Hey guys I'm Dr. Jason Barker with the Natural Athlete's Clinic and today I want
to go over how your thyroid gland functions,
how to interpret some common blood tests, some common signs and symptoms,
how I interpret those blood tests in the clinic and then who's at risk for
thyroid issues because your thyroid gland is probably one of
the most important glands in your body. It governs your metabolism so it has an
effect on every single cell in your body and of course every organ
if your metabolism isn't running properly, you're going to have issues in
pretty much every single department. So you've heard of people who say oh I have
a fast metabolism I can eat whatever I want, I stay lean...
that's because they're good at burning energy rapidly and
efficiently. Now you've heard of people who say
oh I have a slow metabolism you know even if I look at a piece of cake I'll
gain weight these are the people who have a slow metabolism who just gain
weight for no reason. They're not good at burning energy so
thyroid is super important to understand especially if you're an active and
athletic person and you want to get the most out of your body.
Okay so let's get into it here is your brain.
Inside of your brain is your pituitary gland which is often referred to as the
master gland. It dictates what all of your other
hormonal glands in your body do. So the pituitary will release TSH
thyroid stimulating hormone - it does what it sounds like - it stimulates the thyroid
gland which is right here base of your neck and the thyroid gland
will release two hormones T4 also known as thyroxine and T3 also
known as triiodothyronine. Now it releases the T4 and T3 in about
an 80 to 20 percent ratio mostly T4 a little bit of T3.
T4 is pretty inert - it really doesn't have any
action in your body - it needs to get converted into T3
and the T3 is what does the thyroid magic.
Now T4 gets converted a little bit in the bloodstream by itself,
it gets converted a lot in the kidney and liver and then also to some extent
in every single cell of your body. This is a collection of cells there so you're
going to see conversion of that T4 into T3. T3 is the
active hormone. Now the T4 and the T3 circulate around
the body - they do their thing - they also find their way back into the brain where
the pituitary senses their levels. Now if the pituitary
thinks that there is not enough T4 and T3 in the
body, it will increase the rate at which TSH is
secreted so the TSH comes up and stimulates the thyroid gland.
Likewise if there's too much T4 or T3, the pituitary gland will shut down that
TSH production so this is what's referred to as a negative feedback loop.
These are common throughout nature, they're also common in engineering - best
example I can give you is your thermostat in your house: So if
you've got that thermostat set to 70 degrees,
air temperature cools off that will click that thermostat on
which then tells the furnace to turn on and the furnace spits out all that warm
air - that warm air comes back tells the thermostat to switch off which
then the thermostat switches the furnace off - so that's also
a negative feedback loop. That's exactly what's going on your body
all the time to varying degrees. Okay so let's talk about ranges really
quickly: Now if you're lucky enough to get a
thyroid test because most people in my clinical experience who come into
the office it's rare for them to get a thyroid test.
If you're lucky enough to get one, you'll usually end up getting just the TSH
there. These are the standard accepted ranges
here so 0.4 to 4.5 is for the TSH and these are different
units of measurement on each one of these I didn't bother writing those down
because that's not important for our purposes today.
Pretty wide range here, there's a lot that can go on
interpretation wise as to whether you have a thyroid problem or not and I'm
going to come back to that in a second. So but first of all
let's talk about common signs and symptoms of thyroid issues. So again if
you have hypothyroidism where your thyroid is
running slow you're not burning energy as well. So
what's the first thing that will happen is you're going to gain weight just
doing absolutely nothing even without changing your diet.
You'll notice what we call boggy skin, sometimes
where you collect fluid under the skin - good place to see this is down in your
shins if you push your thumb into the front of your shin and it leaves a
little dent in that tissue down there that's called pitting edema.
That's a very common sign of slow thyroid function.
Your hair will get dry, it'll get brittle, it'll break, it'll fall out, you'll lose
some of your lashes and brows, you get constipated, you get cold
hands and feet - so lots and lots of stuff.
Also slow mental emotional capacity too - you'll have what we call brain fog. So
a lot of problems right?.. forget trying to get a PR in any kind of event or have
efficient training too. You know physical exertion is going to
be out the window if you're suffering from hypothyroidism
or it's going to be a real struggle. Now on the opposite end of that spectrum if
you have hyperthyroidism thyroid is going too fast your
metabolism is going too fast so you're going to be sweaty, you're going to be
hot, you're going to be anxious, nervous palpitations, you know funny heartbeats,
you'll have insomnia - a lot of symptoms and signs along those
lines too. Now how do i interpret thyroid labs?
