The thyroid is responsible in taking certain nutrients that are consumed from the food we eat and supplements we take and converting it into thyroid hormones. These hormones are important in how your body uses energy, body temperature regulation, maintaining optimal health with the brain, heart, muscles, and other organs. Every cell in the body depends on thyroid hormones for regulating their metabolism.
Optimize Your Thyroid
Patients With Suboptimal Thyroid Function Are at an Increased Risk For:
- Heart disease
- Heart failure
- High cholesterol
- Weight gain
- Metabolic syndrome
- Elevated blood pressure
- Birth defects
What Are the Causes of Hypothyroidism or
Low Thyroid Function?
Adrenal/Cortisol Imbalance
High cortisol interferes with the conversion of T4 to T3. High cortisol also suppresses TSH.
Age/Menopause
Thyroid hormones are not made as effectively as we age.
Bromide Toxicity
Bromide is a chemical compound found in commercially prepared baked goods, soft drinks, some vegetable oils, pesticides and plastics, carpets and mattresses. Bromide displaces iodine from the thyroid molecule so that thyroid hormones are not getting made.
Dysbiosis
Organisms in the gut such as yeast can unleash an immune attack on these invaders which then releases chemicals that affect thyroid hormones.
Environmental Toxins
Fluoride, mercury (usually from tooth fillings), bisphenol A, phthalates and tobacco can block thyroid hormone function.
Prescription Medications
Birth control pills, Lithium, seizure medications, sulfonylureas, amiodarone interfere with how the body makes thyroid hormones.
Selenium
Selenium is needed to convert T4 into the active hormone T3.
T4 to T3
Any problems that interfere with the conversion of T4 to T3 (see below).
Thyroid Hormone Resistance
A patient may have adequate levels of T3, but if the hormone can’t get into the cells to do its job, symptoms of low thyroid will remain. Normal levels of cortisol are needed for thyroid to get into the cells. Iron is also needed for this transfer to occur.
Symptoms of Hypothyroidism or Low Thyroid Function:
- Weight gain or difficulty losing weight
- Dry skin
- Hair thinning/hair loss or Hertoghe’s Sign (eyebrow thinning)
- Feeling cold (especially cold hands and feet)/heat intolerance
- Constipation
- Heavy periods or irregular bleeding
- Goiter (swelling of the thyroid gland visible in the neck)
- Anxiety/depression
- Arthralgias (muscle aches)
- Headaches
- Hoarseness
- Fatigue or too tired to exercise
- Fluid retention (swelling in face, hands, ankles, or feet)
- Hypertension (elevated blood pressure)
- Brain fog (memory loss/slowed thinking)
Process & Results
Thyroid Testing
Step 1.
The Consultation
Your initial consultation with one of our providers will begin with a thorough look into your past medical and surgical history, family history, and current medications, with specific attention paid to the symptoms you are struggling with. This visit will be billed to your insurance company.
Step 2.
Facilitate a Thyroid Panel
What is a comprehensive thyroid panel? The thyroid is best tested with a blood test. The labs that we look at include your TSH, Free T4, Free T3, Reverse T3, Thyroid peroxidase (TPO) and Anti-thyroglobulin antibodies.
Step 3.
Follow up & Results
We will see you back in the office in 1 to 2 weeks, review your test results and initiate therapy if appropriate. This visit is billed to your health insurance company. Diet, exercise, and optimal supplementation are all discussed as an important part of this treatment plan.
Why Patients Love Us
Thyroid
Thank you, thank you, thank you to Dr. Thieman for listening to me and taking care of me these past few months. I am such a better version of myself now!
-Margaret.
Thyroid
I have a thyroid issue since 2002. I switched couple doctors all were the same. They were checking my blood work and prescribe the exact same medicine every visit. But Dr Jennifer Thieman is different and changed my life 3 years ago. At every visit she gave me printouts comparing with my last year blood work result and discuss what is my problem, how it can be improved, explain all my question, listen to me and try to help me. She is my Angel! Thank you Dr Thieman!
-Aygen G
Thyroid Testing FAQs:
Why is Treatment With T4 Unsuccessful in Many Patients?
The thyroid gland secretes T4 in response to TSH and the body’s needs for thyroid hormones. However, many patients don’t adequately convert the prohormone, T4, into the more active hormone, T3. When this conversion is not happening adequately, symptoms of hypothyroidism will ensure – even with a “normal” TSH! Therefore, our approach to treating thyroid dysfunction with thyroid hormone is to use a combination of T3 and T4 hormones and optimize the T4 to T3 conversion. This approach has been shown in the literature to be more effective than using T4 alone and patients prefer combined therapy.
The thyroid gland secretes T4 in response to TSH and the body’s needs for thyroid hormones. However, many patients don’t adequately convert the prohormone, T4, into the more active hormone, T3. When this conversion is not happening adequately, symptoms of hypothyroidism will ensure – even with a “normal” TSH! Therefore, our approach to treating thyroid dysfunction with thyroid hormone is to use a combination of T3 and T4 hormones and optimize the T4 to T3 conversion. This approach has been shown in the literature to be more effective than using T4 alone and patients prefer combined therapy.
It makes sense to use a combined T4/T3 product when you understand thyroid physiology. Why are some doctors opposed to this method of treatment?
Traditionally – perhaps because of large pharmaceutical companies, doctors have been trained to test only the TSH and occasionally the T4 levels and thus, replace only the T4 hormones. There was a met analysis (review of 9 individual studies) performed by Joffe RT et. al. that was sponsored by a pharmaceutical company that revealed no significant difference in psychiatric symptoms when T4 alone or T4/T3 was used. Our criticism of this study is that many of the papers they examined were not using a high enough dose of T3(only 5 ug of T3) to even make of difference. So, of course, the conclusion of the paper was that there was no benefit to using a combined regimen.
It makes sense to use a combined T4/T3 product when you understand thyroid physiology. Why are some doctors opposed to this method of treatment?
Traditionally – perhaps because of large pharmaceutical companies, doctors have been trained to test only the TSH and occasionally the T4 levels and thus, replace only the T4 hormones. There was a met analysis (review of 9 individual studies) performed by Joffe RT et al. that was sponsored by a pharmaceutical company that revealed no significant difference in psychiatric symptoms when T4 alone or T4/T3 was used. Our criticism of this study is that many of the papers they examined were not using a high enough dose of T3(only 5 ug of T3) to even make of difference. So, of course, the conclusion of the paper was that there was no benefit to using a combined regimen.
My Doctor Told Me That My Low TSH Would Put Me at Risk for Osteoporosis and Atrial Fibrillation. is This True?
In the traditional medical community, there is a lot of concern that suppressing the TSH will cause medical conditions such as osteoporosis and atrial fibrillation. It is true that endogenous hyperthyroidism (patients developing hyperthyroidism on their own – not treating hypothyroidism) is associated with osteoporosis. There is medical literature on both sides of the fence as to whether bone loss occurs or not with suppressed levels of TSH. We monitor bone turnover closely in our patients who have a suppressed TSH.
Pairing Treatments Can Get You
Dramatic Results
Combining treatments can be the answer to getting the most out of your Thyroid Testing and Treatments. The overall goal when it comes to treating you for Thyroid issues is to optimize overall quality of life. When you come in for your consultation, your provider can speak to you about combining your treatments.
*Actual Patient
