Is TSH a sufficient indicator of thyroid gland function?


Is TSH a sufficient indicator of thyroid gland function?

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.



Dr. Nikoleta Koini, M.D.

Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine.
Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).



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