Thyroid-stimulating hormone (TSH) is the most commonly used test to check how well a person’s thyroid gland is working. Although not everyone will be tested, most people who are suspected of having a thyroid condition are. For those who do go through this test, it can be stressful and confusing. Do your results pass or fail? And what does that mean? Read on and we’ll answer some common questions surrounding TSH: like why it is done, what should your levels be, what the high and low levels indicate, how to support healthy TSH levels, and how to support yourself until you know the results.
What is TSH? How To Know if Your TSH Levels Are Healthy or Not
What is TSH?
Thyroid Stimulating Hormone, more commonly referred to as TSH is a hormone that is released by the pituitary gland. What is TSH and what is the purpose of TSH is to be a messenger sent from your brain to stimulate and regulate your thyroid gland to produce and secrete its hormones.
What are the thyroid hormones produced in the thyroid gland?
The thyroid gland produces two different types of thyroid hormones: T4 and T3. T4 is known as levothyroxine and is considered to be the storage form of thyroid hormone. It’s converted into T3 once it reaches your cells and tissues. T3 is known as triiodothyronine and is the active form of thyroid hormone.
How To Know if Your TSH Levels Are Healthy or Not
If TSH levels are too high or too low, it can lead to hypothyroidism or hyperthyroidism.
The first thing that’s important is do you have symptoms of a thyroid condition. If you do, it’s important to get tested for thyroid health. The most common test is a TSH test. To get an accurate reading on this, your doctor will likely recommend a combination of tests that include TSH levels as well as other thyroid hormones like T4 and T3. It’s also important to note that just because your levels are within the reference range doesn’t mean they are “normal” or considered healthy.
Let me explain further. You can have a “normal” TSH but still have a problem with your thyroid function. This is because the interpretation of your thyroid panel or TSH, T3, and T4 hormones needs to be done in conjunction with your symptoms. If you are experiencing symptoms of hypothyroidism such as fatigue, weight gain, depression, hair loss, or constipation then it’s likely that your levels are not normal. The reference range is set based on the average population and doesn’t take individual factors into consideration like age and gender.
TSH levels alone usually aren’t very informative but TSH with other thyroid hormone levels and taking into consideration your symptoms is the best way to diagnose and treat thyroid problems. Also, if your TSH is “normal” but other thyroid hormones like T4 or T3 are low, this can indicate that you have a problem with the conversion of T4 into T3 (the active form of thyroid hormone).
The majority of people with hypothyroidism have a problem converting inactive T4 into its active form—T3. This can be caused by a number of factors including iodine deficiency, stress, and gluten intolerance.
Having symptoms of low thyroid but “normal” thyroid numbers on your labs should lead to a deeper dive into other possible causes such as stress and gluten intolerance. Unfortunately, many doctors are quick to dismiss symptoms of thyroid problems as stress-related or psychosomatic without doing any additional testing or investigating other possible causes.
It is in these cases that it is important to work with a functional nutritionist to identify the underlying causes of fatigue, coldness, brittle hair and or constipation.
Do you have symptoms of a thyroid condition?
Thyroid illnesses can be either autoimmune or non-autoimmune. In autoimmune diseases, the immune system attacks healthy tissue in the body as though it were foreign matter. Non-autoimmune diseases include cancerous tumors or nodules that can form on or around the thyroid gland itself.
These disorders can cause many symptoms, including:
- Fatigue not feeling rested especially first thing in the morning, even after sleeping enough hours.
- Weight gain or loss, usual rapid changes in weight and otherwise unexplained and without eating more than usual. Along with hair loss can be brittle nails and dry or flaky skin.
- Hair loss or thinning hair and seeing hair in the drain is a common occurrence.
- Irritability or depression that has recently started or is getting worse.
- Heat sensitivity (feeling hot when others feel comfortable) or you feel cold all the time despite wearing warm clothes.
- Change in your bowel habits, usually to being more constipated.
- What does it mean to have high thyroid hormone levels?
When it comes to the thyroid, it’s important to know what your TSH level is. TSH stands for thyroid-stimulating hormone and it’s a messenger hormone that tells the thyroid how much T3 and T4 to produce. As you may know, there are two main hormones produced by the thyroid: triiodothyronine (T3) and thyroxine (T4). When someone has high levels of either of these hormones, it can cause serious symptoms such as weight gain, fatigue, hair loss, depression, and more.
Thyroid dysfunction is one of the most common endocrine disorders in the United States. In fact, approximately 30 million Americans have some form of thyroid disease or hypothyroidism (too little thyroid hormone) — but many people do not know they have it because they have the symptoms, but their doctor may not be ordering the right tests, or their doctor may not be versed in functional medicine and are unaware of the updated interpretation guidelines!
Thyroid hormone is produced by the thyroid gland, which is located in the neck. It helps regulate metabolism, body temperature, and heart rate.
TSH stands for thyroid stimulating hormone and is produced by the pituitary gland in the brain. When your thyroid gland needs more thyroid hormone, TSH production increases and stimulates your thyroid to produce more hormones.
Thyroid function is regulated by a complex system involving many hormones, including TSH; thyroxine (T4); and triiodothyronine (T3). T4 and T3 are critical for converting food into energy.
