As a thyroid patient, there are many important factors that should be considered. Asking your doctor the following ten questions can bring clarity to common thyroid-related issues that are often overlooked.
1: Are You Willing to Run a Full Thyroid Panel Including T4, T3, Reverse T3, TSH, and Thyroid Antibodies?
Traditionally, doctors rely solely on TSH (thyroid stimulating hormone) tests to evaluate thyroid health and function. Unfortunately, because TSH does not measure the amount of thyroid tissue levels it cannot be relied on as the sole method of testing – learn more about the inadequacy of the TSH test here.
To get an accurate representation of thyroid function it’s important that your doctor is willing to run a full thyroid panel including Free T4, Free T3, Reverse T3, and thyroid antibodies in addition to TSH.
If your practitioner is unshakable in their belief that TSH is the only metric needed, it’s time to find a different doctor.
2: Do You Believe Optimizing Free T3 Levels is an Important Part of Treatment?
T3 is the active form of thyroid hormone and is responsible for maintaining many bodily processes. Low levels of T3 cause the thyroid to slow significantly. Alternatively, excess levels of T3 can result in overactive thyroid function. These two cases can cause hypothyroidism and hyperthyroidism respectively.
Many doctors believe that optimizing TSH or T4 levels is the only action needed to ensure proper thyroid function. However, for those with T4 to T3 conversion issues, TSH and T4 levels can fall within optimal ranges while the patient still suffers from thyroid dysfunction.
As the primary influencer of thyroid function, it is important that T3 be optimized.
3: Is Levothyroxine the Only Thyroid Hormone Treatment You Prescribe?
Levothyroxine is a synthetic version of thyroxine (T4). Because T4 is converted into other vital thyroid hormones, this medication is frequently prescribed to resolve thyroid issues.
Unfortunately, T4-only medications may not be the best option for everyone. Those who do not experience improvement of thyroid symptoms after treatment with T4 or Levothyroxine may benefit from other treatment options. Find out why Levothyroxine isn’t working for you!
T3 formulations, specifically time-released or sustained-release/slow-release versions, can subvert possible conversion issues and directly impact thyroid function. It’s best to have a doctor who is knowledgeable of T3 analyze the thyroid before beginning treatment because improper dosage may result in overactivity.
Another alternative to Levothyroxine is Natural Desiccated Thyroid hormone. This medication option provides thyroid hormones that more closely resemble those naturally produced by humans.
4: What Treatment Option is Best For Me?
The standard method of treating hypothyroidism is through thyroid hormone replacement therapy. This usually involves taking a pill that contains the appropriate amount of thyroid hormone.
In most cases, this method of treatment is enough to balance hormone levels. However, there are other treatment options such as bioidentical hormone replacement therapy and additional supplementation that can significantly improve thyroid function.
It’s vital that your physician understand the importance of an individualized treatment plan.
5: Will You Run an Ultrasound to Assess Physical Changes in my Thyroid?
Even though the effects of thyroid malfunction are usually related to energy level and mood, physical changes or growths relating to the thyroid can develop.
Thyroid nodules and growths can result in elevated thyroid hormone levels and other protuberances or enlargements could indicate thyroid cancer. One of the best methods for assessing and diagnosing this possibility is through an ultrasound.
If there is swelling of or around the thyroid, greater examination of the thyroid should be pursued.
6: If I Still Experience Symptoms After Your Prescribed Treatment, Will You Help Optimize Treatment or Pursue Other Treatment Options?
It’s a common occurrence for practitioners to prescribe thyroid treatment simply to get their patients to standard TSH or T4 levels. Optimal thyroid levels are unique to the individual and even minor fluctuations can cause symptoms to arise.
Even if your TSH is maintained within the standardized range (0.5 to 4.5), you can still experience dysfunction. If a patient’s optimal level is 4 while their medication is only getting them to a 1, they may still feel terrible. For this reason, it is important that patients and practitioners work together to optimize hormone levels.
7: Do I Need to Change My Diet?
A common difficulty associated with thyroid disease is weight management. Some find it difficult to lose weight or gain weight, while others uncontrollably acquire or drop pounds. After getting prescribed a proper thyroid medication, weight management should become easier. However, it is still important to keep an eye on your diet.
Certain foods such as soy and coffee can inhibit thyroid hormone absorption. Those with a gluten sensitivity or celiac disease may experience increased fatigue, joint and muscle pains, and difficulty losing weight when they consume foods containing gluten.
Your doctor should be able to provide a list of “danger foods” for those with a thyroid condition.
8: Are My Adrenals Functioning Properly?
The thyroid and adrenals are closely related! Changes to either system can cause the other to react in positive or negative ways – learn more about the thyroid-adrenal connection here.
Some find that soon after commencing thyroid treatment, they experience a return of their symptoms. Adrenal imbalances can cause one to regress even after treatment has been sustained for an extended period.
Generally, adrenal imbalances can be diagnosed and subsequently corrected with proper treatment and lifestyle changes. Resolving an adrenal issue may be an important aspect of optimizing thyroid function.
9: When Should I Take My Medication?
Generally, thyroid medications are to be taken daily, first thing in the morning. Optimally this is done on an empty stomach to allow for easier absorption of thyroid hormone. Many substances can inhibit hormone absorption even if they are ingested multiple hours after the medication has been taken.
A general guideline is to avoid taking other medications or eating absorption-inhibiting foods for four hours after thyroid medication is taken. Your doctor should be able to provide a complete list of substances to avoid when taking your thyroid medication.
10: Can I Exercise Safely?
In some cases, thyroid dysfunction can be so severe that you’re unable to safely exercise or even undergo minor exertion. If the body is overtaxed when it’s experiencing an energy deficit due to poor thyroid function, there is a risk of damage and long-term fatigue.
As thyroid function decreases, so does the rest of the body. Even if you think that your body can complete a certain physical activity, changes in thyroid function may make it dangerous for you to do so.
If diagnosed with a thyroid condition, it is best to speak with a physician prior to engaging in exercise or rigorous physical activity.
Asking the Right Questions
Because the thyroid is such a complex system it is important to get care from a doctor who is thyroid literate. If your doctor is unwilling to answer these questions or at least listen to your concerns, it may be time to find a new doctor.
By asking your doctor the questions within this article, you can improve your understanding of the thyroid. Awareness and understanding is an important step to reaching improved thyroid wellness.