So if you go see a standard medical doctor and they run a TSH on you
and you fall within this range - let's pretend you've got a 4.2 on your TSH
yet you have a lot of those symptoms i just talked about, they'll look at you
and they'll say "well your thyroid is normal, have a nice day,
bye" And that's clearly a big problem because
what's actually going on is that you are functionally hypothyroid. That doesn't
mean that's different than clinical
hypothyroidism where it's actually on a piece of paper says that you have
hypothyroidism but if you're at the opposite end of one of
these ranges or towards the extreme end of one of these ranges
and you have thyroid symptoms, you either have functional hypothyroidism or you
could be functionally hyperthyroid. Now I use a grading scale with this so
one thing to remember before I get into that is that the lower
the TSH is the faster your thyroid is running and the higher the TSH is the
slower your thyroid is running - so it's kind of the opposite of what you would
think and remember that's because if the
thyroid is slow, it's not spitting out enough of this T3 and T4, the levels are
low, they get to your brain, your brain starts
yelling at your thyroid to make more of it right? So this
signal is amplified, the TSH goes up so higher TSH,
slower thyroid. Now back to that grading scale,
in an ideal world, a perfect thyroid level or perfect TSH level would be
around a 1 okay. So if I were to give you a grade in
thyroid class and you had a 1, I'd say you had an
A. If you were around a 2, that would be kind of a B.
Around a level 3, we call that a C and if you're up around a 4 to
a little bit higher than four I'd give you a D or maybe even an F
based on your symptoms. And we all know that the person who is getting a D
in class, they're still passing and they're not doing as well as that person
who's getting an A but they're still passing
and that's what happens to a lot of people who go into their doctor
and they've got some sort of hypothyroid type complaint, some sort of metabolic,
slow metabolism complaint and they are within this range at the upper end.
They're told they're fine and to have a nice day and go away and so that's
the people that we end up having come in our clinic a lot because
we're gonna look at this with a finer tooth comb. Now these other ranges I put
up here because it's important to get these
other tests done too as part of a thyroid screening. Like I
said earlier, if you're lucky to get a thyroid test,
you'll get a TSH, but you really need to look at that T4 the free T4 the free T3,
these guys over here, and you also need to look at these TPO
antibodies - so that's thyroid peroxidase antibodies.
These are chemicals that your immune system will make that will damage your
thyroid gland if your thyroid gland is under attack by
your immune system and that stuff happens sometimes. Our immune
system is meant to kill foreign invaders into our body but every
now and then a switch gets flipped in your immune system will start attacking
a certain part of your body and autoimmune thyroid conditions are very
common. There's Hashimoto's disease and then there's Graves disease - those are
the two most common conditions like that. Now
who is at risk for thyroid issues? Unfortunately it's women. So women have a
lot more thyroid problems than men do. Women with family history are even at
higher risk, if your mom had thyroid issues or you're aunt did,
then you need to be more aware of that. Now family history is not your destiny
but it is going to raise your risk so this is something that you need to watch
out for now just because women are at higher risk doesn't mean that guys don't
ever get thyroid problems because they do.
I'd say in my practice for every maybe 25 or 30 women who
come in with thyroid issues we'll find one guy. So
it still happens but not nearly as common. Okay so I hope this helps you
guys understand how your thyroid works.
Definitely ask for all these labs if you suspect there's a thyroid issue.
If you have standard medical care, they don't like to pay
for extra labs, they don't like to spend the money so you're really going to have
to advocate to get these other tests done to make sure that
you're not dealing with any thyroid issues and remember to look at that TSH.
Closer to one is ideal - that doesn't mean everybody has to have a 1 but
far better to have it near a 1 rather than up near a 4 there.
So, important to understand this again because your metabolism
governs how well you burn energy and if you cannot burn energy.
You're going to have a heck of a time trying to perform your best too. Okay
so I hope this helped you, I hope you learn.
Please share this with somebody or one of your friends who maybe suspects they
have a thyroid issue and of course we're always looking for
more subscribers!