You've been told you have an underactive thyroid and you are taking Levothyroxine but yet you continue to feel terrible. Sound familiar?
If you have been diagnosed with an underactive thyroid, you may have been prescribed Levothyroxine (synthetic thyroid hormone replacement) and then sent on your way. The unfortunate truth is that taking Levothyroxine doesn't always work well for everyone, and it might not help to relieve the symptoms you’re struggling with.
With this in mind, let’s talk about why comprehensive testing is important.
Why do I have an underactive thyroid?
The thyroid plays a key role in metabolism, impacting our energy levels and overall health and wellbeing. Therefore it’s not surprising how terrible it can make us feel when this organ isn't functioning well.
Usually it’s unclear what the underlying cause of an underactive thyroid is. An underactive thyroid is tested for by the NHS via a thyroid function test, which checks TSH (Thyroid Stimulating Hormone) and Thyroxine (T4), sometimes referred to as "Free T4", to ascertain if there are any issues concerning your thyroid.
Testing for the hormone Triiodothyronine (also called "T3", which is converted from T4, and is a more active form) is not commonly checked for by the NHS. A thyroid antibody test might also be ordered after the thyroid function test, but this is not standard procedure and means that most people don’t know whether they have thyroid antibodies or not. "Reverse T3" isn't routinely checked either and can be raised in periods of illness or chronic stress so it's worthwhile checking as part of your investigative process.
Why is checking for antibodies important?
Antibodies are a protein made by our immune system in response to an antigen, which is a foreign substance that launches an immune response. Checking for these antibodies is particularly relevant when it comes to the thyroid because even though antibodies are generally helpful, they can also be problematic, especially in terms of autoimmunity.
Autoimmunity is essentially when the body's immune system mistakenly identifies its own tissue as "foreign" and attacks it. This can happen in different places in the body including the thyroid. Identifying the presence of certain antibodies can therefore help to ascertain if you have an autoimmune thyroid condition (also referred to as Hashimoto's Thyroiditis - named after a Japanese doctor).
Hashimoto's Thyroiditis is considered to be one of the most common causes of an under-active thyroid, yet because most testing relies on looking at the TSH levels in isolation, the autoimmunity element can often go undetected.
If Autoimmunity is identified, what next?
Identifying an autoimmune conditions can indicate, not only that your immune system needs support, but it can also indicate that inflammation is present. Since autoimmunity has been linked to genetic and environmental factors; implementing changes that support the environment around you e.g. exercising, managing stress levels and focussing on sleep and a healthy diet might have the potential to improve your symptoms.
If you are currently being treated and its still not fully relieving your symptoms, ask your doctor to request a full thyroid panel (which includes TSH, T4, T3), as well as testing for autoimmunity so that you can gain more insight into your condition.
Amy Cottrell is a Registered Nutritional Therapist and thyroid health specialist. To learn more about her work visit her website or on Instagram @amy_cottrell_nutrition
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