Beyond the Thyroid - Episode 2: 3 Things I Wish More Doctors Knew About Thyroid

Welcome back to Beyond the Thyroid! I'm Dr. Dana Gibbs, and in this second episode, I’m building on the foundational knowledge I shared in the first episode by diving deeper into thyroid physiology and common thyroid disorders. I’ll also be sharing a compelling story about a young patient that highlights the importance of thinking outside the box when diagnosing thyroid issues.

A Young Patient's Journey to Diagnosis
I want to start by telling you about "Brianna," a high school student who came to my clinic after seeing several other doctors. She’s a talented singer, but she was struggling with hoarseness, vocal fatigue, and neck discomfort. Despite following all the recommended treatments, her symptoms just wouldn’t go away. When I examined her neck and took her family history into account, I discovered that she had Hashimoto's disease, an autoimmune condition affecting the thyroid.

This experience really emphasizes how important it is to thoroughly examine patients and be willing to consider less obvious diagnoses, especially for younger patients who may not fit the typical profile for thyroid disorders.

Understanding the Basics of Thyroid Physiology
Now, I want to go over some key concepts about thyroid physiology and testing that I wish more doctors understood:

1. The Limitations of TSH Testing: The TSH (Thyroid Stimulating Hormone) test is often used to assess thyroid function, but it can be misleading. Just because a person’s TSH level is normal or low doesn’t mean their thyroid hormones are balanced. I always recommend additional tests, like Free T4 and Free T3, to get a clearer picture of thyroid health.
2. Thyroid Hormone Conversion: The thyroid gland produces T4, a precursor hormone, which the body needs to convert into the active hormone T3. But there’s also Reverse T3, a molecule that can block T3’s effects, complicating the assessment of thyroid function. This is something I look for when evaluating patients.
3. The Importance of Consistent Testing: Thyroid hormone levels fluctuate throughout the day, so it’s crucial to get blood drawn at the same time during your dosing cycle to ensure accurate and comparable results. I can’t stress this enough for managing your thyroid health.

Practical Tips for Thyroid Management
If you're managing a thyroid condition, here are some practical tips that have helped my patients:

• Splitting Medication Doses: I often recommend splitting your daily dose of thyroid medication into two doses, 12 hours apart. This helps maintain more consistent hormone levels throughout the day.
• Timing Your Blood Tests: When getting blood tests done, aim to do it halfway between your morning and evening doses. This will give a more accurate assessment of your thyroid hormone levels.

In future episodes, I’ll be talking about the wide range of symptoms that can signal thyroid disease, and I’ll delve deeper into how thyroid hormones interact with other systems in the body. Stay tuned!

If you found this episode insightful, please consider leaving a five-star review for the Beyond the Thyroid podcast. Your support helps others find this valuable resource. To learn more about Dr. Gibbs and her approach to hormone health, visit her website at www.danagibbsmd.com. Remember, this podcast is for educational purposes and should not replace personalized medical advice. Stay tuned for more episodes as we continue this journey together beyond the thyroid.