The second difficulty in diagnostic hypothyroidism is that we, as physicians and scientists, are trained to rely more on objective findings, such as laboratory tests, than subjective factors, such as a patient’s symptoms. Unfortunately, many doctors will not feel comfortable making a diagnosis of hypothyroidism if a patient’s blood tests fall anywhere within what is strictly defined as the normal range, even if such levels may be close to indicating the possibility of an under active thyroid gland in a symptomatic patient. There are definite “gray zones” that exist clinically; such that a patient’s clinical symptoms may not be completely documented by their laboratory results.

It is important to remember that blood tests only reflect a “moment in time” in the human body and consequently may not always accurately represent its true condition! Therefore, a patient’s symptoms must be considered as being of equal significance as their blood test results in diagnosing hypothyroidism.

In my experience, many women who present with physical and psychological symptoms associated with hypothyroidism will have some degree of improvement when treated with supplemental thyroid medication.

Improvement should be noted in two to eight weeks. Increases in energy levels, sex drive, body temperature and memory are the first changes noted. Water retention also improves fairly rapidly. An increased feeling of well-being may also be noticed, as depression resolves.

Hair and skin begin to improve after 4-6 weeks, but weight loss usually will take quite a bit longer since the body takes time to breakdown existing fatty deposits. When I treat women who have symptoms associated with hypothyroidism, I initially use a natural thyroid medication that has been available since the 1940’s, called Armour Thyroid Extract U.S.P. It is a combination of two active forms of thyroid hormone, T3 and T4. T4 is the form of the thyroid hormone that is in the synthetic thyroid medications commonly prescribed today. Normally, T4 is converted into T3, which is the biologically active form of the thyroid hormone that actually controls the body’s metabolism. In a significant number of individuals, the body is unable to properly convert T4 into T3. Hence a patient may be clinically hypothyroidism, yet have “normal” blood tests. Therefore, I find that a woman’s clinical response to the natural form of a combination of T3 and T4, will often be better than giving T4 alone.

It is of critical importance that a physician be finely attuned to a patient’s symptoms and her symptomatic response to treatment. Thyroid supplement therapy is very individualized, since the dosage requirements are quite different for each patient.

Fortunately, thyroid supplementation has no significant risks or downsides. A patient virtually never becomes hyperthyroid when taking dosages of medication typically prescribed. If a patient feels some degree of clinical improvement after 6 – 8 weeks on medication, treatment will be continued and will be necessary for the duration of their lifetime. If, however, a woman notices no symptomatic improvement with thyroid hormone supplement treatment, the medication should be discontinued and an alternate diagnosis be pursued.

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