Why a Standard Thyroid Test May be Wrong

By: Cat Ebeling, BSN,co-author of the best-sellers: The Fat Burning Kitchen,The Top 101 Foods that Fight Aging&The Diabetes Fix

You are fatigued—beyond what a good night’s sleep would help, you lack energy, you’ve gained weight, you feel chilly most of the time, you may even be slightly depressed. You don’t even have the energy to follow any kind of fitness program.

You’ve been catching every cold or flu going around, so you go to your physician and he does some blood work. The doctor checks your thyroid, but he tells you, “Your TSH is in the normal range, so your thyroid is fine.” He sends you home with some vitamins, tells you to get a good night’s sleep or even worse, says it’s all in your head, and offers you an anti-depressant.

Back to square one? Why DO you feel tired all the time? Even if your physician is telling you your thyroid is ‘normal’, it may not be. Unfortunately, most physicians will only do a standard test for thyroid dysfunction which is the TSH test. TSH stands for Thyroid Stimulating Hormone.

Around 30 million people suffer from thyroid disorders. More than half of those (60%) have no idea their poor health and low energy is related to thyroid problems. One in eight women will develop a thyroid disorder at some point in their lives, and the number of people suffering from dysfunctional thyroid is increasing every year. Some studies have suggested that up to 10 percent of women over 60 have diagnosed or un-diagnosed hypothyroidism.

Low thyroid, the most common thyroid disorder, is characterized by foggy thinking, depression, weight gain, constipation, dry skin, hair loss, an intolerance to cold, a hoarse voice, menstrual problems, infertility, muscle stiffness and pain, and other symptoms.

If you consider that every cell in your body has receptors for thyroid hormone, then it’s easy to see that the thyroid gland governs all major systems of the body. Thyroid hormone is closely tied to brain function, the G.I. tract, cardiovascular system, bone metabolism, red blood cell production and growth, gall bladder and liver function, hormone production, glucose control, cholesterol metabolism, nutrient metabolism, and body temperature regulation.

The thyroid is basically the accelerator in a sophisticated engine. If that accelerator isn’t working properly the engine is stuck going either too slow or too fast.

How does this happen?


Thyroid physiology is complex. Most conventional doctors use only a standard test for thyroid function which includes only TSH and T4. But this standard test only picks up a small percentage of thyroid disorders, unfortunately.

Normally when the body cannot supply enough usable thyroid hormone for it to function properly, the Thyroid Stimulating Hormone (TSH) increases in an effort to get the thyroid to make more thyroid hormone. Many thyroid problems, however, exist even if TSH shows as “normal”. This is more common than you may realize.

Just what is considered “normal” on a thyroid test? Ranges for “normal” vary from lab to lab, and from one doctor’s interpretation to another doctor’s. Lab ranges are not based on research that tells us a true optimal range, but on a bell curve of values obtained from people who come to the labs for testing, many of whom may have thyroid problems. So that’s the starting point for thyroid (mis)readings. They just aren’t looked at within an optimal lab range context.

That brings us to another problem with the TSH standard thyroid test.

Many doctors consider the thyroid stimulating hormone (TSH) level to be the gold standard for diagnosing thyroid issues. This test is typically performed each year as part of your routine physical. The problem with just this test is that it often will show up in the normal range, in spite of thyroid problems it’s just not picking up. In truth, looking at TSH levels is only the tip of the iceberg when it comes to diagnosing thyroid issues.

Your body creates two primary thyroid hormones—T3 and T4. About 94 percent of the hormone made in the thyroid gland is T4. The remaining 6 % is T3, named for its three molecules of iodine.

Your body converts the T4 hormone into the active form of thyroid hormone, T3. If your body is not good at this conversion, (which happens fairly often) your TSH will still show as normal, even though you are low in T3. Many people are poor converters of T4, meaning they may have enough T4 in their bodies but just don’t convert the T4 into T3 well enough to function properly. When this happens, you can have all the symptoms of a low thyroid and still have a normal TSH test.

It is necessary to get a more thorough thyroid test called a “complete thyroid panel” that will look at T3 and T4 levels and other essential components of thyroid function.

