The ‘poor man’s thyroid test’

For those wondering why they have all the symptoms of hypothyroidism (low thyroid hormone) but are always in the “normal” range, take heart, you’re not crazy, and in fact, there may be something not quite right. with your thyroid. First, the thyroid tests used by labs are notoriously inaccurate, being ‘wrong by three standard deviations’ (virtually useless except in certain cases).

Adding to the confusion is the difference between T3 and rT3 (triiodothyronine and reverse triiodothyronine). T3 is the active form of thyroid hormone in the blood and is converted from T4, which is produced in much larger amounts than T3. Synthetic T4 is what is provided in pharmaceutical drugs, which works fine as long as everything else works.

The tricky part comes when T3 is no longer converted from T4, but instead converted to rT3 (reverse triiodothyronine). Think of it like this: the inverse forms of natural substances that we need are chemical mirror images. They are exactly flipped and they don’t work the same way. Because the chemical ‘lock’ is facing to the right or left and the inverted form is facing in the opposite direction, the inverted ‘key’ just doesn’t fit.

For example, our bodies use D-glucose (dextrose) with a clockwise rotating molecule. L-glucose, a left-rotary molecule, cannot be metabolized. It may taste the same, look the same, often have the same properties (dissolves the same in water, burns the same, etc.) but it’s still not D-glucose. So, since the body’s tissues need T3 and rT3 doesn’t fit the lock, the symptoms of hypothyroidism occur.

Many doctors have treated the symptoms of hypothyroidism as indicative of hypothyroidism even though laboratory tests are “normal.” Those symptoms include the following:

Tired
Dry skin/hair/eyes
Constipation
weight gain
Hair loss (head and outer eyebrows)
cold intolerance
Hormonal problems (men and women)

Most of the time, doctors simply order a TSH (thyroid-stimulating hormone) test, which detects glaring changes such as the true hypothyroid state of not producing enough (causing an elevation in TSH levels) or the state extremely low hyperthyroid (producing too much, causing a drop in TSH levels). The rest (more than 80%) of us who produce rT3 are told that there is nothing wrong with us, that it is all in our heads, and that the lab tests are normal. For more information on what to do about it, check out the other articles in this series.

Performing the ‘poor man’s thyroid test’ is easy. Get a thermometer that is easy to read first, not a fever thermometer. You want a ‘basal body thermometer’ or ‘pregnancy thermometer’ because you need to be able to actually read small temperature increments. The standard is the mercury thermometer, but you can also use a digital thermometer if necessary, but it is not recommended as they can be very inaccurate.

Shake the thermometer to bring the mercury down completely and place it in a safe place on the nightstand for use in the morning. The axillary temperature is the usual preferred location for temperature taking. Just be sure to place the tip of the thermometer right in the middle of your armpit and hold your arm tight against your body for 10 minutes. Most doctors will tell you to start taking your temperature about three hours after you wake up and then two more times at three-hour intervals. The trick is to make sure your temperature is checked at the same time and during the same activity levels every day for a week. Some of us like to have the morning temperature recorded and averaged as well.

Take at least three temperature readings a day and average them together, recording that average, over a week. Normal temperatures are low in the morning and higher in the late afternoon. There are many references to the Broda Barnes method of thyroid assessment, where it is suggested that below normal is 97.8 degrees Fahrenheit. Dr. Denis Wilson (Wilson’s Temperature Syndrome) suggests that 97.8 degrees is too low for proper metabolic functioning and that 98.6 or higher is preferable (as has been the case with my own patients).

If people had higher temperatures during adolescence, that could be an indication that a higher than “normal” temperature would be desirable. If someone ran 99.6 during the healthy years of adolescence and young adulthood, and then dropped to 97.8 in midlife, that might be an indication that bringing the temperature back into the 98.9 to 99.6 range might be better for that person.

Of course, everyone is different and you should watch out for heart palpitations and anxiety (good indicators of too much thyroid).

Once a week’s worth of temperature assessment is done and it is below normal, one can approach a naturopathic or holistic doctor to determine the next step. Or, iodine supplementation could be tried, which might fix the problem on its own. In either case, avoid things that load the system with bromide, fluoride, and chloride. Since many people are very shy to have anything close to the required dose of iodine in the diet, adding some supplements through shellfish, kelp, and other sea vegetables could make a world of difference. For those who hate the very idea of ​​trying iodine, which is admittedly quite unpleasant, there are forms of pills that can help.

© 2010 Dr. Valerie Olmsted All Rights Reserved