How to know if you have an underactive thyroid

You have been struggling with some strange symptoms, like unexplained weight gain (you are definitely not pregnant), feeling very tired all the time, and sleeping for all hours of the day.  Someone then suggested that you have your thyroid tested, or you make an appointment to see your doctor.  It makes sense, so you do make an appointment to see your doctor.  

In the meantime, you wonder: is there any way to know for sure if you have an underactive thyroid?

Symptoms of an underactive thyroid

Every thyroid patient, including myself, at some point, have done an internet search on the symptoms of an underactive thyroid.  The most common symptoms you will read about will include the following:

  • Unexplained weight gain
  • Fatigue
  • Feeling cold
  • Dry skin
  • Hair loss.
Once you know more about how important thyroid hormones are to just about every single cell in your body, you may be able to link some other symptoms to your underactive thyroid.  This is because thyroid hormones are important for energy and cellular metabolism!  
If you don’t have enough thyroid hormones in your body (called hypothyroidism or an underactive thyroid), then you can experience many symptoms, that you may not have linked to your hypothyroidism, such as:
  • Inability to lose weight
  • Chronic pain
  • Swelling
  • Waking up tired
  • Depression
  • Digestive problems
  • Reproductive problems
  • Heavy and painful menstruation
  • Skin conditions
  •  Dry, brittle and splitting nails
  • Frequent infections, such as colds, flue and sinus infections
  • Low or no libido
  • Brain fog
  • Memory problems
  • Insomnia (waking up in the middle of the night)
  • Ringing in the ears
  • Vertigo
  • Dizziness
  • Irritability.
These symptoms are very real.  Unfortunately, not everyone will present the same symptoms or experience it the same way.  

The challenge with thyroid problems, is that you are dealing with hormones.  And hormones are petty, complicated and you cannot be diagnosed with an underactive thyroid by just ticking off the symptoms and doing a feel-around the throat area.  Unfortunately, the only way to know for sure if you have a thyroid problem, is to do the thyroid blood tests.  And for this, you need to visit your doctor. 

Thyroid Panel Blood Tests

  • The standard blood tests to check for thyroid function are the following:
  • TSH.  This is the first marker that doctors check for, and if this marker is out of range, then there is a follow-on test the lab will do, which is 
  • Total and Free T4 test.
I believe that you must learn more about how the thyroid works, the thyroid hormones and how they work together with other hormones.  Because then you will know that the TSH is a hormone sent by the pituitary gland to the thyroid gland, basically telling the thyroid gland how many thyroid hormones to make.  And, you will also learn that the thyroid gland makes mostly T4 hormones, which are the inactive hormones, and very little of the T3 hormones, which are the active hormones that your cells actually use for energy and metabolism.  

There are many reasons why your thyroid could be underactive.  These may include a conversion problem (your body is not converting enough T4 to T3 hormones), a transport problem (the thyroid hormones are not getting to the cells), an usage problem (the thyroid hormones are not getting into the cells or doesn’t have enough nutrients to work effectively), or presence of thyroid antibodies (which indicates an autoimmune thyroid condition, where your thyroid gland is destroyed by your immune system and therefore becoming underactive).  Any one or more of these reasons could be the reason why you are struggling with hypothyroid symptoms.  

This is why it is important to get a complete thyroid panel done so that you can have a full picture of what your thyroid is trying to tell you.  Therefore, in addition to the above, I recommend that you include the following lab tests:

  1. Total and Free T3
  2. TG antibodies
  3. TPO antibodies
  4. Reverse T3
  5. Iron and ferritin levels

While iron levels are typically not part of the thyroid panel, I include it here.  Because if you are low in iron, nothing you will do in terms of thyroid hormone therapy will be effective.  Your cells need oxygen, and if your iron levels are too low, your cells are not receiving enough oxygen and it cannot use the thyroid hormones effectively.  


In closing

If you think you have an underactive thyroid, the only way you will know for sure is to have a full thyroid panel lab tests done.  And remember to include the iron level test as well. This is the only way you will know for sure if your thyroid is underactive. 

Adele du Rand

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