Anytime Is a Wonderful Time to Have Your Thyroid Tested!
“How can I know why I have a slow metabolism?” That’s one of the most common questions I get. In my clinics, many of my clients have certain lab tests run to help understand their body chemistry and how it affects the metabolism. (See: “7 Signs of a Slow Metabolism“)
This is a practical blog post! Print it out, take notes and highlight any symptoms that pertain to you.
The lab tests aren’t necessary, but if you feel you’re stuck on a plateau, or the diet isn’t working for you like you hoped, gaining a picture of your body chemistry is a good place for you and your doctor to start.
These tests are meant to create an open dialogue with your doctor: They’re a conversation starter, and they can give you a window into your health. They might point to a health issue you didn’t know you had, or might tell you that you’re doing pretty well and just need a little kick in the pants (metabolically speaking). Or they might just clue you in on specific food choices, to therapeutically balance your body chemistry. They provide you and your doctor with some helpful hints, but of course, they aren’t the whole picture. That’s why it’s essential to partner with a doctor that’s open to your weight-loss goals and efforts to improve your metabolism.
In many states, only a medical doctor can legally interpret your lab results, but listed below are the ranges I look for in my clinics when I partner with my clients’ physicians. Your test results might come back with a different unit of measure than those below. Just ask your doctor to convert the values. If your values are outside of these ranges, I’ve included some suggested issues you might want to discuss with your doctor. Don’t let your doctor just say “everything looks fine” — you’re entitled to view the results, and your doctor is required to explain them to you.
Keep in mind that different specialists interpret blood chemistry in different ways. For example, cardiologists love to see very low cholesterol. But for a neurologist, especially those specializing in Alzheimer’s, there may be concerns with cholesterol being too low, indicating a risk for loss of memory and cognition. Whereas an anti-aging doctor or endocrinologist specializing in sex hormones might see high cholesterol and say “yeah” — with the right support, they can convert this elevated cholesterol into estrogen, progesterone, and testosterone. You are in the process of becoming a specialist in your metabolism. By partnering with your doctor, you can get your labs run, then open a conversation about your levels and what they mean for YOU.
Keep in mind that for insurance billing reasons, your doctor may need to have a reason to request these tests beyond just you asking for them. I always sit down with my clients, and we make a list of symptoms — that directly correlate with the labs we want to run. Don’t just ask for these tests; give your doctor the ammunition they need by explaining why you think you need the test and how it pertains to your body. Then my client can approach his or her doctor and ask for help figuring out what might be causing their symptoms. Always say, “we” to include your doctor in the conversation. Here’s an example of a successful dialog you might have with your doctor: “I’m cold all the time, my hair is falling out, my throat tickles constantly, and I’m tired all the time – these are the test I’d like to run. Once we know the results, I have some nutritional ideas I want to try, but we need a baseline to see what kind of positive impact I can make.” Doctors appreciate patients who are proactive and take charge of their health!
This article covers thyroid tests; we’ll cover other lab tests in future articles.
Your TSH (thyroid stimulating hormone) level tells us how hard the pituitary is working to communicate with your thyroid. The lower, the better, indicating that the brain/thyroid channel of communication is wide open and effortless.
What symptoms might prompt your doctor to run these labs: Many people get told their thyroid is normal, but if you’re experiencing fatigue, exhaustion and brain fog, your TSH, even if it’s in the normal range, can help tell you why. Often, this is the only tests that doctors run, but on its own, it’s an incomplete view of your complete thyroid function.
Normal: .4 – .4.5 mIU/L
Fast Metabolism: Under 1.0 mIU/L
If your levels are high: Typically my clients whose levels are high find weight loss difficult, and they experience a lot of stress hormones, so they need extra adrenal TLC. Pay extra attention to make sure you get your cardio in on Phase 1. Go with higher glycemic fruits and grains.
