You thyroid gland is located in the front part of your neck adjacent to each side of your pharnyx or what many know to be the “Adams Apple”. The gland is the 3rd of 3 glands that participate in the regulation of metabolism at the cellular level.

The hormones involved in thyroid function are as follows:

  • TRH is a hormone secreted into the bloodstream from the hypothalamus travels into the pituitary gland and causes the pituitary gland to secrete TSH. TSH is a hormone that is secreted by the pituitary gland into the bloodstream until it is picked up by the thyroid gland where it gives instructions to the thyroid gland to produce T4.
  • T4 or thyroxine is a hormone secreted from the thyroid gland into the bloodstream. T4 travels through the bloodstream either bound to a protein (the bound form) or unbound in free form. In its free form it binds to the outside of target cells and is converted to T3, the active form of thyroid hormone.
  • T3 or triiodothyronine, is found in both protein-bound and free forms and directs the cells to carry out various metabolic functions. T3 is the most active form off thyroid hormone.

Okay, so now that we have some context, we can talk about the problem. One of the reasons you struggle with weight retention is because your thyroid gland is not producing enough of one of the first 4 hormones listed above. In other words, you have hypothyroidism.

The causes of hypthyroidism include side effects from pharmaceuticals, exposure to infection, dysfunction of the pituitary or hypothalamic glands, iodine and selenium deficiency, poor diet, auto-immune conditions, electromagnetic fields, and chronic stress.

A sluggish thyroid causes a slow metabolism, which will increase your chances of developing obesity and make it more difficult for you to lose weight. So what can you do about it? If you are struggling to lose weight, you need to be tested. Below I have listed the most important tests you need to check for low thyroid function:

  • TSH – below 2.0 is a good target.
  • Free T4 – should be in the middle of the range
  • Free T3 – should be in the middle of the range
  • Reverse T3 (RT3)– should be on the low end of normal. Too much of this can cause problems with metabolism.
  • 24 hour urine Iodine Spot Test – greater than 90% of the people who take this test are miserably low in iodine
  • Thyroid peroxidase (TPO) antibody – a test which measures the antibodies specific against TPO.
  • Elevated numbers are a problem
  • Thyroglobulin antibody – a test which measures antibodies specific to thyroglobulin the building block for thyroid hormone. Elevated numbers are a problem.
    24 hour urine cortisol and DHEA – If the cortisol numbers are out of range, you have a problem.
  • The adrenal glands MUST always be treated when treating the thyroid gland. Often, weak adrenals are contributory to poor thyroid function.

Find a doctor who is willing to run these tests and stick with them.Treatment goals include symptom improvement, and finding the cause. If your doctor just wants to give you medicine to improve symptoms, you should move on and find someone who is interested in helping you fix the problem.

Thyroid dysfunction is truly one of the most complex medical problems we face in healthcare today and it requires aggressive, comprehensive diagnosis and treatment in order to improve function.

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