Thyroid Problems Becoming More Common: 3 Blood Tests to Take

Friday Jan 23 | BY |
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Thyroid Tests

There is no reason for people with thyroid imbalance to go undiagnosed.

There’s a lot of concern about thyroid health. There should be! It’s a problem that’s getting worse.

Doctors used to think that for every eight low thyroid cases, one was of overactive thyroid (hyperthyroidism), and the other seven were of underactive thyroid (hypothyroidism).

That’s changed. Now, general practitioners see one hyperthyroid case in about every four hypothyroid cases. And, hypothyroidism is becoming more common. The same goes for autoimmune thyroid disease.

When I first started practicing about thirty years ago, autoimmune thyroid disease like Hashimoto’s Thyroiditis was uncommon. Now this condition is not only more common, but more complicated, and there’s a gender difference: it’s 15-20 times more common in women than in men.

The Beginnings of Thyroid Treatment

One of my first mentors in bio-identical hormone replacement therapy was Dr. Thierry Hertoghe from Belgium. We spent time together in the mid-1990s in San Diego and I later visited his clinic in Brussels. One of the many things that made Dr. Hertoghe a leader in hormone therapy was his family background. His lineage spans more than four generations of endocrinologists, including his great-grandfather who was the first doctor in Europe to give patients thyroid hormone.

At that time, desiccated pig thyroid gland preparations were used. It was not until 1958 that the first synthetic levothyroxine tablets were marketed in the US.

I saw the original photos of patients before diagnosis and after three months of treatment. A thirty-year-old man with a few strands of thin white hair, dropping facial muscles, puffy eyes, and a blank stare was transformed into a young man with thick dark hair, erect posture, and a clear gaze. The results were so dramatic, patients and doctors believed it was like a miracle.

We’ve learned a lot about the thyroid gland since the time of Dr. Hertoghe’s great-grandfather. Doctors and patients now regularly perform blood tests to evaluate thyroid health.

In our times, there is no reason for people with thyroid disease to go undiagnosed.

What Tests to Take?

Because thyroid gland disease and hormone imbalance has become so common, I routinely screen all new patients using three basic blood tests. You no longer need a doctor to check your thyroid health markers, though. You can order your own blood tests through online personal lab testing services.

To see if your thyroid is functioning correctly, order these three tests: Thyroid-stimulating Hormone (TSH), Free Thyroxine (free T4), and Free Triiodothyronine (free T3).

Basic Thyroid Screening Panel

Test Names 2

I find these three tests more useful for my patients than the standard thyroid panel that includes T3 uptake and total T4, because results are relatively easy to interpret.

If your TSH is high, your thyroid gland is under functioning. TSH is a hormone made in the pituitary gland, which regulates the function of the thyroid gland. When the body needs more thyroid hormone, the pituitary secrets TSH, which signals the thyroid gland to increase hormone production.

A low TSH level means your thyroid gland is on overdrive, so the pituitary gland doesn’t need to secrete TSH. Low TSH suggests hyperthyroidism.

If you are not on thyroid hormone replacement therapy, results within the desirable range suggest a normal functioning thyroid gland. However, if you have hypothyroidism and are taking thyroid hormone replacement, you may not feel well until your TSH is in the optimal range level.

TSH graphic 2

The same goes for Free Thyroxine and Free Triiodothyronine. To feel well and more energetic, you may need to achieve FT4 and FT3 levels in the upper limits of the normal range

Your FT4 is the form of thyroxine that circulates in the blood unattached—“free” or unbound to proteins that help shuttle hormones around the body. Too much is associated with hyperthyroidism. Too little means an underactive thyroid and is associated with metabolic syndrome.

Free T3 is a form of bioavailable thyroid hormone and the most metabolically active of thyroid hormones. Too little is associated with hypothyroidism and too much with hyperthyroidism. Some thyroid experts call FT3 the metabolic throttle that fuels cellular function. Low levels are also associated with coronary artery disease and other states of chronic inflammation in the body.

Symptoms of Thyroid Problems

Severe chronic fatigue is the main symptom linked to an under functioning thyroid gland. But there are many other symptoms, including dry rough skin and hair loss, that make up the complete symptom picture of hypothyroidism.

Top 10 Symptoms of Hypothyroidism

  1. Dry, coarse skin
  2. Fatigue and lethargy
  3. Slow thinking
  4. Depression
  5. Reduced heart rate
  6. Increased sensitivity to cold
  7. Tingling or numbness in the hands
  8. Goiter (an enlargement of the thyroid gland in your neck)
  9. Constipation
  10. Heavy menstrual periods

Top 10 Symptoms of Hyperthyroidism

  1. Fatigue and weakness
  2. Rapid heartbeat
  3. Feeling shaky, overly nervous
  4. Weight loss
  5. Increased appetite
  6. Diarrhea
  7. Thin skin
  8. Intolerance to heat and excessive sweating
  9. Goiter
  10. Bulging of the eyes

If you have any of these symptoms, get tested for TSH, FT4, and FT3. If you find abnormal results, see your doctor or endocrinologist for an assessment and to figure out if other tests are necessary.

