Understanding thyroid problems
Best thyroid treatments
Understanding Thyroid Tests
A simple, regular blood test is used to guide treatment for hypothyroidism and monitor the condition. Results from a hypothyroidism blood test are the key to unlocking your best treatment plan.
If there’s a bright side to hypothyroidism, or an underactive thyroid, it’s that treatment usually just involves taking daily medication, and testing is limited to a simple blood test. Your hypothyroidism test results are your doctor’s blueprint for prescribing the right dose of synthetic thyroid hormone medication and tracking how well it’s working.
Thyroxine, Triiodothyronine, and TSH Levels
The main job of the thyroid gland is to make the hormone thyroxine, also known as T4 because it has four iodine molecules. The thyroid also makes the hormone triiodothyronine, known as T3 because it has three iodine molecules, but in smaller amounts, the thyroid gland makes mostly T4, [and] the T4 has to be converted to T3, because T3 is the part of thyroxine that actually does the work.
The pituitary gland at the base of the brain controls hormone production in your body. It makes thyroid-stimulating hormone, or TSH, which tells the thyroid gland how much T4 and T3 to produce. The TSH level in your blood reveals how much T4 your pituitary gland is asking your thyroid gland to make. If your TSH levels are abnormally high, it could mean you have an underactive thyroid, or hypothyroidism.
“TSH levels go in the opposite direction of your thyroid hormone. If you’re making too little thyroid hormone, your TSH will go up. If you’re making too much thyroid hormone, your TSH will go down.”
What’s normal can vary depending on a number of factors, including the laboratory where your blood test is done. A normal range for TSH in most laboratories is 0.4 milliunits per liter (mU/L) to 4.0 mU/L.
If your TSH is higher than 4.0 mU/L on repeat tests, you probably have hypothyroidism.
Your doctor may also order a T4 test. Most of the T4 in your blood attaches to a protein, and when it does, it can’t get into your cells. Only T4 that is unattached or ‘free’ can get into your cells to go to work. A blood test can measure how much free T4 is available.
Hypothyroidism Tests: A Measure of Treatment Success
Hypothyroidism is treated with daily medication. Taking synthetic thyroid hormone medication can bring your T4 and TSH levels back to their normal ranges. Once you’re on the right dose, you should have no symptoms.
When you first start taking medication, your doctor will need to monitor your blood to fine-tune the dosage. Initially you will need to be tested more frequently. A person who is newly diagnosed and taking medication for hypothyroidism should be tested every six weeks until the dosage is just right.
The dose you start with is your doctor’s educated guess about what’s best for you — most likely the lowest dose possible to avoid side effects, which can include a rapid heartbeat and restlessness.
Medication for hypothyroidism is slow acting, and it can take several weeks for your body to adjust. If your TSH is still high and your symptoms haven’t subsided after 6 to 10 weeks, your doctor will likely increase the dose, and you’ll need your blood tested again after another 6 to 10 weeks.
How to Keep Hypothyroidism Under Control
Because you’ll need to take thyroid medication every day for the rest of your life, even after the right dose is found, your hormone levels will be monitored regularly to be sure that your treatment is working properly. Eventually, most people with hypothyroidism can just be seen yearly by their doctor.
The American Thyroid Association recommends that you keep your TSH within a narrow range of 0.5 to 2.0 mU/L, but don’t be alarmed if your test results vary a little. Some variation is normal because your pituitary gland sends out TSH in pulses, not a steady stream. Also, the time of day you’re tested can make a difference. TSH levels are likely to be higher at night and lower during the day.
If you have new or worsening symptoms or your health-status changes — such as if you become pregnant, go through menopause, or are given another medicine that can interfere with the absorption of your thyroid hormones, such as anticonvulsants, certain antacids, or iron or calcium supplements — you should see your doctor and have your blood tested again, even if it’s ahead of schedule.
Thyroid Treatment Australia
Treatment for Hypothyroidism/Underactive Thyroid
Thyroxine (Oroxine/Eutroxsig/Eltroxin) is prescribed for patients who have had a total thyroidectomy or who suffer from an underactive thyroid gland, (hypothyroidism). Oroxine/Eutroxsig/Eltroxin is synthetic forms of the hormone Levothyroxine (T4). It is the closest form of thyroxine hormone to what a healthy thyroid gland produces.
If the thyroid gland is underactive, your doctor will prescribe a small dose to start your treatment, usually 50 mcgs; and increase the dose as the thyroid gland becomes progressively inactive. If this medication is prescribed as a result of a total thyroidectomy, your treating doctor will determine the initial dose, after pathology tests. It is unusual for patients to cease this medication once it has begun.
Time to Take Levothyroxine Medication
Recent research supports The ATF’s Recommendation to take Oroxine/Eutroxsig first thing in the morning (as soon as your eyes are open) with a glass of water only, on an empty stomach. Wait at least 30 – 60 minutes after taking the dose before breakfast. Other medications, vitamins/minerals herbal medicines and supplements should not be taken at the same time to avoid interactions with Oroxine/Eutroxsig. An interval of at least 4 hours after taking Oroxine/Eutroxsig is recommended. This is due to possible interactions and lower absorption.
Storage of Oroxine and Eutroxsig
It is essential to refrigerate blister strips not yet in use of Oroxine and Eutroxsig between 2 – 8 Degrees Celsius (refrigerated temperature). The ATF Recommendation is to keep all of your tablets in the refrigerator, all of the time and go to the refrigerator in the morning to get your dose. This is to safeguard against spoilage from room temperatures rising throughout the day, due to seasonal change, or room heating during colder months.
Laboratory tests have shown that if not stored correctly, there is a reduction in potency of the active ingredient, thyroxine sodium.
