I read this morning a good basic explanation of why it simply is not enough to measure TSH if you think your thyroid is underactive.
If you think your body temperature is low and you have the signs of an underactive thyroid (constipation, weight gain, low mood, body dryness, feeling cold, infertility etc), it is important to get your T4 to T3 conversion measured. If positive, it is termed Wilson’s Syndrome and could explain a lot.
Here is the post from www.ovarian-cysts-pcos.com – originally about the link between PCOS, stress and thyroid problems:
2) Might You Have “Wilson’s Syndrome”?
Do you feel fatigued, depressed, or anxious? Are you losing hair or having trouble losing weight? And, have the doctors found nothing wrong with you?
If so, you may have a problem with your thyroid hormones.
But not the usual problem your doctor might be looking for, as we’ll see in a moment.
Thyroid hormones do lots of important things. Perhaps the most important is that they govern your metabolic rate, or how fast your body burns off calories. Essentially, thyroid hormones set the thermostat for your body.
You also need optimal thyroid hormone function to ovulate and have a baby.
If your doctor suspects a thyroid problem, he or she will typically order a TSH (thyroid stimulating hormone) lab test. If your TSH test comes back normal, you may be told that your thyroid is fine and that if you are depressed and can’t lose weight, maybe you should take an antidepressant and go on a diet to lose weight. The implication is that it’s “all in your head”.
But there is a problem with the TSH test. It only checks for ONE of the hormones related to thyroid function.
What else might be going on? A lot of things. There is a complex interplay between your thyroid hormones and other hormones. There is an interplay between your (internal and external) environment and thyroid hormones. There is the conversion of thyroid hormones into other thyroid hormones.
Out of this messy complexity, let’s just pick one thing.
This is important because it appears that stress may disturb your thyroid hormones. Under normal conditions, a thyroid hormone called “T4” is converted by your tissues into the biologically active form called “T3”. T3 is the active hormone that affects your body.
But…when you’re under stress, your tissues do not convert as much T4 into T3. Instead, the T4 is converted into “rT3”, also known as “reverse T3”. In contrast to T3, rT3 is NOT active.
The rT3 occupies the binding sites on your cells, thus blocking the regular T3 from binding to the cell and performing its correct function. It’s like musical chairs. You have two hormones, T3 and rT3 competing for one chair. When the music stops, only one of them will be sitting on the chair. The other one will be left out.
The result is symptoms of low thyroid function, even if your typical thyroid test says you are “normal”. The reason is that almost no one tests for rT3. In fact, many doctors don’t even think it exists!
A chronic condition that appears to be hypothyroidism, combined with stress and low body temperature is referred to by some health professionals as “Wilson’s Syndrome”, named after Denis Wilson, M.D., who first brought it to our attention.
Here are the takaways:
1) A normal TSH does not necessarily mean that your thyroid function is OK.
2) Stress is more dangerous than you think, and may be impairing your thyroid function. It is absolutely crucial that you reduce stress.
3) A tipoff for Wilson’s Syndrome is a low body temperature. For one month, do an armpit temperature test every morning before you get out of bed. Low body temperature reduces enzyme activity in your body, which adversely impacts every cell in your body.
4) Normal thyroid hormone function is required for reduction of PCOS symptoms, losing weight, and pregnancy.
5) Wilson’s Syndrome is predominantly found in women.
Wilson’s Thyroid Syndrome: A Reversible Thyroid Problem, E. Denis Wilson, M.D. Wilson’s Temperature Syndrome: A Reversible Low Temperature Problem, E. Denis Wilson, M.D. www.wilsonssyndrome.com
I also test for thyroid antibodies in this screen because often those are not looked for either, and their presence can explain why your thyroid may not be working very well – it is being attacked as a ‘self-antigen’.
Both of these tests are especially useful if you cannot get to the bottom of why your body temperature is low and why you have all the signs of an underactive thyroid, cannot lose weight, cannot get pregnant etc but your TSH level keeps coming back OK.
Worth considering, I think.