Thyroid Health Coaching
What is your Thyroid Type?
Did you know that there is more than one way that you can be hypothyroid?
An underactive thyroid can cause havoc in your life! From the typical symptoms of fatigue, unexplained weight gain, struggling to lose weight (despite watching what you eat and exercising), brain fog, hair loss, to name a few. It can be so frustrating!
What is even more frustrating is when you speak with your doctor about your symptoms, you are sent for blood tests, and then when the results are in… your doctor tells you that your results are normal or “that you are just not sick enough”! Yes, that really happens.
So what is happening here?
The standard approach to test for hypothyroidism: a high TSH
The way most allopathic doctors will test for hypothyroidism, is to do some blood tests. More specifically, TSH with a reflect to T4. What does this mean?
TSH is the hormone that is sent from the pituitary glad to the thyroid gland. It tells the thyroid gland how much thyroid hormones to make. So, the doctor will be looking for a high level of TSH, meaning that the brain is “shouting” at the thyroid gland to make more thyroid hormones. Then, if the TSH is high, only then will the lab check the T4 hormone levels:
If your T4 hormone levels are below the reference range, it means that you don’t have enough T4 hormones. You have an underactive thyroid, and you will need take extra thyroid hormones because for some reason your thyroid gland is not making enough thyroid hormones. You receive a script from your doctor (usually for synthetic T4 hormones called levothyroxine) and you are sent on your way.
This is what I call the HIGH TSH Thyroid Type, which is what I call Thyroid Type 2.
Most doctors are trained to test for hypothyroidism this way. But there are more ways you can be hypothyroid, which doesn’t have a high TSH. And this is where many patients are dismissed, misdiagnosed or missed altogether.
You can still experience hypothyroid symptoms, even if your TSH is not elevated or high. Let’s have a look at the other types:
Thyroid Type 1 - Autoimmune Hashimoto's Thyroiditis
According to the American Thyroid Association, this is the most common cause of an underactive thyroid. This is when your immune system attacks and destroys your thyroid gland cells, which then leads to underactive thyroid.
The blood test results are often not showing anything. Over time, a high TSH will show, and then a T4 hormone level that is low. But sometimes it is just now low enough yet, because the immune system haven’t destroyed enough of the thyroid gland cells yet.
Unfortunately many doctors just won’t test for thyroid antibodies, and will simply wait for the immune system to destroy enough of the thyroid gland so that the TSH is high, the T4 is low. And then they will give you a prescription for synthetic T4 – the same as Thyroid Type 2 – High TSH.
But here is why it is so important to check for thyroid antibodies: there is a lot you can do to reduce and even stop the immune system attack on the thyroid gland. You want to preserve as much of your thyroid gland as possible, so that you don’t have to take thyroid hormone pills for the rest of your life.
Also, Hashimoto’s is an progressive autoimmune disease. It will get worse over time. And research have found that you are more likely then to develop other autoimmune diseases.
So if you are struggling with hypothyroidism, checking for thyroid antibodies is important! And if you do have Hashimoto’s, you can then take action to stop the attack.
Thyroid Type 3 - Low T3
This type is very common and so easily missed by doctors, because the TSH and T4 is typically within the “normal ranges”. But the T3 is low.
What we need to remember is that T4 is inactive, like a storage hormone. It must be converted to T3, which is the active hormone that your cells can use. But now, there is not enough T3 for your cells. And there can be many reasons why this conversion process is not working like it should. You also could have high levels of Reverse T3 which blocks T3 from being taken up into your cells.
If you are given synthetic T4 hormones (called levothyroxine), it may not help, because you already have problems with converting T4 to T3. Taking extra T4 will most likely not help.
Thyroid Type 4 - Underactive Pituitary
The pituitary gland sends a messenger hormone TSH to the thyroid gland, which tells the thyroid gland how many thyroid hormones it must make. What happens if there is a problem with the pituitary gland, and not enough TSH hormones is send to the thyroid gland?
With this type, you will see a low TSH and a low level of T4 hormones. Many doctors will dismiss it, as it is not the typical way hypothyroidism works (with the high TSH that they have been taught to look at).
Thyroid Type 5 - Unavailable Hormones
With this type, the TSH is normal or within range. The Total T4 and Total T3 is normal, but the Free T4 and Free T3 is low. What does it mean?
This can be very deceiving, because everything looks fine, but it is not. In this Thyroid Type, the thyroid hormones are “bound” and not being made available for the cells to use. Again, difficult to find if you don’t know what to look for and if you are not doing a full panel thyroid blood tests and some additional tests.
If your labs are “normal“, and your doctor is telling you “it’s in your head, there is nothing wrong with you“, you may need to have a closer look at this Thyroid Type.
Thyroid Type 6 - High T3
This Thyroid Type now confuses everything. If you have high levels of T3, surely that is a sigh of hyperthyroidism? How can this be a type of hypothyroidism?
The secret is how the blood tests results look.
If you have a low TSH and a high T4, as well as a positive antibodies test for Graves, then you have an overactive thyroid or hyperthyroidism (also known as Graves disease).
But this type presents differently. Your TSH is normal, your T4 hormone levels are normal, but your Free T4 and Free T3 is high. This can be when there is an over-conversion happening of T4 hormones to T3 hormones. This is not good, and then you need to look at may be contributing to this process.
The essential blood tests
How would you know which Thyroid Type you are? Well, you need to have the full thyroid panel blood tests done, which includes the following:
- TSH
- Total and Free T4
- Total and Free T3
- Thyroid antibodies (both TPO and TG antibodies)
- Reverse T3.
There are also additional blood tests that provide valuable information into your overall health status, which may include the following:
- Iron and ferritin
- Vitamin D3
- Sex hormones
The next steps
Understanding your Thyroid Type is the first step in developing your action plan, and to determine what next steps you should take in terms of thyroid hormone medication, dietary changes, stress management, exercise and even which supplements you should consider taking.
If you want to learn more about the Thyroid Types and how to determine your thyroid type, I have developed an on-demand Masterclass to show you exactly what you want to know.
Let's get acquainted
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