Storage of Eltroxin
Eltroxin does not need to be refrigerated. Eltroxin should be kept at room temperature below 25 degrees Celsius. Please note Eltroxin is not the same formula as Oroxine/Eutroxsig.
Thyroid Testing In Australia. What Are The Best Tests For Thyroid Function?
Thyroid Wellness & Diet
Comprehensive testing can assess central thyroid function, peripheral thyroid hormone activity, and screens you for a possible auto-immune thyroid disorder such as Hashimoto’s disease.
What’s Included in a Complete Thyroid Panel?
A comprehensive thyroid panel normally tests:
- Thyroid stimulating hormone (TSH)
- Free thyroxine (T4)
- Free triiodothyronine (T3)
- Reverse T3 (RT3)
- T3/RT3 ratio
- Anti-thyroglobulin antibodies (tgab)
- Anti-thyroperoxidase (TPO) antibodies
How Can You Get Comprehensive Thyroid Testing in Australia?
It’s becoming more popular for Australian integrative medical practitioners and Naturopaths to do private testing using pathology laboratories such as Healthscope Functional Pathology, and NutriPATH Integrative Pathology. Thyroid function tests are blood tests which are ordered by doctors to determine how well the thyroid gland is functioning. The thyroid function tests examine the levels of hormones in the bloodstream to determine how well the thyroid can respond to signals from the pituitary gland, and also how well the thyroid gland can produce the thyroid hormones. These tests are commonly used to monitor patients with thyroid disease, and also have a role in diagnosing thyroid disease.
For example, NutriPATH Integrative Pathology measures TSH, free T4, free T3, reverse T3 (RT3), anti-TG antibodies, anti-TPO antibodies, and provides the T3/RT3 ratio. The only downside of this comprehensive thyroid panel is that it is not covered by Medicare.
NutriPATH Integrative Pathology provides a laboratory testing service based on a practitioner-referral system. If you wish to get this testing done you will need to discuss this with your healthcare practitioner. Once you have a signed pathology request form you can continue with the test.
The actual blood draw is done at a local pathology collection centre. The pathology company then sends the blood sample to NutriPATH for testing.
The NutriPATH comprehensive thyroid panel currently costs $175, plus a $20 collection fee. You may get a separate bill from the pathology company for the blood draw. The total charge for a comprehensive thyroid panel could therefore be around $228.00.
Interpreting Your Thyroid Test Results
Understanding your results
Bear in mind that once you have all these thyroid test results you then need help in understanding the results.
A high TSH result might mean:
- That you are receiving too little thyroid hormone medication to treat hypothyroidism
- There might be a problem with your pituitary gland.
A low TSH result might mean:
- You are taking too much thyroid hormone medication to treat hypothyroidism.
Your doctor will be aware of your circumstances and can discuss what the results mean for you.
The thyroid gland is located on the front part of the neck below the thyroid cartilage (Adam’s apple). The gland produces thyroid hormones, which regulate metabolic rate (how fast calories are consumed to produce energy). Thyroid hormones are important in regulating body energy, body temperature, the body’s use of other hormones and vitamins, and the growth and maturation of body tissues. Diseases of the thyroid gland can result in either production of too much (overactive thyroid disease or hyperthyroidism), too little (underactive thyroid disease or hypothyroidism) thyroid hormone, thyroid nodules, and/or goiter. Thyroid problems are much more common in women than in men.
Production of thyroid hormones:
The process of hormone synthesis begins in a part of the brain called the hypothalamus. The hypothalamus releases thyrotropin-releasing hormone (TRH). The TRH travels through the venous plexus located in the pituitary stalk to the pituitary gland, also in the brain. In response, the pituitary gland then releases thyroid-stimulating hormone (TSH, also called thyrotropin) into the blood. The TSH travels to the thyroid gland and stimulates the thyroid to produce the two thyroid hormones, L-thyroxine (T4) and triiodothyronine (T3). The thyroid gland also needs adequate amounts of dietary iodine to be able to produce T4 and T3, the molecules of which contain four and three atoms of iodine, respectively.
Regulation of thyroid hormone production:
To prevent the overproduction or underproduction of thyroid hormones, the pituitary gland senses how much hormone is in the blood and adjusts the production of hormones accordingly. For example, when there is too much thyroid hormone in the blood, TRH and TSH production are both decreased. The sum effect of this is to decrease the amount of TSH released from the pituitary gland and to reduce production of thyroid hormones from the thyroid gland to restore the amount of thyroid hormone in the blood to normal. Defects in these regulatory pathways rarely may result in hypothyroidism (underactive thyroid problem) or hyperthyroidism (overactive thyroid problem). The most common cause of hypothyroidism and hyperthyroidism occurs due to problems within the thyroid and not the regulatory system.
Thyroid goiter is any enlargement of the thyroid that can occur with hyperthyroidism or hypothyroidism but also with benign and malignant (cancerous) nodules. Worldwide, the most common cause of goiter is iodine deficiency. Although it used to be very common in the U.S., it is now less common with the use of iodized salt. Multiple nodules in the thyroid are very common, but only about 5% of the nodules are a thyroid cancer. Thyroid cancer rates have been increasing steadily by about 6% every year for more than 20 years. It is one of the few cancers whose rate is increasing and whose very low rate of mortality is also rising with time. Although radiation exposure as a child can increase the risk of thyroid cancer, we do not know why the overall rate has been increasing. Thyroid cancer is diagnosed after a thyroid ultrasound exam and a needle aspiration biopsy of the nodule.
If you have any questions regarding Thyroid Testing, we are more than happy to answer, Call now on 0893289233 to arrange an appointment with Lesley Oakes who specializes in treating thyroid conditions.