Thyroid disorders, tests, how to treat
DIY at home thyroid metabolism tests
Thyroid metabolism tests
Clinical tests to determine cause of thyroid dysfunction
Simple "Do-it-yourself" tests to determine thyroid function
Involves taking your basal temperature for 5 days or measuring urine temperature:
(1) Barnes Basal Temperature Method
(2) Confirming Clinical Hypothyroidism
(1) Barnes Basal Temperature Method
Developed by Broda O. Barnes, M.D., author of Hypothyroidism: The Unsuspected Illness as long ago as 1942. Not
definitive, but provides a good indicator of potential hypothyroidism.
(1) Obtain a Basal / Fertility
Thermometer (accurate to
within 0.1 degrees, compared to a standard thermometer which is only accurate to within 0.2
degrees). A digital Basal Thermometer is less than $10 at your local
pharmacy.
(2) Place the thermometer
on your nightstand - for immediate access when you wake up in the morning.
Do not use an electric blanket.
(3) Upon awakening place
the thermometer snuggly in your armpit - this axillary temperature is
more accurate than oral, since it is less affected by sinus and oral infections;
(4) Make sure you give the
thermometer plenty of time to accurately measure your temperature (10 minutes
is generally recommended for a basal thermometer - Refer to the instructions that came with your
thermometer) - It is important that you don't get out of bed and remain as still as possible until you
have read your temperature. (basal temperature reads about 0.5 -1 °F less
than oral temperature)
(5) Take your temperature each morning for 5
days.
For women who are menstruating
-
start on the third day of menstruation (Menstruating can lower basal
temperature).
For men and postmenopausal women -
it makes no difference what day you start.
If your average temperature is :
97.8°F - 98.2°F - your thyroid function appears to be normal.
Below 97.3°F - suspect a
low
thyroid metabolism problem, or possibly hypoadrenal
function.
Menstruation and illness can elevate temperature
(2) Confirming Clinical Hypothyroidism
(Test normal for T3,
T4, TSH, but experiencing hypothyroid symptoms)
Another reliable way to confirm clinical
hypothyroidism
is to measure your urine temperature for
3 consecutive days
Immediately on rising in the morning,
urinate into a Styrofoam cup
Measure urine temp. with an ordinary
health thermometer
Continue for 3 consecutive days
(if you forget a day, start again).
If the temperature is consistently below
98.6 (usually 97), then you most likely have
clinical hypothyroidism .
Clinical tests to determine cause of thyroid dysfunction
The following tests can determine whether a problem is in the pituitary
(related to aging), the thyroid (related to development of systemic antibodies),
or a mineral and/or vitamin deficiency (E.g. iodine ,
selenium , calcium,
magnesium, antioxidant
vitamins A, D ,
E and C ).
Thyroid stimulating hormone (TSH)
Normal TSH Adult Levels - 0.4
-4.5 mIU/L or mU/L; (recently lowered to 3.0)
High TSH may be caused by:
An underactive thyroid gland
(hypothyroidism) - Hashimoto's thyroiditis is the most common
cause of primary hypothyroidism;
Pituitary gland making too much TSH -
uncommon;
Low TSH maybe caused by:
An overactive thyroid gland
(hyperthyroidism)
- usual causes are Grave's Disease,
a toxic multinodular goiter (Plummer
disease, enlarged thyroid) or a
toxic nodule (a non-cancerous tumor);
Damage to pituitary gland -
preventing it from making TSH, called secondary
hypothyroidism;
Pregnancy during 1st
trimester
The designated TSH high level is too low - this
figure was determined in 1973 from a sampling of volunteers that did not exclude
thosewith a family history of hypothyroidsm. As a result people can test with a
"satisfactory"TSH, but still demonstrate hypothyroid symptoms
Rather than testing
TSH, a better approach is to look for:
1) Elimination of symptoms
2) A mid-afternoon temperature
of 98.6 (using a mercury thermometer) - while maintaining a normal heartrate
3) Getting free T3 in the normal range - together
with healthy adrenal function
free t4
Measures AVAILABILITY of thyroxine (represents
75% of thyroid hormone) - only unbound hormone (not attached to TBG binding protein
in blood) is easily bioavailable;
Normal Adult T4 Levels - 4.5
to 11.2 mcg/dL;
High T4 along with low TSH levels - may
be due to conditions involving an overactive thyroid:
Early Hashimoto's thyroiditis
Grave's
disease
High levels of hormone-binding protein Thyroid
