“My TSH came back normal so why am I’m still having symptoms?” This is a question that many patients ask me. A TSH test is a very important piece to the thyroid puzzle but we must look at all the pieces to the puzzle. What you need is a full thyroid panel.
So what does that look like and what do each one of these markers mean?
I’m going to break this down for you.
1. TSH, also known as thyroid stimulating hormone, is a hormone produced by the pituitary gland that essentially tells the thyroid gland to produce T4 which can then be converted into T3.
2. T4, otherwise known as thyroxine, is the inactive form of thyroid hormone produced by your thyroid and must be converted into the active form T3.
3. T3, otherwise known as triiodothyronine, is the active form of thyroid hormone. It is converted from T4 into T3 in the liver and controls all the metabolic functions of your body and the majority of the physiological processes including growth, development, body temperature, and heart rate.
4. RT3 is reverse T3, which is an inactive form of T3. The issue with rT3 is that it can bind to T3 receptors, but it is inactive. This can cause patients to have all the symptoms of low thyroid, but the lab tests will all come back “in range”.
5. TPO, otherwise known as thyroid peroxidase, is an enzyme found in the thyroid gland that helps to produce thyroid hormone. If levels of antibodies are high against TPO, it can be an indicator of low thyroid and Hashimoto’s Thyroiditis.
6. Thyroglobulin is a protein produced only by your thyroid gland. It llays a role in T4 production and acts as a storage for thyroid hormones. Elevated thyroid globulin antibodies can indicate Hashimoto’s thyroiditis or some other disease of the thyroid.
7. TSI is thyroid stimulating immunoglobulin. TSI’s are the antibodies that tell your thyroid to become active and to release thyroid hormone. Low TSI can be an indicator of hypothyroidism while high TSI can be an indicator of Grave’s disease.
When you find that one or more of these are elevated there is a cause.
You need to find out what is driving the abnormal lab marker then you need to handle it so that the body can heal itself.