December 24, 2015
By Raphael Kellman, M.D., Kellman Center for Functional and Integrative Medicine
One of the main complaints new patients come in with is that they are currently on thyroid medication, often for many years, and have never improved. In most cases people still feel very tired, have issues with weight, constipation, some have mood swings and even anxiety or feel depressed. I also see a great deal of this in patients having trouble getting pregnant. They may have been diagnosed with a low thyroid, but have never experienced the relief proper medication can bring-especially increased fertility.
As a patient on the merry-go-round of prescriptions and medications it’s easy to feel overwhelmed when you’re sick, have symptoms that can be life altering and your doctor is saying things like “This is just aging”, or “Maybe you are just depressed”, because they think your thyroid is just fine. In most cases, if you are on thyroid medication and have not seen improvement, the problem isn’t you, it’s your medication, dose or both.
The standard of care is to give thyroid patients T4 replacement which is the primary hormone made by the thyroid. Synthroid, Levothroid and Levoxyl are a few of the more common brands people may have heard of. While these medications are helpful to some, for others they will be ineffective simply because T4 needs to be converted in the body to T3 to be used and things like inflammation, intestinal and liver issues and illness can block that process. Inflammation can even cause T4 to go down the wrong path and become reverse T3 or RT3 which is inactive. Many patients actually need a combination of T4 and T3 medications or even a course of just T3. Everyone is different and having the ability to properly track that, is imperative.
Another issue with thyroid treatment today is one that I always write about-ineffective testing leads to ineffective treatment. It is that simple. The routine TSH test used by mainstream medicine is rife with problems, missing huge populations of people tested and is not a good a good guide to use to adjust medication. There are too many health conditions that will cause the test to look “normal” while people are anything but regulated or optimally functioning. Doctor’s that rely on this test to diagnose and as a barometer for treatment are in the dark much of the time and they may not even know it.
The best way to diagnose and track thyroid conditions is by running the most comprehensive set of blood tests available. Patients deserve nothing less than this which why it is my cause and my goal to have deep testing become part of mainstream medicine. Until that happens, the Kellman Center is pleased to offer this as routine care at our facility. The TRH stimulation test is the most accurate thyroid test today. It often gives insight into thyroid dysfunction years before other testing methods are able to pick up these changes. Patients get help that much sooner and those on medication already can get much more accurate information about how the body is responding to their current prescription. When used in combination with a full thyroid panel including Free and Total T3 and T4, RT3, TSH, and thyroid antibodies, the results are unparalleled.