Folks often ask “what tests should I get?” when it comes to thyroid labs. Here’s a good basic list: Free T3 Free T4 TSH Reverse T3 TPO and TgAb (antibodies for Hashimoto’s) and TSI (antibodies for Grave’s). Note that upwards of 80% of those with […]
I often hear the question “what are your best tips for starting the AIP (Auto-Immune Protocol)?” Dramatically changing up your diet and lifestyle can be daunting, that’s for sure. So, as requested, here are 20 tips for starting AIP. First, the food part: 1) BABY […]
So many of us with thyroid conditions are put on synthetic meds like Levothyroxine or Synthroid. These meds contain synthetic versions of the thyroid hormone T4. However, many of us are “poor converters”. This means that our bodies have trouble converting T4 into the useable […]
I have a few friends who have kids with ADHD, so this study piqued my interested. The study explores the correlation between zonulin and ADHD.
Zonulin is a protein found in our guts that helps regulate “drawbridges” and “trap doors” found in the gut lining. Those drawbridges and trap doors determine what’s stays in the gut and what is ready to leave the gut to be used by cells in the body.
Gluten (technically gliadin, a protein found in gluten) messes with how zonulin works and can cause these bridges and doors to get stuck open, much like the drawbridges in this photo (ok, the ones in the photo weren’t really stuck, they were all open for the semi-annual boat run in Chicago).
If your “trap doors” get stuck open, lots of things get through that aren’t supposed to get through. This is known as leaky gut or intestinal permeability.
And leaky gut can lead to autoimmune disease. Yes, genetics and environment play a HUGE role in acquiring AI disease, but, in a nutshell, that is what happens. My point is, one thing leads to another which leads to another, which may create a whole host of health issues.
My own reaction to this study is that a gluten-free diet may help kids with ADHD. What do you think?
From the study:
Children with ADHD had higher serum zonulin levels and were more impaired in social functioning compared to controls. The level of zonulin was independently predicted with hyperactivity symptoms and SRS scores in regression analysis.
In this sample of children with ADHD, elevated zonulin levels were associated with increased symptoms of hyperactivity and impairment of social functioning.
Full abstract of the study here for those curious:
Functional medicine – what is it? What is a functional medicine practitioner, or functional MD? What is a functional medicine health coach? Good questions all! Functional medicine, in general, looks at the whole body, instead of just a part at a time. Everything is connected, […]
What is AIP? AIP is the AutoImmune Protocol (sometimes called AutoImmune Paleo). The most important thing to remember about the AIP is that it is NOT a diet – it is a PROTOCOL that includes dietary interventions. Aside from diet, the protocol addresses lifestyle, sleep, and […]
It’s best to not take any thyroid meds prior to your labs, as T3 spikes rather quickly in the blood and may give you a false high reading in your labs – and your doctor may want to decrease your meds, which may not be the best thing. Skip your meds for 12 hours prior to blood work.
I also do all my labs first thing in the morning, while fasting. This gives a good baseline with fewer variables – for example, food may also affect TSH/hormone levels. Fasting lessens the chance of this variable affecting labs.
Biotin has also been known to skew labs, so it’s good to stop taking it a few days before any blood work.
So, what labs to get? A full panel consists of:
Antibodies: TPO and TgAb (for Hashimoto’s) and TSI (for Graves).
NOTE: Some sources say that upwards of 80% of those with hypothyroidism also carry the antibodies to the autoimmune disorders Hashimoto’s and Graves. Still, it’s good to check and monitor antibodies just to be sure – and to make sure that the antibody counts aren’t rising crazily. Keep in mind that you can have elevated antibody counts and few or no symptoms – but if the antibody counts keep going up, something is going on. Best to figure it out and get it in check before you DO start to have symptoms!
Now, a word on TSH. I’ve said this before and I’ll say it again: TSH is a pituitary hormone, NOT a thyroid hormone. If the body is not making enough thyroid hormone, the pituitary gland signals the thyroid to make more hormone by stimulating it (with TSH, aka Thyroid Stimulating Hormone).
When the TSH levels go down, some doctors may think that that’s good enough and move on. However, it’s best to check the Free T3 and Free T4 labs as these will give you a clearer picture of what exactly is happening in your blood. The Free labs test the unbound hormones. Other labs (T4, total T3, etc) may test the bound and unbound – which doesn’t give as clear a picture.
If you are on an optimal dose of thyroid replacement hormone (levothyroxine, Synthroid, Amour, Naturthroid, Westhroid, etc) your Free labs should be in the upper parts of your lab’s range. Not just “in range”, but the *upper* parts.
Also, when on an optimal dose of T3 containing thyroid meds it is quite common to see a very suppressed TSH. This is to be expected and no cause for alarm, remember that TSH is a pituitary hormone, NOT a thyroid hormone. If there is enough thyroid hormone circulating in the body the pituitary gland will have little reason to stimulate the thyroid gland to make more.
If you are optimally dosed (Free T3 and Free T4 in the upper parts of the range AND your symptoms have lessened or disappeared completely) but still have a high TSH, this may indicate a pituitary issue, not a continuing thyroid issue.
– stop taking biotin a few days before labs
– stop taking thyroid meds 12 hours before labs
– do labs first thing in the morning, fasting
– get a FULL panel, not just TSH.
If your doctor refuses to order these labs, it may be time for a new doctor…! Know that you can also self-order labs from many places online, I’ve been doing this for years due to insurance issues. Easy peasey!
I get asked that question a lot. Heck, I even had that question at one time! A sports coach came to mind whenever someone mentioned the term “health coach”. The vision I had was of someone throwing things at you, telling you what to do, […]
Greetings all! This website has been a long time coming, and I’m excited it’s finally up and running! Within its walls, you will find, among other things, blog posts on various topics ranging from lifestyle to thyroid and adrenal health. And, of course, I love […]