Holtorf MedicalGroup®Contributor
Thyroid Nation
TSH Misses Thyroid Hormone Transport Issue

More and more research is pointing to the fact that the TSH (thyroid stimulating) test is not the best marker for diagnosing thyroid dysfunction among patients. The TSH test is considered the “gold standard test” for many physicians. However, this test fails to determine if an individual has hypothyroidism because the levels that are tested are not from the thyroid, but rather from the pituitary where there may be no problem at all.

What is TSH?

TSH is produced in the pituitary gland when it receives a signal from the hypothalamus in the form of TRH (thyrotropin-releasing hormone). Once the pituitary gland is triggered by the TRH, it produces and releases TSH. The TSH then causes the thyroid gland to start producing the thyroid hormones T3 (triiodothyronine – the active thyroid hormone) and T4 (thyroxine – the inactive thyroid hormone that later will be turned into T3 or rT3 (reverse T3).

What is the TSH Test Missing?

While the test may seem like a good way of giving us an indication of thyroid function, new research is demonstrating that it completely misses the problem of reduced T4 and T3 transport into the cells. New research is showing that the thyroid hormone transport across cellular membranes plays a vital role in intracellular T3 levels. This is extremely important because unless the thyroid hormones cross the cellular membrane they won’t have the proper effect on the body. The test misses this problem in thyroid hormone transportation because the pituitary has different transporters than every other tissue in the body. So while it is still getting an adequate amount of the hormones, the rest of the body may be suffering. This results in “normal” TSH levels despite the presence of hypothyroidism among other tissues.


What Affects the Thyroid Transport?

The transport into the cells of the thyroid hormones is largely based on energy so any condition that lowers cellular energy, also known as mitochondrial dysfunction. Mitochondria are found in every cell and are responsible for providing energy to our cells in order for them to function properly. So, if you have any condition that is linked with reduced mitochondrial function, you may have impaired thyroid transport. These conditions include, insulin resistance, diabetes, obesity, chronic and acute dieting, depression, bipolar depression, neurodegenerative diseases, chronic fatigue syndrome, fibromyalgia, migraines, chronic infections, physiologic stress and anxiety, cardiovascular disease, and conditions that are associated with high cholesterol and triglyceride levels.

What Tests Should be Done?

So what happens if your TSH level is normal, but you are still experiencing hypothyroid symptoms? These symptoms can include,

  • Cold hands and feet
  • Weight gain or difficulty losing weight
  • Fatigue
  • Dry skin
  • Hair loss
  • Depression
  • Brain fog
  • Decreased libido
  • And more

Stop-The-Weight-AdIf you are still experiencing these symptoms it may be time to run a few different tests such as:

  1. Free T3
  2. Free T4
  3. Reverse T3
  4. Anti-TPO antibody (to test for autoimmune thyroiditis)
  5. Antithyroglobulin antibody (to test for autoimmune thyroiditis)
  6. SHBG (sex hormone binding globulin)

These tests when used in combination with clinical assessment, measurement of reflex speed (either the Achilles or the Brachio-Radialis), and basal metabolic rate should be able to accurately determine a patient’s thyroid status.

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About Holtorf Medical Group®

Hyper-Or-Hypo-Thyroid-What’s-The-DifferenceKent Holtorf, MD is an American physician and entrepreneur. He is a board examiner of the American Board of Anti-Aging Medicine (ABAAM). He is the founder and medical director of Holtorf Medical Group, a practice of five centers that reports to specialize in the treatment and management of medical conditions and disorders including fibromyalgia, adrenal fatigue, complex endocrine dysfunction, hypothyroidism, age management, chronic fatigue syndrome, low libido, Lyme disease, migraines, PMS, perimenopause and menopause. His practice focuses on alternative therapies that are not yet standard practice with mainstream doctors,[2] maintaining that mainstream medicine tends to be an average of 17 years behind the emergence of new and advanced treatments. Holtorf Medical Group was founded on the belief that every patient deserves to have the highest quality of care, compassion, and understanding when striving for a better quality of life. We practice this belief every day as we treat thousands of patients who suffer with chronic conditions, have been treated by multiple doctors and some that have even lost hope. There is a solution! Check out their website HoltorfMed.com, for more information and please follow Dr. Holtorf on Facebook and Twitter.

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Sources: https://www.nahypothyroidism.org/wp-content/uploads/2014/08/Thyroid-Hormone-Transport-into-Cellular-Tissue.pdf https://www.nahypothyroidism.org/wp-content/uploads/2014/08/Peripheral-Thyroid-Hormone-Conversion-and-Its-Impact-on-TSH-and-Metabolic-Activity.pdf