I am so glad you asked! I have many conversations per week about the thyroid. Most people that reach out to me suspect they have a thyroid problem despite being told "Your Thyroid looks fine." That can happen when only a partial evaluation is being done. Typically, the TSH (Thyroid Stimulating Hormone) and T4 levels are run on lab tests. That is only the tip of the iceburg.
T4 is a INACTIVE form of thyroid hormone. We create this because it's stable. When we need active (or useable) thryoid hormone, our bodies convert T4 to T3. At least that is what is suppposed to happen. In many cases, however, this isn't happening. A person will have great levels of T4, but their T3 is on the lower side. This means there is an issue with conversion for T4 to T3. This can make a person look great on paper, but feel like they have a slow thyroid. They can get frustrated when they have all the symptoms of hypothyroidism (a slow thyroid) but continuously get told they don't have a problem with their thyroid. I see this all the time.
But, what does that have to do with your liver!? The liver is where 60% of this conversion takes place. So, if you have a liver that is overworked and struggling, it can mean that the conversion from T4 to T3 isn't as good as it should be. You can even have levels "In range", but the T4 is at the top of the range and the T3 is at the very lowest end of the range. That's why it's really important to have your Thyoid evaluated by someone with a functional perspective who is not just looking at the traditional lab ranges and checking a box that says "Fine" as long as you are "In range". Those ranges are, in my opinion, almost useless because they rely on statistics rather than science and experience.
Lab "Reference Ranges" are simply calculated by taking all of the tests run for a particular marker, like TSH or T4 and saying 95% of values fall between this number and that number. We will call that the reference range. If you know that 1 out of every 5 American women has a thyroid problem and many are undiagnosed, then you understand why you need a different way to look at labs. A functional approach that considers what your Thyroid is actually doing not just checking boxes that it's "In Range."
So, back to the liver. If you notice the pattern of a slightly elevated TSH (not enough to be called "out of range" but higher than optimal), a normal T4 and a lower T3 level (even still in range, but low), you know that you are not converting T4 to T3. There are several reasons this can happen. I look at all of those reasons when I evaluate someone, but the liver is a common reason this conversion can be off.
I wanted to tell you about that because I see a lot of people struggling with their thyroid and they are not being given the help they need. The mainstream medical system is failing them by simply waiting until their thyroid issue is very advanced and then just giving them thyroid hormone medications. This medication is almost always a synthetic form of T4 thyroid hormone. You can see how this is not super helpful if they are not converting T4 effectively to T3.
If the liver is hindering this conversion, it's important to figure out why. Are you being exposed to toxins? Are you missing some critical nutrients? Is it time to do a well thought out detox protocol?
I hope this helps you connect a few dots. True health is a total body proposition. Many times it is super helpful to look at what effect one body system has on another. In the case of the liver and the Thyroid, I feel like this is very important and often overlooked.
If you have any questions about this, and want to speak with me to see if this is happening in your case, please feel to reach out and use the button below to schedule a time for us to chat. I can listen and try to help.
To your health!
Dr. Jeni
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