Thyroid Health: Keed to know info! and the 6 thyroid tests you need to ask for from your Doctor

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(adapted from Dr.Aviva Romm, MD, 2014)

I see a lot of patients that complain of weight gain, fatigue, constipation, dry skin, PMS, and complaining of always being cold. All these symptoms point to the possibility of hypothyroidism, or under active thyroid function. Sometimes, their TSH (thyroid stimulating hormone), the most common test for thyroid function, has been tested and may still fall into the “normal range”. However, TSH is only one of the markers for abnormal thyroid function, and many patients are unaware that there are other tests that can give a much better picture of thyroid health and function.

Statistically, hypothyroid is an under diagnosed condition. In fact, in the US only ½ of Americans that have hypothyroidism know it.

What is the Thyroid?

The thyroid is a butterfly-shaped gland that sits at front of your neck and controls your metabolism. It therefore controls your weight, energy levels and also plays a role in cholesterol and hormone production.

When the thyroid is out of balance and not functioning optimally you can gain weight, have sluggish bowels, experience dry skin, have fertility problems, brain fog and feel tired…even if you have a great diet and activity level!

The Key Thyroid Tests

Thyroid tests should be easy to obtain from your primary doctor, naturopathic doctor or functional medicine doc. However thyroid tests do take some skill to interpret and some docs may be reluctant to order more than a TSH test. If this is the case, consider getting a second option by a doctor that is familiar with thyroid health and testing.

Thyroid Test #1: TSH (Thyroid Stimulating Hormone)

TSH is the commonly order thyroid test. This hormone is produced by the pituitary gland (a small gland in your brain). TSH communicates with the thyroid to tell it to produce more thyroid hormones T3 and T4. When all is going well in the body, TSH is in a normal healthy range and so is T3 and T4. When T3 and T4 (those important thyroid hormones produced by the thyroid gland) are LOW, TSH starts to INCREASE, telling the thyroid gland to produce more T4 and T4.

The “healthy TSH range” has become a somewhat controversial topic in medicine. Most Canadian labs consider the upper range of TSH to be 4-5mU/L. However, many experts, including many conventional endocrinologists, consider the upper limit of TSH should be no higher than 2.5-3mU/L. This is based on the data collected on Americans without any hypothyroid symptoms. When they have a TSH test done, this is the common upper range.

Thyroid Tests #2 and #3: T3 (Triiodothyronine) and T4 (thyroxine)

As mentioned above, T3 and T3 are hormones produced by your thyroid gland. T4 is produced in much higher amounts by your thyroid gland, and then is converted into T3 in the periphery. This is important because T3 is the more active form of thyroid hormones and is necessary for proper metabolic function.

Thyroid Tests #4 and #5: TPO and TGAb (Thyroid Antibodies)

As mentioned previously, autoimmune hypothyroidism is the most common cause of hypothyroid. As with any other health condidition, to achieve optimal health we must look at the underlying cause of the problem. If a patient has hypothyroidism, but does not address the autoimmunity (if present), the problem will not be addressed at the root cause. Thyroid antibodies can also be measured every 6-12 months to gauge how thyroid treatment is progressing.

Thyroid Test #6: Reverse T3 (RT3)

Although there is some controversy over the usefulness of this test, I have personally found it of benefit in my practice, especially if hypothyroid symptoms are persisting despite treatment. Sometimes, when the T4 is being converted to T3, it can be converted into RT3, a less active form of T3 that the body cannot use as well as T3. This can happen is one is under a large amount of stress or is sick. If the patient it producing a large amount of RT3, certain medication or supplements can help replenish the body with T3 and encourage the body to produce T3 over RT3.

If you have an inkling that your thyroid health is sub-optimal and your doc is not open or familiar with thyroid testing, consider switching docs or having a second opinion.