What Causes Thyroid to Malfunction?

thyroid anatomy

Interestingly enough, the liver and gut are primary locations for conversion of T4 to T3 and places where a breakdown in this conversion process can occur. (Are you beginning to see just how important your gut health to your overall health?)

Your liver metabolizes your hormones, filters out toxins, and cleans out the blood system. Many of the waste products from the liver are sent to the gallbladder or digestive system for removal.

Since thyroid function impacts the entire body, when it is low, everything is SLOW—including the liver, gallbladder and digestive system. A liver bogged down with toxic sludge cannot convert T4 into T3 very well, so easy to see how this becomes a vicious cycle.

That brings us to the all-important gut bacteria. Our intestines help to convert at least 20% or more of T4 into T3, but that requires healthy gut bacteria. Among many other things including having an effect on proper immune function, creation of serotonin (for a happy mood), and helping with digestion, the gut also helps convert T4.

A poor diet creates an overabundance of bad bacteria and yeast overgrowth. When there is a lack of the appropriate beneficial bacteria, the body cannot process the T4-T3 conversion well.

Other things that hinder thyroid conversion in the gut include antibiotic use, inflammation from gluten and other food allergies, and certain medications—all leading to inadequate T3.

If you have celiac disease or gluten sensitivity, it is very likely that you will have thyroid problems as the two maladies tend to go hand in hand.

Cortisol, the stress hormone can further decrease the active T3 levels as well. Low serotonin (of which 90% is created in the gut) and low levels of dopamine, two essential brain neurotransmitters can also cause thyroid problems.

Nutrient deficiencies can also lead to thyroid problems. Iodine, selenium and zinc are vital to proper thyroid function, so deficiencies in these minerals can cause thyroid disorders.

So, it’s easy to see that there are several reasons that a poor diet, high in processed starches and sugars and additives, will not only cause gut dysbiosis (overgrowth of bad bacteria), but will also lead to nutrient deficiencies, all opening the door to thyroid dysfunction.

Thyroid problems tend to run in families too, so if you know your grandmother, or mother had thyroid problems, it’s easy to assume you may get them too, at some point in your life.

Thyroid disorders can have a negative impact on almost every body system.


Since they govern your metabolism, thyroid hormones can cause you to lose or gain a lot of weight, affect your sleep, your mood, your energy, your appetite, your digestion, how fast your hair and nails grow, how well your body heals, and how well you fight infection. A high or low thyroid also has a big effect on emotions and mental capacity, causing either anxiety and nervousness, or depression and brain fog.

Thyroid dysfunction falls into two main categories: hypothyroid or low thyroid, and hyperthyroid or high thyroid. Hypothyroidism is the most common type of dysfunction and affects primarily women (but men can be affected, too) of all ages. Often hypothyroidism is related to an autoimmune disease called Hashimoto’s thyroiditis.

Hyperthyroidism is a condition in which the thyroid gland becomes overactive and makes excessive amounts of thyroid hormone. When the thyroid gland is overactive every function in the body is sped up, causing nervousness, anxiety, rapid heartbeat, hand tremor, sweating, weight loss, and in, among other symptoms.

The most common cause of hyperthyroidism is the autoimmune disorder Graves’ disease. This type of thyroid disorder causes the body to make an antibody that causes the thyroid gland to go haywire. Graves’ disease tends to run in families and is more commonly found in women.

Hyperthyroidism also may be caused by lumps or nodules in the thyroid gland that cause the thyroid to produce excessive amounts of thyroid hormones. In addition, inflammation of the thyroid gland—called thyroiditis—resulting from a virus or a problem with the immune system may temporarily cause symptoms of hyperthyroidism.

You can actually have fluctuating levels of both hyper-and hypoactive thyroid as well.