The thyroid gland primarily produces T4 (and a little bit of T3). This test gives us an indication of how much T4 thyroid hormone is being produced, but not what the body is doing with it. It’s crucial to monitor your T4 level if you’re on any thyroid medication (natural or synthetic). We like to see these on the higher end of normal, as long as the T3 is also on the higher end of normal.
What symptoms might prompt your doctor to run these labs: Cold hands and feet; crepey skin, fatigue. Also, constipation and/or IBS
Normal: 0.7 – 2.0
Fast Metabolism: 1.5 – 2.0
If your T4 levels are below the normal range: This is called hypothyroidism — your thyroid isn’t producing enough of this hormone.
If your levels are above the normal range: This is called hyperthyroidism — your thyroid is overproducing. Then we typically check for Grave’s disease, heavy metal exposure, or irregular heartbeat.
If you have a high TSH and a low T4, it’s as if your body is screaming at the thyroid, but your thyroid isn’t reacting or producing. Focusing on Phase 3 and its healthy fats can help improve this balance.
If you have a low TSH and a low T4, we’re usually suspicious of an elevated reverse T3, because the thyroid isn’t getting the right encouragement, and there may be a receptor site blockage. Now we would want to look at anti-thyroid antibody (ATA) and Reverse T3 levels.
If your TSH is high and the T4 is also high, we need to calm the body, soothing the adrenals. Focus on Phase 1’s high glycemic fruits and whole grains.
If your TSH is low and the T4 is elevated well above the normal range, we typically look for inflammation in the thyroid. We often also consider running the thyroid peroxidase lab test.
Overall, iodine-rich foods are important for T4, so be sure to include sea vegetables like seaweed, nori, and spirulina in your diet. Cod, shrimp, turkey, navy beans, and eggs are also good sources of iodine.
Basically, the liver converts T4 into T3 by removing an iodine molecule (resulting in the “3”). T3 is the most bio-available of the thyroid hormones and has the strongest the positive impact on your metabolism — this is our superstar hormone. We like to see T3 on the higher end of normal.
What symptoms might prompt your doctor to run these labs: When T3 is low, we see weight gain, edema (swelling), disruption of sleep, and/or depression. Other symptoms include cracked heels, brittle hair, and crepey skin.
Normal: 2.3 – 4.2 pg/ml
Fast Metabolism: 3.0 – 4.2 pg/ml
If your T3 is low, focus on Phase 2, and support the liver with tons of alkalizing vegetables. Add detoxifying Bieler broth to your meal plans. Choose foods rich in selenium include fish and shellfish, such as tuna, halibut, sardines, shrimp, oysters, and scallops. Meat and poultry, eggs, mushrooms, and onions are also good sources of selenium.
The thyroid takes the brunt of environmental and food-based toxins; it’s the canary in the coal mine. Unfortunately, in my years of clinical practice, I’ve seen less and less healthy thyroid function. If your T3 is elevated beyond the normal range, we typically look to goiters and nodules on the thyroid, and to certain forms of hepatitis.
Test: Reverse T3
This is often a hard test to get your doctor to run, but it’s important for assessing your metabolism. Even though the rest of your thyroid panel may come back normal, your reverse T3 may still be out of balance.
In normal T4 to T3 conversion, one iodine molecule is removed from each cell. But when that iodine molecule is plucked from an odd place, or in an irregular way, you end up with a misshapen thyroid hormone, reverse T3, or RT3. RT3 blocks the healthy functioning of T3 by interfering with your receptor sites.
We do need some RT3 in our body, so we’re not in a constant state of burning fuel. But for a healthy metabolism, we want this number to be on the low end.
What symptoms might prompt your doctor to run this test: Hair loss, especially in women; family history or previous diagnosis of Hashimoto’s; low basal body temperature; inability to lose weight despite best efforts. Some doctors believe a significantly elevated RT3 is indicative of some kind of autoimmune disorder. Make sure when asking for this test, discuss any family history of thyroid disease, bring in a food diary and show your doctor how hard it’s been to lose weight.
