You’re feeling kind of “off” lately. You don’t have a lot of energy, and you have trouble concentrating or remembering things. Plus, your pants are getting a little bit tiiiiighter, due to the extra ten or fifteen pounds you’ve gained recently. Or, you feel anxious and shaky, and you’re hot all the time.
If this sounds like you, it may be time to head to your doctor to discuss your symptoms. Many illnesses have similar symptoms (for instance, not having a lot of energy is common to a lot of illnesses), but one thing you’ll want to have checked is whether or not your thyroid gland is functioning properly.
There are few things that doctors consider when they are considering hypothyroidism as the cause of someone’s symptoms. Blood tests, patient symptoms, a physical examination, and health history are all factors that doctors take into account when diagnosing thyroid illness.
Insurance companies will often require a visit to your primary care doctor before authorizing care from a specialist, such as an endocrinologist. If that is the case for you, your primary care doctor will most likely order a test of your Thyroid Stimulating Hormone (TSH) levels.
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TSH is produced by the pituitary gland and tells the thyroid what level of thyroid hormones it should be pumping into the bloodstream. If the number is high, that means the pituitary is detecting low levels of T4 and is trying to get the thyroid gland to rev up its pace.
Some doctors stop at the TSH screening, but there are other thyroid hormones that can and should be checked if a thyroid imbalance is detected. An endocrinologist would be more likely to order these types of tests.
Many doctors stop at the TSH screening to assess thyroid health, but we believe it is critical to also measure Free Triiodothyronine (fT3), Free Thyroxine (fT4), and TPO antibodies to get a complete picture. An endocrinologist is more likely to order this complete panel than your primary care physician.
If your doctors don’t seem inclined to have bloodwork done, you’re at liberty to suggest it yourself! Especially if you have any risk factors, such as previous thyroid illness, an autoimmune disease, or a family member with thyroid disease, it’s absolutely reasonable to make this request.
Another part of diagnosing thyroid disease is the physical examination. During an examination, your doctor will feel the thyroid gland, measure blood pressure, heart rate, and reflexes. They will look to see if your skin is dry or your face has any puffiness to it. They’ll also check to see if your body temperature is normal.
As part of the physical examination, your doctor will want to know what symptoms you have been experiencing. Common symptoms of thyroid illness include:
· Sensitivity to cold or warm temperatures
· Depression or anxiety
· Fluctuations in weight
· Fatigue or sleeplessness
· Difficulty concentrating
· Joint pain
Sometimes a patient’s medical history can provide valuable insight into their current health situation. With regards to thyroid disease, a doctor will be particularly interested to know if you have experienced any of the following:
· Radioactive iodine treatment for hyperthyroidism
· Hyperthyroidism, which may indicate a thyroid that has burnt itself by overproducing hormones for a significant period of time
· Autoimmune diseases such as rheumatoid arthritis, Celiac disease, or type 1 diabetes
· Surgery to remove part of the thyroid gland
Your doctor will also want to know if you have a family history of autoimmune disease or thyroid disease, as these are risk factors for thyroid illness.
All of the aspects of diagnosing thyroid illness discussed so far would occur during a visit to either a primary care doctor or an endocrinologist. There are other aspects of health that may need to be examined, but as a patient, it is likely you will have to seek out practitioners who subscribe to a whole-body or holistic health philosophy. This kind of philosophy sees the body as a whole system - including mental, emotional and physical - and attempts to understand illness and health within that context.
These types of practitioners - they can be M.D.s as well as alternative health practitioners - would be interested in learning more about other illnesses, such as viral or bacterial illnesses, food sensitivities, other hormone levels, and adrenal function. They would take into account diet, exercise habits, and stress as a means of getting a patient to their optimum health.
If you suspect your thyroid is not working as it should, contact a medical professional and begin the process of determining the cause of your symptoms! At Paloma Health, we’re here to provide end-to-end care for your thyroid from best-in-class endocrinologists and wellness experts.
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