Signs and Symptoms low thyroid include:

  • Fatigue that won’t go away with a good night’s sleep
  • Lethargy, no motivation to exercise
  • Depression and/or moodiness
  • Feeling chilly all the time
  • Elevated cholesterol, especially LDL
  • Dry hair and skin
  • Slow-growing hair and nails
  • Brain fog, trouble concentrating and forgetfulness
  • Hoarse voice
  • Unexplainable weight gain
  • Constipation, bloating and other digestive issues
  • Muscle weakness
  • Weak immune system
  • Heavy menstrual periods, premenstrual syndrome and infertility
  • Gallstones
  • Anemia

Signs and Symptoms high thyroid include:

  • Nervousness and anxiety
  • Insomnia
  • High heart rate, fast breathing
  • Eyes that appear bulging
  • Unexplained weight loss
  • Heavy perspiration
  • Muscle weakness
  • Multiple bowel movements throughout the day
  • Thin, brittle hair
  • Light or absent menstrual periods

The two main types of thyroid problems, hypothyroidism and hyperthyroidism are at opposite ends of the spectrum, and treatment for each is very different. In one case we want more thyroid hormone, and in the other case you need less thyroid hormone.

Treatment options differ depending on each patient’s particular disorder and the specifics of the case. Here’s how thyroid problems are usually treated with conventional medicine.

  • For hypothyroidism, the common treatment from a conventional medical doctor is to give you synthetic thyroxine or T4. The problem with this treatment is if your body does not convert T4 into T3 well, it doesn’t matter how much extra T4 or thyroxine you get.

If the doctor has done a thyroid panel and sees that you are low on T3, he may prescribe combination of the synthetic version of T4 and T3. Patients who don’t convert T4 to T3 well do better on naturally-derived hormones like Armour Thyroid because it contains both T4 and T3 in the correct ratio.

  • For hyperthyroidism, the most common conventional medical treatment (in the U.S.) is radioactive iodine, anti-thyroid medications or surgery that removes a large portion of actual thyroid gland.

All of these treatments can have lots of side effects and may not be entirely affected. Meanwhile your whole life can be affected by thyroid disorders, so getting to the bottom of it is of key importance.

Natural Thyroid Treatments


1. Supplements to Boost Thyroid Function

Iodine and selenium—These minerals are vital to proper thyroid function, whether you have hyper- or hypo thyroid problems. Most people with a low thyroid are deficient in iodine, and worldwide, this is the number one cause of low thyroid.

While iodine-rich foods are plentiful, they are not in the typical Standard American Diet. Seaweeds like dulse, kelp, and nori are one of the richest sources of iodine, along with wild-caught fish like tuna, cod and shrimp, and raw dairy and eggs.

While you can purchase iodine-enhanced salt, it actually can have an unexpected result. In countries where iodine has been added to table salt, rates of autoimmune thyroid disease have actually gone up. The key to adding iodine to the diet is to balance it with selenium as the combination of nutrients will help thyroid function.

Selenium is one of the most important minerals for a healthy thyroid, and helps balance levels of T4 hormones, while helping convert T4 into T3. To get more selenium, add in foods that are good sources like Brazil nuts, spinach, yellowfin tuna or halibut, canned sardines, grass-fed beef, turkey, and beef liver. People with Celiac disease, gluten sensitivity, or other autoimmune disorders are most deficient in selenium, so a supplement might be necessary to get the needed amounts.

Zinc—A catalyst for many different pathways in the body and essential for digestive health, and for converting T4 to T3. It is also valuable for immune function, tissue healing (internally and externally), and the production of TSH.

Zinc is very helpful to heal and tighten the intestinal junctions in the gut that contribute to intestinal permeability, or ‘leaky gut’. For this reason, increasing your zinc levels may help reduce your symptoms and even lead you towards remission!

B vitamins are also very important for thyroid health, especially if you are vegan. While B12 is the primary B vitamin that plays a role in thyroid health, it is important to take B vitamins that exist in a balanced, multi-B vitamin, as the B vitamins work best in the correct balance with each other.

One of the nutrients that people with Hashimoto’s autoimmune thyroid disease are particularly prone to being deficient in is Vitamin B12. In fact, in studies, people with Hashimoto’s reported testing deficient in this all important vitamin, and 76 percent said they felt better after taking a B12 supplement.


The best sources of B12 and zinc are animal proteins like beef, turkey, eggs, etc. Other non-meat options include green peas, asparagus, chickpeas, cocoa, Brussels sprouts, sesame seeds, flaxseeds, nuts, and mushrooms, but these are not as well absorbed as the B12 from animal sources. Note—if you are taking extra B12, take a multi-B supplement as B vitamins work best in the correct balance.

