Thyroid test?

My physiologist wants me to have my thyroid level tested. I don't mind doing it, but am surprised that this is the first time any of my doctors brought that up as a factor in my a-fib or it is not included in a normal blood profile.

Mary - It's not surprising often, doctors don't make the thyroid connection to afib and do the testing, so it's good that you're having the assessment since either hypo- or hyper-thyroidism is known to contribute to arrhythmia.

I hope the thyroid panel is complete in that it looks at more than just TSH.... and should include not only the TSH the T3 and T4 but most importantly, the Free T3 and Free T4 (also called unbound), Reverse T3 and the thyroid antibodies.

Read more here about the complete thyroid profile assessment: [www.gdx.net]

You can ask prior to going for the test if you are going to have the complete profile and if not, why not since just the TSH and T3 and T4 are inconclusive measurements. You may have to find a naturopathic physician or practitioner of functional/restorative medicine to get the proper testing... but it's worth the effort. If you do end up going this route, it's also important to have your iodine level checked to rule out an iodine deficiency as well. My experience is that none of the endocrinologists (3) I saw had any interest in doing the complete profile or testing for iodine so I use a Functional Medicine Board Certified Family Practice MD.

Let us know your results.

Be well,
Jackie

Thanks Jackie.

The order indicates TSH [Lab 129] only.

Well, Mary - now you have some decisions to make.

Here's a report by one of my favorite thyroid doctors.. wherein he explains the function of TSH and why that measurement alone is not a total indicator.

[drhedberg.com]

quoting:
Thyroid-Stimulating Hormone (TSH)

Traditional medicine relies mainly on the TSH or thyroid-stimulating hormone blood test to measure thyroid function. TSH is not a thyroid hormone. TSH is produced by the pituitary based on how much thyroid hormone is circulating in the bloodstream. As thyroid hormone levels drop, TSH production will increase to stimulate the thyroid to make more hormone. If thyroid hormone increases, then TSH production will decrease because the thyroid is making plenty of hormone. The TSH alone is not adequate to assess thyroid function because it doesn’t take into consideration the conversion of thyroid hormone into its active form which occurs in the liver, kidneys and lungs. The TSH test also does not take into account thyroid hormone receptor resistance. Thyroid hormone receptors can become resistant to thyroid hormone due to thyroid-disrupting chemical exposure leading to normal blood tests but development of low thyroid symptoms. Cortisol produced during stress by the adrenal gland can also inhibit TSH production further throwing off the accuracy of the test. If the TSH is elevated, the traditional physician will prescribe synthetic T4 and this will usually reduce TSH into the “normal” range. This approach does not take into account peripheral thyroid hormone conversion or receptor binding. If the body is compromised in its ability to activate thyroid hormone into T3, then taking T4 will result in a failure of treatment. If the adrenal glands are out of balance, then most likely thyroid hormone function will also be out of balance. In addition, if thyroid hormone receptors are desensitized, this approach will fail as well.

You will find that most medical physicians do not spend much time reading the peer-reviewed medical literature which provides us with valuable data on TSH levels. An excellent study was published by Obal and Krueger (2001) on sleep deprivation and thyroid hormone production. The researchers concluded: “When sleep deprivation is maintained for weeks, the plasma concentrations of T4 and particularly T3 decline but TSH remains normal.”6 Do physicians ask you about your sleep patterns? Perhaps this could be the reason for the abnormal TSH. I have seen many patients who also suffer from insomnia and sleep problems and present with low thyroid symptoms and abnormal TSH levels. Does this mean they should have thyroid hormone dumped into their bodies? Unfortunately, this happens to many people. I always take into account every patient’s sleep pattern and correct it as part of our treatment plan. Many times, sleep patterns are abnormal due to blood sugar and adrenal gland imbalances. Remember, you are not a lab test but a beautiful, complex being where everything is connected as one.

Then continue on to the Testing and Diagnosis section and note his comments about also checking adrenal function.

There is another website that's been functioning for a very long time to help those sort out thyroid problems and get proper testing... (hosted by Mary Shoman). [thyroid.about.com]


Jackie

Further to the above, consider the heart is an electric pump. For example, the term 'vagally mediated AF' means AF caused by high vagal neurotransmitter ACh (acetylcholine) which lowers the heart's electric voltage. Low T3 (hypothyroidism) lowers the electric voltage, the same as high ACh.

Camping on to what Mork says above, my medical mafia feels that the best TSH range for nerves in general is between 1.0 and 2.0 not the "normal" range of 0.6 to 3.6 and prefers me to use one of the animalbased supplements that contains real T3 instead of synthroid, etc.

This also applies to people at risk for RSI, repetitive stress injuries.

Gordon

Gordon - After using Synthroid for 10 years (long ago) and not managing hypothyroid symptoms plus developing thyroid nodules, in 2000, the new FM MD prescribed Armour thyroid which helped somewhat with the symptoms and definitely helped keep my numbers in line but I still had then and have (now) hypothyroid symptoms. She agreed that the TSH should be 1.0 - 2.0 and not lower than 1.0 because of the tendency to trigger AF.

There is much more to managing thyroid issues than just taking the hormone. My experience is that while my numbers are in range, I still have the symptoms so I'm going to be looking at other options since I no longer use the Armour thyroid. My doctor says using Armour thyroid on those over age 70 is contraindicated because of the risk of promoting arrhythmia.


At that link above, Dr. Hedberg notes:

Armour Thyroid, Nature Thyroid, Westhroid – Natural thyroid hormone from desiccated pig thyroid tissue. Contains approximately 38 micrograms/grain of T4 and 9 micrograms of T3/grain as well as other cofactors for thyroid hormone production. Nature Thyroid is a better choice than Armour because it does not contain corn and other binders.

Many alternative-minded medical doctors prescribe Armour and other natural dessicated pig thyroid tissue. This is a better option in some cases than merely prescribing synthetic T4 (Synthroid) because these natural agents also contain T3. The problem with Armour is that it contains corn and other fillers which can be a problem for those with specific sensitivities. Nature Thyroid is the best choice because it doesn’t contain corn or fillers. But the author does not agree with this treatment method because even though it is a better option, it still does not take into account the underlying causes of why the thyroid is out of balance in the first place. These natural prescriptions still only replace thyroid hormone and require dependence on the doctor for continued prescriptions and office visits.

I have seen many, many patients who are on such natural prescriptions who still have many symptoms and have been taking the prescription for a long period of time. Even if someone responds to a prescription such as Armour thyroid, she should be rigorously evaluated for underlying physiological imbalances. (end quote)


Jackie

Thanks, Jackie: Nature Thyroid is what I've been taking for perhaps 7 years now and will continue as long as none of the other issues develop.

Gordon.

My first AF episode was triggered by an overdose of T3 plus TSH too low by a stupid holistic doctor. I was on Armour at the time. Also we must be aware that if someone has Hashimotos auto immune thyroid then iodine is harmful. anneh