My functional medicine visits start out with a 30 minute consultation to determine if you are a candidate for care. It is a time when I can get to know you and listen to your symptoms. I will also ask you what testing has been done and what you have tried so far. The most common symptoms patients typically report are:
*Fatigue
*Inability to lose weight or weight gain
*Brain fog
*Anxiety/depression
*Hormone dysfunction
*Digestive complaints
When I hear this, there are key things I am looking for. One of the first questions I ask is, “Have you had your thyroid checked?” I would estimate that 90% of the time, the answer is, “Yes, but I was told it is normal.” This leaves you thinking, “But I still feel like crap and have ALL these symptoms of a thyroid dysfunction!” So, what gives?
When you get your thyroid levels checked, your doctor will usually run your TSH level, and maybe T4 and T3 levels. There are a few problems with this approach if we want to truly figure out what is going on with your thyroid.
First of all, 90% of thyroid dysfunction has been found to be autoimmune in nature. This means that your body views your thyroid as foreign and will start to attack it. How do we know this? By running thyroid antibody tests. Unfortunately, this is not a routine test that most practitioners order. In the comprehensive blood work at Functional Health Unlimited, thyroid antibodies are a part of our standard thyroid profile. If you haven’t had yours checked and are still having thyroid symptoms, find a practitioner who will run thyroid antibody tests.
Also, the traditional “normal” ranges for TSH levels are quite broad, usually ranging from 0.3-4.5. These are the values used for determining if a patient needs medication. However, in functional medicine, we know there are OPTIMAL values for your TSH level, and other markers too. An optimal TSH range is 1.3-3.0. If TSH is outside of this range, it may be contributing to your symptoms.
In addition to thyroid antibody testing, there are additional labs that should be assessed to determine how your thyroid is working. These include free T3, free T4, reverse T3, T3 uptake, and free thyroxine index. This can give a lot of information about the mechanism of what exactly is going on with your body. It isn’t just about the TSH level.
Other factors that contribute to thyroid dysfunction include inflammation, vitamin deficiencies, hormone dysfunction, stress, chronic infection, anemia, food sensitivities, and blood sugar. While not an inclusive list these can be assessed with the following labs:
*C reactive protein
*Homocysteine
*Micronutrient testing
*CBC with differential
*Fasting glucose and Hemoglobin A1C
*Adrenal stress testing
*Iron panel
*Food sensitivity testing
Based on your history, these are all labs that may be suggested to determine the contributors to thyroid dysfunction. If you have been told “Your labs are normal” but you still don’t feel “normal”, contact us. An in depth look to figure out why you aren’t feeling well is the best approach.
Dr. Lori Jokinen, DC CACCP CFMP BA