There are six major thyroid patterns that can be tested for with thyroid blood tests. When I say thyroid blood tests, I don’t just mean testing TSH and T4. In order to really evaluate these six major patterns, a FULL THRYOID BLOOD PANEL needs to be ordered.
To further complicate things, there are twenty-four known patterns of low thyroid function, many of which need testing other than thyroid blood tests. Only one thyroid pattern is effectively treated with medication. Once you understand why this is true, you will begin to see the folly of considering medication for any other pattern.
Unfortunately, the concept of using thyroid medication and only monitoring two blood indices (TSH and T4) is a 1960s version of treatment. Extremely outdated. The modern approach is to be aware of the various abnormal body function patterns and the underlying physiological mechanisms that can cause the other 5 patterns of thyroid trouble.
The first pattern is primary hypothyroidism. In this case the thyroid gland gets sort of lazy and the pituitary gland rushes in by pumping extra TSH (thyroid stimulating hormone) in an attempt prompt the thyroid to produce more thyroid hormones.
Primary hypothyroidism affects the entire body. A person may begin to feel sluggish, though there are various symptoms that can occur.
In the second pattern the TSH will be low but not as low as with primary hypothyroidism. The pituitary gland, through various mechanisms, fails to produce proper quantities of TSH and so the thyroid gland is not stimulated adequately to produce T4 and T3.
A common way that this occurs is from chronic stress. Chronic stress fatigues the pituitary gland.
The third pattern is thyroid under conversion. This is when the gland is making enough T4 but the conversion to T3 is inadequate and therefore there is low T3. The reason for this can be chronic infection or inflammation.
Increased cortisol from the adrenal gland that is responding to stress from a chronic infection may also cause this. High cortisol is also toxic to the temporal lobe of the brain, causing poor memory and mental fogginess.
This pattern is often missed because low T3 doesn’t affect TSH levels and T3 is rarely checked for with the standard blood tests performed by medical physicians. A clue to this pattern is that all other thyroid tests are normal except for T3.
Over Conversion of T4 into T3
The fourth pattern to cause low thyroid symptoms is thyroid over conversion of T4 into T3. This is possible due to decreased Thyroid Binding Globulin (TGB). This pattern occurs when too much T3 is made and is it overwhelming the cells.
The number one cause of this pattern, especially in women, is high blood sugar (glucose) due to resistance to insulin. Glucose will typically be found in the 100-126 and higher range. Increased glucose causes increased testosterone levels in females resulting in too much free T3 and too little TBG. Insulin resistance, due to over consumption of carbohydrates, is also a very common cause of polycystic ovarian syndrome (PCOS) and subsequent difficulty with infertility. Many women who are having difficulty conceiving or maintaining a pregnancy have a thyroid disorder.
Thyroid Binding Globulin (TGB) Elevation
The fifth pattern is Thyroid Binding Globulin (TGB) elevation. This is when there is too much TGB in the blood and too little T3. When TBG is too high it is like having too many taxi cabs for T3 hormone and the cabs won’t let out their passenger for fear that they won’t get another!
This is mainly caused by oral contraceptives. Oral contraceptives, or estrogen replacement therapy, cause an increase in estrogen which then leads to increases in TBG.
The sixth pattern is thyroid resistance. Chronic stress is the root cause of thyroid resistance. Chronic stress stimulates the adrenal glands, which in turn produces far too much cortisol. High levels of cortisol from the adrenal gland cause cells throughout the body to become resistant to thyroid hormones. The pituitary and thyroid are all right, but the hormones are not getting into the cells.
Learn more about thyroid testing here and see how our approach is different.