Yours in Health,

Dr. Emily


5 Dietary Recommendations for Enhancing Fertility

a921b1a5953616fa7b1e415200b149c7.jpg_srz_p_697_723_75_22_0.50_1.20_0.00_jpg_srzPreparing for pregnancy can involve preparing financially, spiritually, physically and nutritionally.  Whether you are having difficulty conceiving or are consciously preparing for pregnancy, diet is very important.  What we eat can influence fertility, affect hormones and later, affect the fetus.  More and more woman are wishing to be pregnant at later stages of life. As our fertility peaks in our early 20s and begins declining in our late 20’s, many woman who are 30 plus often are interested in foods that can boost their chances of conceiving. (May I add that woman who choose to wait for babies can still have very healthy and happy pregnancies !! ) So without further ado please find my top 5 dietary recommendations for fertility:

  • Eat Organic as much as possible a year before conceiving.  Pesticides are poisons designed to kill living organisms and therefore harmful to humans. Children are actually four times more sensitive to exposure to cancer-causing pesticides in foods than adults. Many toxins used in pesticides are also known hormone disruptors. Some of the chemicals that are used in pesticides are fat soluble, meaning that they can be stored in our fat cells for long periods of time.  Therefore it is best to avoid these chemicals as long as possible before becoming pregnant to minimize the exposure of the growing fetus to these toxins found on conventional produce.

  • Increase consumption of nutritious seeds such as sunflower and pumpkin seeds. Nutritional deficiencies of zinc and B6 can affect fertility. Sunflower seeds are a good source of B6 and other trace minerals and pumpkin seeds contain a high amount of zinc amongst other minerals.  You can add these seeds to cereals, salads or even buy (pumpkin or sunflower) seed butter and spread it on toast.

  • Make you sure your iron intake is adequate.  The best way to find out if your iron levels are high enough is to have your ferritin levels measured through blood.  Ferritin levels lower than 70 can decrease fertility and can also lead to anemia throughout pregnancy.  Red meat is the best source of iron (opt for grass fed, organic). Dark leafy green veggies, beans, legumes and molasses also are higher in iron and cooking in a cast iron pan can also increase the iron levels of the foods that are cooked in them. Some individuals, despite their best nutritional efforts still have low iron and need to take an iron supplement.

  • Eat a diet rich in omega 3 Fatty Acids: These healthy fats are great for the brain, help to balance hormones and also lead to better birth outcomes for the baby.  Aim for 2-3 servings of low mercury fish (sardines, anchovies and mackerel are best), chia seeds, flax and walnuts and/or supplement with a high quality fish oil daily.  Make sure the fish oil has been third party tested for mercury and other heavy metals and the source of the fish is from mackerel, anchovies and/or sardines.  

  • Aim to eat low- medium glycemic index carbohydrates. When we consume carbohydrates they are broken down into sugars that provides energy to our cells. Some carbohydrates break down into more sugars than others and these certain carbohydrates can affect our insulin levels, thus affecting our hormones.  Choose low glycemic index carbohydrates such as rice bran and other whole grains and bright coloured vegetables. Avoid high glycemic index foods such as refined sugars, white breads, white rice and white pastas.

 In Health,

Dr. Emily Lipinski, ND


Phytoestrogens and Hot Flashes

Hot flashes, or vasomotor flushes, affect 50-85% of menopausal women (Northrup, 2006).  The exact cause is unknown however it is thought to be related to neurotransmitter changes.

Phytoestrogens (naturally occurring estrogens in plants) can play an important part in a menopausal diet.  These plant derived estrogens weakly bind to hormone receptors in our bodies, causing a weak estrogen response in some tissues OR an anti estrogen response in other tissues (Hudson, 2006).  Significant amount of phytoestrogens are found in soybeans and flaxseeds.  It has been found that in populations that eat a high amount of foods containing phytoestrogens, hot flashes and other menopausal symptoms occur less frequently (ie. it is hypothesized that Japanese women have a lower incidence of hot flashes because of the consumption of high amounts of soy).  A randomized, double blind placebo controlled trial showed that women consuming soy protein had a decreased incidence of hot flashes, an increase in vaginal moisture and an improved quality of life (Dupree et al., 2005).

If you have a problem digesting Soy, ground flax seeds offer a high amount of phytoestrogens and can be added to cereals, oatmeal or smoothies.

Figure 34-17 Physiology of estrogen and the estrogen receptor. Estrogen binds to estrogen receptors in the cytoplasm or in the nucleus In:Townsend: Sabiston Textbook of Surgery, 18th ed. 2007 Elseiver