Before I was diagnosed with Graves’ Disease, I had some thyroid testing done in my early 30’s that came back normal.
The problem is, my doctor at the time only tested my TSH.
Yes, it was toward the low end of normal. But nonetheless, it was within that normal range. I didn’t have any textbook thyroid ‘red flags’ so I never gave it much thought.
As time went on, I started to experience symptoms that gradually got worse. I told myself it couldn’t be my thyroid because after all, my TSH was normal.
The next time I did any thyroid testing was nearly ten years later.
Within weeks, I was diagnosed with severe hyperthyroidism and Graves’ Disease— and was told I was moments away from a potentially fatal thyroid storm.
Looking back, I can’t help but wonder how different my thyroid health journey might have looked if my very first thyroid test included a more complete panel.
What was really happening?
What was my body trying to whisper before it had to finally scream at me?
Could I have avoided full blown autoimmunity?
The truth is, I don’t know for sure.
I do know two things can be true: you can have normal TSH levels and still experience some degree of thyroid dysfunction.
A large number of the women who come to me for help, have their TSH tested; find out it’s within normal range, feel awful – yet can’t seem to get complete thyroid testing or the insight that could come from it.
LET’S TALK TSH
It’s A Pituitary Brain Hormone
Thyroid Stimulating Hormone (TSH) is a pituitary gland hormone that tells your thyroid gland how much thyroid hormone it should release.
Based on the signal your thyroid gets from your pituitary gland, your thyroid uses iodide from the food you eat to produce and release thyroid hormones.
When TSH Is Low
When your TSH is low, it can mean that you have an overactive thyroid or hyperthyroidism.
It means your pituitary gland is saying: hold up.
Low TSH tells your thyroid to secrete less thyroid stimulating hormone because it detects the amount of thyroid hormones circulating in your blood is high.
When TSH Is High
It can mean that you have an under-active thyroid, hypothyroidism.
It means your pituitary gland is saying: hey, pick it up.
High TSH tells your thyroid to secrete more thyroid stimulating hormone because it detects the amount of thyroid hormones circulating in your blood is low.
What TSH Alone Doesn’t Tell You
Thyroid testing for TSH alone, only explains what message your brain is sending to your thyroid gland. It doesn’t tell you:
- how much thyroid hormone (thyroxine aka T4) is actually being produced by your thyroid gland
- how much of that T4 is being converted into triiodothyronine (aka T3 the active form of thyroid hormone your body uses), or
- whether your immune system is creating antibodies that are attacking your thyroid, its pathways or deactivating T3
To get the best picture of your thyroid health, I encourage women to have a full panel of thyroid testing done.
LET’S TALK TESTING
If you’re experiencing unexplained chronic low energy, weight struggles, issues managing body temperature, or mood disorders with ‘normal’ TSH levels, ask your practitioner for these thyroid tests:
*Thyroid Stimulating Hormone (TSH)
a brain hormone that controls thyroid hormone release
*Thyroxine (T4)
unbound and free for use; the most abundant thyroid hormone but needs to be converted to T3 be active
*Triiodothyronine (T3)
unbound and free for use; most used by the body’s cells and tissues
*Reverse Triiodothyronine (rT3)
deactivates T3, mostly due to stress
*Thyroid Peroxidase (TPO)
antibodies that attack iodide peroxidase pathways and identifies autoimmune activity
*Anti-thyroglobulin (anti-TG)
antibodies that attack thyroglobulin protein (that makes thyroid hormones) and identifies autoimmune activity
*Thyroxine Binding Globulin (TBG)
binds up thyroid hormones to take them out of circulation; deactivates T3
*Thyroid Stimulating Immunoglobulin (TSI)
antibodies that mimic TSH and identifies autoimmune activity
Can’t Get Your Practitioner To Do Full Thyroid Testing?
There are several options beyond the doctor’s office. When it comes to investigating & managing your thyroid health these days, companies like Everlywell and Paloma make at-home testing easy.
Once I was diagnosed, knowing all of my levels helped me avoid thyroid flares. It also allowed me to continue managing Graves’ Disease holistically once I went into remission.
Testing TSH alone is like relying on your tire pressure to tell you why your car won’t move — your tires can be fine, but if the engine is fried, your car isn’t going anywhere.
Normal TSH levels for women ages 30-49 range between 0.4-4.0 mIU/L and by itself doesn’t give you a comprehensive look at your overall thyroid engine. Additionally, it doesn’t give you any insight about potential root causes.
If you’d like to learn more about how you can take action that supports your thyroid health, grab my freebie: 4 Ways to Help Your Thyroid Thrive.
Tell me: what has your thyroid testing journey been like? Let me know in the comments below. I’d love to hear from you.
