So many patients benefit from adjusting their thyroid appropriately. This area is often mismanaged and under-evaluated by incomplete testing. However, if you have looked at T4 and T3, free and total, TPO Antibodies, Thyroglobulin Antibodies, Reverse T3, and Thyroglobulin, what else should be considered?
Clinically we have all experienced the patient who tests normal, but still has some level of hypothyroid symptoms. Maybe they are still struggling to lose weight or fatigued. Maybe they are having hair loss and constipation. As their thyroid improves, they notice some improvement, but symptoms have not completely resolved.
A good next step to consider is our Advanced Intestinal Barrier Assessment and our Oxidative Stress Test.
Why are these important to test?
a) If there is a high level of oxidative stress, it will impair the activity of glutathione peroxidase, the major antioxidant system in the thyroid. Low levels of glutathione peroxidase are associated with an increase in oxidative stress which can decrease the function of T4 and T3, even though their levels are normal. Oxidative stress will also diminish the conversion of T4 to T3. By improving levels of oxidative stress, you will improve the function of thyroid hormones and improve conversion to the more active T3.
b) If there are high levels of LPS, as indicated on the Intestinal Barrier Assessment, LPS causes thyroid receptors to down-regulate. LPS can also be another reason for poor conversion from T4 to T3. This would mean you could have normal levels of hormones, but no receptors for them to bind to, resulting in still feeling hypothyroid even though normal are normal.
– Dr. Cheryl Burdette, ND.