Virtual Clinic for Women's Hormonal Health & Digestion in Ontario

That in-between when your thyroid lab tests are out of normal range, but when no treatment is being offered to you

Suboptimal thyroid levels | When to treat

Many patients come into their first visit presenting with symptoms of hypothyroidism – fatigue, weight gain, constipation, dry skin, hair loss, brittle nails, etc. When I inquire if they have recently had their thyroid tested, often it has been, “but my doctor said it was fine”. What is fine anyway? If you’re experiencing bothersome symptoms of low thyroid hormone, and your lab tests are out of normal range, or even just out of optimal range, I believe this warrants treatment.

In Ontario, “normal range” for TSH thyroid stimulating hormone is 0.35-5 mIU/L, but optimal is 1.5-2 mIU/L. It is totally fine to be out of that optimal range, as long as you’re feeling well and not experiencing symptoms. On the other hand, if you do have symptoms, naturopathic doctors are well positioned to help as we have gentle tools that can be enlisted earlier on the spectrum of thyroid decline than medications, which are normally reserved for more severe disease. For instance, most family physicians will not prescribe synthetic thyroid hormone until TSH levels are 10 nIU/L, which is often after the patient has gained considerable weight for example, which in turn puts them at greater risk of other chronic diseases. It is also crucial to test free T4 and free T3 to see how the entire hypothalamic-pituitary- thyroid axis is balancing, and potentially work on improving conversion of T4 to active T3 if necessary.

Naturopathic doctors can do a full assessment to confirm that there is not a peripheral condition leading to the decline in thyroid hormone, such as a nutrient deficiency, a chronic adrenal dysregulation, or an autoimmunity. We can then use nutritional, lifestyle, herbal and supplemental interventions to improve the thyroid hormone levels. And when needed, we can prescribe desiccated thyroid hormone or refer the patient back to their primary care physician for synthetic thyroid medication. 

The thyroid is the governor of the body. If it is sluggish, the patient will struggle and even suffer. Optimizing the metronome will help to set straight the entire band 🙂

Sarah Goulding naturopath

Dr. Sarah Goulding | Naturopathic Doctor

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