The Thyroid Hormone

Thyroid Hormone Replacement Therapy in Omaha is a metabolic hormone secreted by the thyroid gland. It is responsible for regulating our temperature, metabolism, and cerebral function. It can also help protect against cardiovascular disease by lowering cholesterol.

Problems associated with the thyroid gland are the most common production problems whether that is too much or too little thyroid hormone production. Thyroid levels do naturally decline as we age, similar to other hormones. This situation is not considered true hypothyroidism but rather a thyroid insufficiency.

Thyroid hormone is produced in the thyroid gland as T4 and is then converted into the active form of the hormone called T3. It is the T3 that is responsible for the actions of thyroid hormone. In addition to production problems, there are secondary issues that may lead to a decline in the function of the thyroid hormone. These include the resistance of the receptor cells or blocking of the receptors and a decline in the body’s ability to convert T4 into T3.

Hypothyroidism Symptoms

Low Thyroid Levels

Hypothyroidism is the condition where there is too little thyroid hormone production. The cause may be considered primary where the production is decreased due a genetic predisposition, development of autoimmune responses (Hashimoto’s Thyroiditis), or thyroid tumors. Other causes of low thyroid hormone can be due to a decrease in the conversion of T4 to T3 as well as resistance to T3 at the cellular level.

  • Weight gain
  • Fatigue
  • Slowed Thinking
  • Sensitivity to Cold
  • Hair Loss
  • Brittle Nails
  • Depressed Mood
  • Constipation

Hyperthyroidism Symptoms

High Thyroid Levels

Hyperthyroidism is the condition where the levels of thyroid hormone are too high.

  • Tachycardia
  • Anxiety
  • Insomnia
  • Weight Loss
  • Diarrhea

How Are Thyroid Levels Assessed?

All of our patients at 88MED undergo an initial set of labs to check the hormone levels in their blood. Traditionally, the Thyroid Stimulating Hormone (TSH) level is followed. If it is elevated and the T4 is low, the patient is diagnosed with hypothyroidism. If the TSH is low and the T4 is elevated, they are diagnosed with hyperthyroidism. But, we take it a step further and follow the patient’s level of the active hormone T3.

The majority of thyroid hormones in the circulation are bound to a storage protein, thyroid binding globulin; only the unbound or free hormone is available for activity. So, we follow the Free T3 level and aim to optimize this value in the upper end of the normal range.

My Doctor Said My Thyroid Labs Are Normal

Many patients continue to experience symptoms of low thyroid hormone despite being told that their labs are “normal.” This may be due to the decreased conversion of T4 to T3 or receptor resistance as mentioned above. There is another subset of patients that were diagnosed with hypothyroidism and placed on synthetic T4 products such as Synthroid or Levothyroxine that continue to experience their symptoms despite having their labs return to “normal” while taking the medication.

Most physicians only check the TSH and T4 levels and do not check the Free T3. Most of the thyroid hormone is bound by a protein called thyroid binding globulin and is inactive. Unless a physician orders a lab measuring the unbound/free amount of the hormone, he or she could be misled into thinking everything is “normal.”

By optimizing the Free T3, many patients are able to alleviate their symptoms.

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How Do I Optimize My Thyroid Levels?

At 88MED, we recommend patients who are experiencing hypothyroidism symptoms take a natural thyroid hormone that contains both T4 and T3. These are commercially available as Armour Thyroid, Nature-Thyroid and Westhroid. We adjust the dosing stepwise until the Free T3 level is optimized or the patient experiences symptom relief.


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