General Thyroid Information
WHAT IS THE THYROID?
WHAT ARE THYROID HORMONES?
Your thyroid produces two different hormones, T3 and T4. Triiodothyronine T3 hormone is the most active form of thyroid hormone. Both thyroid hormones are made up of two molecules of the essential amino acid tyrosine, to which iodine is attached. The manufacture of thyroid hormones requires several micronutrients including selenium, a trace element, which is crucial for adequate thyroid hormone production. Because thyroid hormones are vital for the functioning of your body, the gland stores huge amounts of thyroid hormone within a big protein called thyroglobulin. Twenty-percent of the T3 hormone that your body produces comes from your thyroid gland, and the remainder comes from the conversion of T4 to T3 in our organs. Fun fact: the difference between the two is that another iodine atom is attached to T4.
HOW DOES THE THYROID WORK?
The thyroid gland is regulated by the pituitary gland, or “master gland.” The pituitary gland sits like a boss at the base of the brain in a bony socket in the skull called the sella turcic. The thyroid and the pituitary receive feedback signals from one another and are delicately balanced. The pituitary gland delegates how much thyroid hormone the thyroid should produce. It emits signals to the thyroid gland using the right amount of thyroid stimulating hormone (TSH), which is the hormone that makes the thyroid gland produce thyroid hormone.
WHERE CAN THYROID FUNCTION GO WRONG?
Thyroid imbalances can result from improper signaling because miscommunication between your thyroid, brain, and body can occur on many levels. The most common reason for having abnormal function of thyroid is an immune attack, causing the gland to slow down or to work excessively. Autoimmune thyroid conditions are the most common autoimmune diseases in mankind. However, thyroid disorders is not always due to the thyroid suddenly producing too much or too little T4 or T3. A complex network between the hormones pumped throughout your body and the interpretation of them in your brain affects thyroid function. Your body’s condition may not be sensed correctly by your brain or thyroid, and consequently, the over- or under-production of thyroid hormone will continue to tip your thyroid off balance. So many factors can alter your thyroid hormone levels: depression, being overweight, sex hormone balance, surgery, radiation, contamination, medications, and improper nutrition.
Important trace elements such as selenium, zinc, and other antioxidants are crucial for thyroid hormone to work efficiently in your body and brain. You need the exact right amount of thyroid hormone in your system for your body and mind to function optimally.
AUTOIMMUNE THYROID DISORDERS
The most common thyroid conditions, and also the most common causes of thyroid imbalances, are autoimmune thyroid disorders, where antibodies start attacking your thyroid. In one form of autoimmune thyroid disorders called Hashimoto’s thyroiditis, the thyroid no longer produces hormones normally, so it leads to hypothyroidism (low thyroid). In the opposite form, Graves’ disease, the antibodies stimulate the gland and make the thyroid produce too much T3 T4. Often a genetic predisposition causes autoimmune disorders of the thyroid, but many other factors, like radiation or vitamin deficiencies and stress can trigger an autoimmune attack. To learn more about what causes Hashimoto’s thyroiditis and Graves’ disease and how to prevent an autoimmune attack, see Thyroid Disorders or Thyroid Health.
The conventional way to diagnose an underactive thyroid or overactive thyroid is to get a TSH T4 T3 profile but a TSH test may be enough as a first step. TSH is the pituitary hormone that makes the thyroid gland function properly. When the gland becomes sluggish, TSH levels become elevated in an attempt to restore thyroid function to normal.
The TSH test shows high numbers when your thyroid is not working well. In contrast, when the gland is overactive or when there is too much thyroid hormone in your system, TSH is low- the higher your TSH level is, the more severe your hypothyroid condition is.
You may be suffering from hypothyroidism even though your TSH test is still within the normal range (learn more about covert hypothyroidism in The Thyroid Solution). When the TSH test is normal but the T3 T4 levels are normal the hypothyroidism is low grade or subclinical. Subclinical hypothyroidism and covert hypothyroidism are quite common and can cause symptoms. In moderate and severe hypothyroidism T3 levels are low and the diagnosis is quite obvious.
In hyperthyroidism T3 and T4 levels are usually high but some patients have high T3 levels but their thyroxine (T4) levels may be normal.
Other useful tests to diagnose thyroid disease:
- Anti-TPO antibody= the best marker for Hashimoto’s thyroiditis.
- TSI= (Thyroid stimulating immunoglobulin) immune blood marker for Grave’s Disease.
- Thyroglobulin= blood test marker for thyroid cancer
- Calcitonin= blood test marker for medullary thyroid cancer
- Ultrasound= useful to diagnose thyroid nodules and Hashimoto’s thyroiditis and for detection of suspicious lymph nodes in patients with thyroid cancer.
HOW TO SELECT THE BEST THYROID DOCTOR FOR OPTIMAL THYROID WELLNESS
Generally speaking, patients affected by a thyroid disorder are diagnosed, treated and monitored by their primary care physicians who are either Internist or family practitioners. In many circumstances, however, female patients receive their thyroid treatment from their gynecologists or an alternative, holistic doctor. Less often, thyroid patients are diagnosed and treated by an endocrinologist (meaning a doctor specializing in the endocrine system which includes the thyroid gland system). Some endocrinologists have a passion for thyroid disorders, have acquired a tremendous amount of experience in the treatment of thyroid disorders, and are often members of the American Thyroid Association. Treating thyroid disease is not only testing and administering medication. It is also listening to the wide range of symptoms and suffering and tailoring the treatment to each individual based on their symptoms and their condition. Selecting a doctor knowledgeable in thyroid disease may not be easy, but these are a few tips that will help you select the best thyroid specialist that will fulfill your needs:
*Preferably the doctor should be an endocrinologist with years of experience in treating thyroid patients.
*Choose a doctor who has the reputation to use thyroid medications, and a combination thereof, that mimic what your thyroid gland would be doing in normal circumstances (Armour Thyroid, T4/T3 treatment, T4/T3 therapy).
*Choose a doctor who addresses the needs of your immune system since many thyroid conditions, and particularly hypothyroidism and hyperthyroidism, are immune-mediated.
*Choose a physician who has experience, not only with the physical effects of thyroid, but also emotional and mental effects.
*Choose a physician who believes in thyroid supplements and recommends to patients a comprehensive mix of micronutrients, vitamins and antioxidants, omega-3 fatty acids, etc. to support the immune system, the thyroid gland and to boost thyroid hormone efficiency.
*Choose a physician who uses in-house thyroid ultrasound, who can read and interpret the thyroid ultrasound, because reading thyroid ultrasounds can be tricky.
*It is preferable to select a physician who not only knowledgeable in thyroid disorders but also knowledgeable in metabolism and in weight loss management.
*If you are perimenopausal or menopausal, your thyroid doctor should be able to manage your hormones and prescribe the best form of bioidentical hormonal replacement therapy since the thyroid system and female hormone system affect one another.
If you are interested in learning more about thyroid disorders, click here.
If you are looking for a Houston endocrinologist and thyroid specialist, consider seeing Ridha Arem, M.D. You can read more about his practice by visiting www.TexasThyroidInstitute.com or by clicking on the tab labeled “Dr. Arem” above.