Binding Globulin (TBG) - can occur with pregnancy, birth control use,
estrogen dominance, liver disease;
Iodine -induced
hyperthyroidism ;
Subacute or chronic thyroiditis;
Toxic multinodular
goiter
Gestational trophoblastic disease -
a group of rare tumors that involve abnormal growth of cells that start
in the cells that would normally develop into the placenta during pregnancy;
Low T4 maybe caused by:
Hypothyroidism;
Illness
Malnutrition
Certain medications - Anabolic steroids,
Androgens ,
Antithyroid drugs (for example, propylthiouracil and methimazole), Interferon alpha,
Interleukin-2, Lithium, Phenytoin, Propranolol
free T3
Measures AVAILABILITY of triiodothyronine (T3)
- the active thyroid hormone;
TSH
T4
T3
INTERPRETATION
High
Normal
Normal
Mild (subclinical) hypothyrodism
High
Low
Low or normal
Hypothyrodism
Low
Normal
Normal
Mild (subclinical)hyperthyroidism
Low
High or normal
High or normal
Hyperthyroidism
Low
Low or normal
Low or normal
Nonthyroidal illness; rare pituitary (secondary)
hypothyrodism
Thyroid Binding Globulin (TBG)
Elevated by
estrogen
hormone excess
Reduced by
androgen
excess
Reverse T3 (rT3)
Reverse T3 is the right isomer of T3
(R-T3)
- only the left isomer is active (L-T3)
Having high levels of reverse T3 is known as thyroid
resistance and produces symptoms of hypothyroidism
- a certain amount of rT3 is normal, the problem occurs when the ratio
of Free T3 drops in proportion to rT3, allowing rT3 to interfere with T3 energy-production
activity. rT3 binds to T3 receptors, which
blocks T3 from binding and empowering cellular energy production / metabolism .
About 60% of T4 is converted to its active form
T3, but 20% is irreversibly converted to rT3 - Even though it
is inactive, its purpose is to lower T3 activity
Levels of reverse T3 are elevated:
With excessive
physical or emotional stress - which first raise CORTISOL
▲ levels to deal with it and then lower
CORTISOL
levels if adrenals become "worn down".
When your body needs to conserve energy to
deal with something else (E.g. emotional or physical stress, such as being ill),
the excess CORTISOL will increase the amount
of T4 converted to RT3 to reduce activation of T3.
Over time adrenals can become fatigued - and CORTISOL levels either drop
to low or alternate between low and high. A low CORTISOL
level manifests as chronic anxiety, inability to cope with problems, psychological
issues (E.g. paranoia), frequent nausea, light/sound sensitivity, and blood
thyroid hormone levels can increase, necessitating the conversion of T4 to excess
RT3.
Also, taking T4-only hormones can cause
CORTISOL levels that are too high or too low - as
CORTISOL is produced to deal with ongoing
hypothyrodism, which ongoing production canlead to adrenal dysfunction / fatigue.
With low iron levels - Iron is a needed to transport
thyroid hormone into the cells, and lack of it can lead to excess thyroid hormone
in the blood, which the body then converts to rT3. Adding more T3 will not help.
Many other factors
can cause high rT3 - including Low B12 and chronic inflammation.
Antibody Tests
Usually ordered to give more information on autoimmune
thyroid disease, when TSH, T4 or T3 levels are abnormal .
TPO (Thyroid peroxidase)
antibodies (TPO Ab) -
TPO Ab blocks the enzyme TPO responsible for
adding iodine to thyroglobulin in TH production.
Test is
read as positive if levels exceed normal range - elevated in 85-90% of those with
hypothyroidism (found in most patients with
Hashmoto's hypothyroidism).
A positive result indicates an indirect measure ofiodine and
selenium deficiencies;
Test is read as negative if normal (i.e.
the actual numbers are not important).
Antithyroglobulin Antibodies
(Tg Ab) -These antibodies block thyroglobulin (Tg), a protein made by the thyroid, necessary for making thyroid
hormones (T4 and T3).
Test is positive in patients with
Hashimoto's thyroiditi s -
Tg Ab level may also be elevated in other
autoimmune conditions such as rheumatoid arthritis, lupus and
Sjogren's syndrome. Tg Ab
is used to monitor patients who have had thyroid cancer for recurrence.
This test should be negative in most
patients who have had their thyroid removed.
Thyroid Receptor Antibodies (TRAb)
- tested in those with Grave's hyperthyroidism . These antibodies
stimulate thyroid hormone production
by binding to TSH receptors. Thyroid-stimulating immunoglobulin (TSI) and thyrotropin-binding
inhibitory immunoglobulin (TBII) are also implicated in Graves disease .