What’s Causing It?

Hypothyroidism is a relatively common condition. Hyperthyroidism and autoimmune forms of thyroid disease are becoming more common than ever before. We don’t know all the reasons for rising thyroid gland imbalance, but stress, indoor air pollution, chemicals in our water and food supply, and modern diet—including iodine deficiency—are just some of the potential causes.

Increased levels of radiation exposure, including overuse of dental x-rays, and long-term exposure to bisphenol-A (BPA) found in plastic water bottles are two other potential triggers.

One common thread in the mystery is inflammation. Thyroiditis (inflammation of the thyroid) is a known medical condition. Hashimoto’s thyroiditis is an example of a type of autoimmune hypothyroidism.

Chronic, low-grade inflammation may have a role in other forms of thyroid disease as well. For example, gluten and gliadin associated with allergy to wheat are known to trigger inflammation. If you have celiac disease, you are four times more likely to develop an autoimmune thyroid condition.

Some experts claim we are in the midst of an epidemic of undiagnosed thyroid disease. All the statistics are not in yet, but from a clinical perspective, doctors are seeing more thyroid cases than before. One thing we do know is that all autoimmune diseases are becoming more common, including autoimmune thyroid conditions.

Given that all types of thyroid diseases have become common, including thyroid cancer, it’s wise to consider testing your thyroid gland.

Dr. J. E. Williams


Dr. Williams is a pioneer in integrative and functional medicine, the author of six books, and a practicing clinician with over 100,000 patient visits. His areas of interest include longevity and viral immunity. Formerly from San Diego, he now resides in Sarasota, Florida and practices at the Florida Integrative Medical Center. He teaches at NOVA Southeastern University and Emperor’s College of Oriental Medicine.

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  1. June Hanson says:

    Very appropriate, as January is Thyroid month. I, can read your very informative article, several times, still cannot comprehend. To say, I am so thankful, your my Doctor, is putting it mildly. Other Doctors only measure T3 or T4. Had that done for years, still had problems. You were so thorough with my blood tests. You see problems that will arise, before they happen. You, changed dosage, have not had any problems for years.

    Appreciate that you are so thorough, take time to explain. Always have alternative, natural methods, from all your years of research. Interested in life style of patients. So many times there is a reason, adding healthy changes, reap big benefits.

    Years ago if child or adult was overweight it was always her Thyroid. Simple med was given, they just kept gaining weight. Thyroid is such a important hormone, takes someone who, will think, outside the medical box. Do extensive testing.

    We have more hidden thyroid problems, than ever before. As you say, this modern world of chemicals, etc, do affect our bodies. Let us heed your advice, become aware of what is happening to our world, and do something about it.

  2. I didn’t see the two antibody tests for Hashi’s mentioned. You cannot assume a patient has Hashi’s just by Free T3 and Free T4 plus TSH. There is also Reverse T3, which can be significant for someone who has additional illness; it can replace Free T3 in the receptors and essential worsen the patients condition; I have been there and done that and have had a compassionate and knowledgeable physician to assist me in my recovery. There is also the problem of insufficient adrenal function that can be related to poor thyroid function and all the thyroid treatment in the world is not going to work until this has been addressed and properly treated. BTDT. These can be crucial in the continued illness of a patient or their gradual recovery with proper treatment. The article was very good, but incomplete.

    While some of the information in this article is helpful, there are a few statements which are incorrect. Please review the information at the above website. It reflects the experience of many thyroid patients over a number of years.

  4. Mary says:

    What is not mentioned in the article is the amount of bromine, fluoride and chlorine in our environment and diets. All displace iodine in the body. And it is not just the thyroid that requires iodine.

    No wonder we are having more and more thyroid issues.

  5. Irma says:

    Thyroid awareness is now! Please continue to bring this topic to the forefront. I was on antidepressants for 15 years. My medications stopped working after 5 years, but the doctors offered no other treatments. They offered no diet recommendations and did the wrong tests. Finally got an accurate diagnosis of Hashimoto’s after one doctor did a full thyroid panel that checked the antibodies. Chronic fatigue, Fibromyalgia, depression, and anxiety can a lot of times have something in common, a thyroid disorder. The following doctors have amazing stories, a lot of them have been on their own personal journeys to healing!
    Dr Kelly Brogan, Dr Mark Starr, Dr Kent Holtorf, Dr Jacob Teitelbaum, Dr Steven Hotze, Dr David Brownstein, Dr Denis Wilson,and Dr Ben Lynch

  6. Unfortunately, many doctors, including my own endocrinologist are useless when it comes to finding a solution for hypothyroidism. I feel exhausted all the time and am constantly trying to find my own solution to just feel normal. For the last two weeks I have had to take 3 hour naps each day plus sleep 8 hours a night and yet I am dragging and my mind is in a fog. Synthroid is not the answer for me though I take it but what is? I’ve spent so much money and time starting over again with new doctors only to find them Big Pharma robots.

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