If your thyroid doesn’t produce enough thyroid hormone, it’s called hypothyroidism. Your doctor may order blood tests to check your TSH levels if you’re experiencing symptoms of low thyroid hormone levels — such as fatigue, weight gain, and constipation — or if you’ve had your thyroid removed surgically or due to cancer treatment.
But ordering only a TSH is not enough. You need to check your T4 and T3 levels as well. If you have hypothyroidism, your doctor may recommend taking thyroid hormone replacement medication. The most common thyroid disorder, hypothyroidism is caused by an underactive thyroid gland. Hypothyroidism can happen as a result of autoimmune disease, inflammation, nutritional deficiency, stress, or surgery.
What does it mean to have low thyroid hormone levels?
The thyroid hormones are made from the amino acid tyrosine. The body uses iodine to make them. Iodine comes from food or is added to salt (iodized table salt).
The hypothalamus in your brain tells the pituitary gland to release thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid gland to produce T3 and T4.
When your blood tests show that you have low levels of T3 or T4, you may have hyperthyroidism (high thyroid function.)
Hyperthyroidism causes symptoms such as rapid heartbeat, agitation, and irritability.
I have also seen a number of cases of overmedication. What this means is the individual has low functioning thyroid or more than likely has had their thyroid removed and is being given medication to try to control their metabolism.
Unfortunately, the patient that has had their thyroid removed doesn’t feel themselves on the medication (Synthroid/levothyroxine, etc.). They may still have symptoms and their physician or endocrinologist increases their medication dosages. This can lead to high thyroid function and symptoms like fatigue, nervousness, insomnia, and weight loss. This is not a good thing as these symptoms are relieved by lowering the dosage of medication.
Understanding Thyroid Testing: What Tests Need to Be Ordered?
- TSH
- T3, total
- T3, free
- T4, total
- T4, free
- Iodine
- Thyroid Antibodies (thyroglobulin and thyroperoxidase)
The main test for thyroid function continues to be a TSH test. It stands for thyroid stimulating hormone and it is produced by the pituitary gland and controls the production of the thyroid hormones T3 and T4 from the thyroid gland.
It is released into the bloodstream to stimulate the thyroid gland to produce more thyroid hormones. The thyroid hormones then travel through your bloodstream to all areas of your body, including your brain, heart, and muscles.
The main task of TSH is to stimulate the thyroid gland to produce two important hormones: thyroxine (T4) and triiodothyronine (T3). There are also free T4 and free T3.
T4 is the inactive thyroid hormone and T3 is the active thyroid hormone that has receptors on virtually every cell in your body. T3 controls how fast your body uses energy. It can also increase or decrease body temperature and cause changes in weight.
The thyroid gland produces these two hormones by taking iodine from food and combining it with another substance called tyrosine to make T4, which then becomes T3 once it leaves the thyroid gland.
This process occurs when a message from your pituitary gland that there aren’t enough hormones being produced by the thyroid gland, so it releases more TSH into your bloodstream to stimulate more production of T3 and T4.
This process can also occur when you are exposed to an environmental pollutant that mimics the structure of iodine and blocks its ability to bind to tyrosine, preventing it from becoming T4.
If you have Hashimoto’s disease (autoimmune hypothyroidism), your immune system attacks your thyroid gland. As a result, you may experience symptoms such as fatigue, muscle weakness, and weight gain.
The only way to know if you have Hashimoto’s disease is through testing. Functional nutritionists and doctors will take several tests to determine if you have an underactive thyroid gland (hypothyroidism) or an overactive one (hyperthyroidism). They’ll also test for antibodies against the body’s own tissues (autoantibodies) because autoimmune diseases like Hashimoto’s are linked to high levels of these antibodies.
In my professional opinion, Hashimoto’s thyroiditis is an inflammatory condition, and I’m not sure it needs to be treated with hormone replacement if it’s caught early enough. The individual’s inflammation is attacking their thyroid function, causing symptoms while depleting their thyroid hormone production. It is common practice to prescribe thyroid medication when Hashimoto’s antibody testing is positive. In reality, I believe more attention should be to find the cause of the inflammation to slow down the destruction. But in modern medicine rarely does diet or further testing come into play when the thyroid antibody tests are positive, the usual course of treatment is a medication for an inflammatory problem.
What are some things you can do to support your thyroid?
- Eat a healthy diet rich in whole, unprocessed foods.
- Avoid gluten, dairy, and soy (if you’re sensitive).
- Reduce stress by practicing meditation and yoga.
- Exercise regularly (20 minutes of exercise, 3-4 times per week).
- Supplement with magnesium and vitamin D3 (for adrenal support).
- Get a thorough thyroid panel of testing if you suspect your thyroid isn’t working properly. If your doctor is hesitant to order a complete thyroid panel, reach out to me here, especially if you have a family history of thyroid issues.
Takeaway: Your TSH, and more specifically, your other thyroid hormone levels are an important part of how you feel, your overall energy level, and your metabolism. Thorough testing and proper detection of any underlying thyroid hormone and TSH imbalances can be life-changing!
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