Lastly, other nutritional deficiencies also play a role in thyroid dysfunction. These include deficiencies of vitamin D, omega-3 fats, vitamin A, and vitamin E, so be sure to supplement with high quality forms of these nutrients, as well as getting plenty of wild caught fish, grass fed meat, and colorful veggies in your diet. And don’t forget to get some sun!

2. Manage Your Stress

Physical and emotional stress can elevate the hormone cortisol and put your body into a chronic state of ‘fight or flight’. Cortisol has negative effects on your body long term like increased blood pressure and pulse rate, and creating high levels of inflammatory proteins that suppress immune function and damage the thyroid gland and adrenals. The hormonal changes in the body also affect libido, fertility problems, mood swings and more.

Managing stress is tricky if you cannot take away the cause. You can however, do plenty of things that help ease the effects of stress, including getting a good eight hours of restful sleep, meditation, vigorous exercise, and making time to relax with friends and family.

3. Reduce Toxins and Inflammation


Chemical toxins including medications, birth control pills, commercial beauty products, cigarette smoke and household cleaning products can all contribute to inflammation—especially in the gut, affecting the T3-T4 conversion.

Many household cleaning products and beauty products can contain very toxic, unregulated chemicals which can wreak havoc on the body. These toxins exit out through the digestive system and contribute to the inflammatory processes in the body, affecting thyroid function.

Other inflammatory toxins include air pollution, unfiltered tap water, plastic bottles, pesticides on fruit and vegetables, conventionally raised meat, and conventionally grown wheat, corn, oats and soybeans (sprayed with the herbicide glyphosate, that harms gut bacteria). These toxins act as hormone or endocrine disruptors and interfere with thyroid hormone metabolism and function.

Chronic inflammation in the gut is very common and most common is inflammation related to gluten in wheat, barley, rye and spelt. Gluten is a very common allergen that affects at least 10 to 20 percent of the population. Even if you have no sign of a gluten intolerance, it is so tightly associated with thyroid problems, it is wise to remove gluten entirely from your diet.

Key Points to Solving Your Thyroid Problems

While it isn’t an overnight remedy, you can take these steps if you have experienced any of the above symptoms for hypo or hyperthyroid problems and fix the problem not the symptoms.

  • The thyroid gland is the body’s thermostat, regulating every function in the body. Thyroid problems will affect weight, appetite, moods, fertility, digestion, energy levels, and libido.
  • Hypothyroid conditions are fairly common, especially in women, and often undiagnosed.
  • Request a Full Thyroid Panel if you have any symptoms of hyper or hypothyroid.
  • If you have celiac disease or gluten sensitivity, you can be pretty certain that you may also have a thyroid problem. Celiac disease can go undetected, get a full celiac panel test. And be sure to ask your doctor for a full thyroid panel test.
  • Other co-existing health issues for thyroid problems include anemia, high cholesterol, depression, heavy menstrual periods and infertility. If your doctor diagnoses any of these, you should also request the full thyroid panel.
  • Optimize Your Nutrition by making changes in your diet and supplementing with essential nutrients. Cut out processed, sweetened, starchy foods and conventionally raised foods.
  • Minimize stress by exercising and meditation.
  • If you need a thyroid supplement, request a bio-identical, natural hormone replacement that contains both T3 and T4, like Armour thyroid.

Once you get back on track with your thyroid in the optimal ranges, you will absolutely feel like a new person!


About The Watchdog

Mike Geary has been a Certified Nutrition Specialist and Certified Personal Trainer for over 15 years now. He has been studying nutrition and exercise for almost 25 years, ever since being a young teenager. Mike is originally from Pennsylvania, but has fallen in love with mountain life and now resides in the picturesque mountains of Utah. Mike is an avid adventurist and when he’s not spending his time skiing, mountain biking, hiking, or paddleboarding on the lake, he has enjoyed skydiving, whitewater rafting, piloting an Italian fighter plane (seriously), scuba diving, heli-skiing, and traveling all around the world, enjoying learning about different cultures. At the age of 40, Mike now feels healthier, stronger, and more energetic than when he was 20... All because of a healthy lifestyle and great nutrition!

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