Many women experience the frustration of having normal thyroid blood tests even though they have sluggish thyroid symptoms.
In this podcast we talk about three big reasons why you can have many hypothyroid symptoms and still have normal blood tests.
Common sluggish thyroid symptoms include:
We talk about why the size of the thyroid, subclinical hypothyroidism, and the Metabolic Storm can all cause normal testing
Dr. Martin Jr.: You're listening to the Doctors in Podcasts from Martinclinic.com. Although we share a lot of practical and in our opinion, awesome information, what you hear on this podcast is not intended to diagnose, cure, treat or prevent any disease. It's strictly for informational purposes. So enjoy.
Hello, I'm Dr. Martin Jr.
Dr. Martin Sr.: I'm Dr. Martin senior.
Dr. Martin Jr.: And this is the Doctors in Podcast and [00:00:30] this is episode 175. And today we want to talk about a very common story or frustration that we hear about on a regular basis. It's something that we hear in our clinic. It's something that we hear when people email us questions. It's stuff that we hear on Facebook Lives or inside of our private Facebook group, and it goes something like this. So I'll introduce a fictional character, we'll call her Jane, for some reason. [00:01:00] We'll call her Jane. So Jane is tired, she's not sleeping well, she started to gain a little bit of weight. And you know what? She just can't lose it like she used to be able to lose the weight. Also noticed her hair is thinning or falling out a little bit more than it used to. Even her nail seem a little bit weaker. And then even her eyebrows are not as thick as they used to be.
So Jane goes on and looks on the Internet and soon discovers that she has a lot [00:01:30] of symptoms of a sluggish thyroid, of hypothyroidism, right? So she books an appointment with her family doctor. Her family doctor runs the typical tests, typical thyroid stuff, and it comes back and everything's normal. Everything is good. So what we want to talk about today is, how is it possible to have a lot of symptoms of a sluggish thyroid, and yet have still normal [00:02:00] thyroid blood tests? Because this is very common. This is not an isolated incident. This is something that's very common. And another scenario along the lines of that is, Jane goes through all that again, goes and gets tested and the doctor comes back, says, "Yeah, your thyroid's off a little bit. We'll put you on some thyroid meds." And they feel better for a bit. Then they get the same symptoms. And then the doctor checks their levels and they constantly have to adjust the levels [00:02:30] of medication because they can't seem to get the thyroid down pat.
So that's what we're going to talk about today. And there's three ... Listen, there's a lot of reasons why that happens, but we're going to list three big reasons why your thyroid tests are normal, even if you have thyroid symptoms. So that's what we're going to talk about. Now, before we give the three reasons, I think we have to talk first about how complex the thyroid is, and how difficult [00:03:00] it is in terms of all the things associated with thyroid. Because the thyroid is, first of all, it's a puppet. Something else, it's pulling its strings. And the thyroid has a control on every cell in your body, right?
So the way the thyroid works, and we've shared this with you before, so we're going to go through this quickly because that's not really the point of this episode here, is your brain, specifically your hypothalamus secretes a hormone, which is TRH. And TRH goes to your pituitary [00:03:30] and then gets your pituitary to create a hormone that then tells your thyroid to get to work. And of course that hormone is TSH, thyroid stimulating hormone-
Dr. Martin Sr.: That the one that they test, right? That's the most common test for the thyroid is the TSH test.
Dr. Martin Jr.: And so then your thyroid gets going. So your thyroid then makes a bunch of hormones, right? So TSH stimulate your thyroid, your thyroid makes a bunch of hormones. Specifically [00:04:00] it makes T4 it makes T3, T2, T1 and a little bit of Calcitonin. And that's how it works. However, as we've mentioned, every cell in your body is influenced, or affected by your thyroid, and the active hormone that your thyroid makes, that influences cell is the T3. So T3 is the active form in a sense of the thyroid. But when the pituitary tells your thyroid to get to work, 90% [00:04:30] of the hormones made by the thyroid is in the form of T4. So there's another step that has to occur. T4 has to be converted into T3
Dr. Martin Sr.: Where does that happen?
Dr. Martin Jr.: That happens in the liver. So the liver, think of all the things that can affect the liver, can affect the way you convert T4 to T3. So the reason why we went through that is just to give you an idea of the complexity of the thyroid, and how involved it is, and how a [00:05:00] problem with the Hypothalamus, the pituitary, the thyroid, T4, the liver ... There's so many things, that's not including the other stuff in the body, that can block how your thyroid works. Right, which we'll talk about in a second. But the thyroid is very complicated.