Reverse T3 ranges:
Normal: 90-350 pg/ml (or 9 – 35 dl/ml)
Fast Metabolism: 120 or lower pg/ml (or 12 or lower dl/ml)
If your RT3 is high, be diligent about avoiding soy — even check your lotions and skin care products. Focus on immune-boosting foods: mushrooms, kombucha, coconut vinegar, cabbage, along with very colorful fruits and veggies that carry a strong anti-oxidant component. Be diligent about getting 8 hours of sleep.
Some doctors will give supplementals like Cytomel to help wash the T3 receptor sites and drive down RT3. Because Reverse T3 is a by-product of the conversion of T4 into T3 — be careful if you are taking T4 Synthroid — it’s important to monitor, to be sure it doesn’t elevate your RT3.
Especially if your bad cholesterol (LDL) is high — and good cholesterol (HDL) is low, it’s important to check reverse T3. That’s because all these things run along the same pathway in the liver, indicating that your body’s ability to convert substances is off.
Test: TgAB or ATA
This supplementary test is especially important for those having metabolism problems. Your thyroid panel might be normal overall, but elevated anti-thyroid antibody (ATA) works just like a flu virus — even though your body might be making the right amounts of thyroid hormone, you could be producing an antibody that prevents proper thyroid health.
What symptoms might prompt your doctor to run this test: Hair loss, fatigue, swollen glands, tender lymph nodes, pseudo fevers (feeling feverish or clammy, but normal or low body temperature), family history of thyroid disease; also rosacea. Elevated SED rates on a lab (for those with arthritis). Individuals with pre-diagnosed auto-immune disorder should look to ATA
Normal range: less than 20 iU/ml
Fast Metabolism: The lower, the better
If your levels are elevated, avoid inflammatory foods like nightshades (tomatoes, bell pepper, eggplant). In your workouts, use heavy weights — as heavy as you can — to build muscle and bone strength. Be sure to include calcium-rich foods. Include phosphorus and potassium-rich foods like pumpkin seeds, chia, sunflower, and flax seeds. Use more seed and seed butters than whole raw nuts on P3.
Test: Thyroid peroxidase
This is the enzyme that loosens up that iodine molecule — shakes it loose so that it activates T4, teasing it into releasing that iodine molecule and converting into T3. But when thyroid peroxidase levels are too high, T4 is actually incinerated before it’s converted to T3. So even though your body produces a normal range of T4, your T3 might be very low.
What symptoms might prompt your doctor to run this test: Sudden seasonal allergies, sudden food allergies, rashes, difficulty swallowing, itchiness in the throat. This dysfunction happens directly on the thyroid gland, so systemically, an imbalance can look like allergies.
Normal: Less than 35 iU/ml
If your levels are high, this can be indicative of an autoimmune disorder.
If you have elevated thyroid peroxidase levels, choose antihistamine foods that help stabilize your body’s pH, like nettle tea, lemon/lime, quercitin. Choose folic acid-rich foods, like lentils, broccoli, eggs, and great Northern beans. Choose foods rich in bioflavonoids like bell peppers, strawberries, citrus, tropical fruits, spinach, and broccoli.
Putting it all together
In my practice, because I have such long and collaborative relationships with my client’s doctors, we run all these tests annually. For my virtual clients, I suggest you read through this post carefully and highlight your symptoms, taking that info with you when you visit the doctor.
As you discuss your tests and results with your doctor, you can begin to see how even a normal result on one test doesn’t rule out an imbalance on another test. This is why it’s important to have a collaborative and caring doctor who will take the time to analyze and explain your labs to you, and help you fully understand their implications. If your doctor isn’t willing to work with you, it might be time to consider a switch.
Then you can use this info to customize the Fast Metabolism Diet for your body chemistry so that it helps therapeutically bring your body chemistry back to balance.