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Is TSH a sufficient indicator of thyroid gland function?

thyroid

26 Feb Is TSH a sufficient indicator of thyroid gland function?

Posted at 13:24h in Autoimmune Diseases, Chronic Diseases by

There is a tendency among physicians to assess a person’s thyroid gland status, merely by measuring the levels of Thyroid Stimulating Hormone (TSH). But, is that really enough? Clinical evidence shows that most often the real causes of thyroid gland dysfunction are ignored.

 

Dysfunctional Thyroid – The usual tests to evaluate its function

Routine thyroid testing includes assessing the levels of the following blood markers:

  1. TSH
  2. T3
  3. T4
  4. Anti-TPO & Anti-Tg antibodies

 

Dysfunctional Thyroid – What does its proper evaluation should include

Diagnosing thyroid disorders is not easy and the results of laboratory tests can be confusing and misleading.

In the above thyroid indices, it is necessary to include Free T4, Free T3, Reverse T3 (RT3) as well as the ratio of free T4 / free T3.

So in addition to the laboratory results mentioned above, a deeper focus will shed light on other organ dysfunctions which are associated with it.

 

Pituitary dysfunction

Hypothyroidism can be caused by pituitary dysfunction due to high levels of cortisol.

Cortisol is increased in cases of:

  • active infection
  • blood sugar deregulation, insulin resistance
  • chronic stress
  • pregnancy

The above factors can disrupt the function of the pituitary gland. As a result, it cannot release enough TSH to stimulate the thyroid gland to produce T4 and T3.

Patients with this dysfunction will experience symptoms of hypothyroidism, TSH above the functional range (0.6-2.0) but within normal limits (0.5-5.0), and low T4.

 

Estrogen & Progesterone

In addition, measuring other hormones, such as estrogen and testosterone, can help determine the elevated or decreased TBG (Thyroid-binding globulin) that causes hypothyroidism.

 

Glucose & Glycosylated Hemoglobin HbΑ1c

Patients with impaired glucose and glycosylated hemoglobin levels are more likely to develop thyroid disease.

 

Additional factors

In addition, intestinal dysbiosis, adrenal insufficiency, deficiency of essential micronutrients and intoxication are additional factors that must be taken seriously in the evaluation of a healthy thyroid gland and be checked through special tests for each individual.

 

The correct treatment of thyroid disorders

Through specialized tests and investigation of the overall health condition of the patient, the underlying causes are detected and identified, in order to achieve a complete treatment and cure. So, before the patient is administered any treatment that is deemed necessary for the restoration of his hormones, it would be wise to precede the investigation and focus on the underlying causes.

 

References:

  • “Thyroid History Timeline – American Thyroid Association”. www.thyroid.org. Retrieved 13 November 2016.
  • Cicekcibasi AE, Salbacak A, Seker M, Ziylan T, Tuncer I, Buyukmumcu M (April 2007). “Developmental variations and clinical importance of the fetal thyroid gland. A morphometric study”. Saudi Medical Journal. 28 (4): 524–8. PMID 17457471.
  • Kim DW, Jung SL, Baek JH, Kim J, Ryu JH, Na DG, et al. (January 2013). “The prevalence and features of thyroid pyramidal lobe, accessory thyroid, and ectopic thyroid as assessed by computed tomography: a multicenter study”. 23 (1): 84–91. doi:10.1089/thy.2012.0253. PMID 23031220.
  • Bowen R (2000). “Thyroid Hormone Receptors”. Colorado State University. Archived from the original on 27 September 2011. Retrieved 22 February 2015.
  • Greenspan’s 2011, p. 178.
  • Boron WF, Boulpaep E (2003). “Chapter 48: “synthesis of thyroid hormones””. Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. p. 1300. ISBN 978-1-4160-2328-9.
  • How Your Thyroid Works: A Delicate Feedback Mechanism. Updated 2009-05-21.
  • The thyroid gland in Endocrinology: An Integrated Approach by Stephen Nussey and Saffron Whitehead (2001) Published by BIOS Scientific Publishers Ltd. ISBN 1-85996-252-1
  • Thyroid Problems eMedicine Health. Retrieved on 2010-02-07
  • So M, MacIsaac R, Grossmann M. “Hypothyroidism – Investigation and management”. www.racgp.org.au. The Royal Australian College of General Practitioners. Retrieved 11 January 2017.
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