!
Just like you watch your speedometer, and not your fuel gauge, if you want to avoid a speeding ticket, your doctor should be measuring your actual hormones (T3 and T4) and testing you for the common thyroid autoimmune disease called Hashimoto’s thyroiditis. She also should know that a lot of endocrinologists now believe any TSH above 2.5 should be treated as hypothyroid. Probably 20%-30% of adults drag around with their TSH above 2.5.
You do need to be realistic and not blame everything on your thyroid.