Dr. Martin Sr.: And your thyroid is your gas pedal, and your thyroid is your furnace. I mean your body won't regulate itself properly. It will not be able to get into its highest level of octane [00:05:30] energy if the thyroid is not running up to snuff. And the other one is your body temperature. And this is why so many people that have trouble with their thyroid, even though they don't think they have any kind of disease of it, is their body temperatures, especially with their hands and feet, nose, they're very cold, right? They just have a hard time meeting up. And of course the thyroid can go on the other end too, of course. And that's more rare is where they get hyperthyroidism, [00:06:00] and then they're not well. They could get tachycardia, where the heart starts to race and their body temperature goes up. But generally it's the other end.
Dr. Martin Jr.: Yeah, probably the 80/20 rule. At least more than that. Even-
Dr. Martin Sr.: Probably 90/10.
Dr. Martin Jr.: Yeah. Majority of the people complain that their thyroid starts to slow down. So all right. So let's just spend the rest of the time talking about those big three reasons why tests are normal, even if you have thyroid symptoms. [00:06:30] The first reason is, and we'll explain this in more detail, is that the thyroid is tiny. The thyroid is tiny. Now before we go any further, we like to use the example of ricin. Ricin is a poison that's found naturally in castor beans. It's possibly the most deadly poison.
Dr. Martin Sr.: Don't need much.
Dr. Martin Jr.: Well, yeah. Exactly. In fact, a dosage of rice in the size of a grain of rice [00:07:00] will kill you. And that's how powerful ricin is. Well, the thyroid is also very powerful and it's tiny. The thyroid weighs less than 25 grams. To give you an idea how much it weighs, 25 grams, a double A battery weighs 24 grams. So your thyroid ways about the weight of a AA battery.
Dr. Martin Sr.: Not big.
Dr. Martin Jr.: It's tiny yet it controls every system and every cell in your body. [00:07:30] So it's extremely powerful little thing. So even though it's tiny, it can directly influence every cell in your body. And obviously it's so tiny, yet it affects your energy, it affects your weight and affects your healthy skin, healthy hair, your brain. So you can imagine. So you would think that in order to control every cell in your body that the thyroid has to make a lot of thyroid hormone, right? It must make [00:08:00] a dump truck full of T4, T3, T2, T1. It must make a dump truck full. It must be pumping out thyroid hormone 24/7 at massive amounts to control everything on your body.
We know that's not true. That's not true. The thyroid only secretes about one teaspoon of thyroid hormone over a full year. One teaspoon of thyroid hormone production in a year, [00:08:30] and it controls every system in your body, which tells you first, how powerful the thyroid gland is and how things are regulated at a micro level. So the problem with that is, any kind of ... Think about that. Microscopic change in the amount that that thyroid produces can cause every symptom in the book. That's very hard to track. So the thyroid is very tiny. [00:09:00] It doesn't produce a lot of hormones and any kind of slight change can have a drastic effect. And here's the thing, a slight change may affect you more than it affects me. I may need a bigger change for it to affect me.
And when you get your testing, they have this range and if you're inside that range are fine. But what happens if a smaller effect hurts me more than it hurts you? And we're both within the normal range, but I was a little higher [00:09:30] and I'm a little lower in the normal range and I'm getting thyroid symptoms. Because, does it matter what the range says if I'm getting the thyroid symptoms? Of course not. I'm getting thyroid symptoms and that's-
Dr. Martin Sr.: It's amazing how many women that we hear from, and we see women because they're much more susceptible to it. And I'm sure we're going to touch on that as we go into some of the reasons why they're testing can be normal. But let me just say that [00:10:00] women are very instinctive when it comes to their own bodies, much more than men. Men rarely have a clue, right? They don't really care as much. I'm not saying all men are like that, but most men are, at least in my experience, whenever they come to see me, they'd been dragged in. Their health is secondary to most men. Unless they get scared skinny by their doctor, most men, "I feel good and nothing's too dramatic."
But women [00:10:30] are much more sensitive to what's going on in their body. It's amazing their instincts, that they go, "You know what? That's thyroid. And I keep telling my doctor. It's thyroid, right? And that my doctor said, well, yeah, but your tests are normal. I don't care what my tests are normal. I don't feel good. And I think it's my thyroid." Thousands of times I hear that because women are smart, and they understand that-
Dr. Martin Jr.: And they know, like you said. They know what's off.
Dr. Martin Sr.: I know what my hair's like. I know what my weight-
Dr. Martin Jr.: They know [00:11:00] they understand that. They know that their hair is falling out more, or that it's thinner. They know their skin's drier than it used to be. They understand-
Dr. Martin Sr.: Their nails. They look at their nails, they under ... They know what ... I don't know what my nails are like. I never look there. But women, I mean, come on. Anyway, it's interesting because they know they're not well.
Dr. Martin Jr.: Yeah. And that's why they get frustrated when they're told that everything's normal. Right? Alright, so the first reason is how small the thyroid [00:11:30] is. The second reason why your tests can be normal, even though you have thyroid symptoms, has to do with the term called subclinical hypothyroidism. And we'll get into that. So first of all, let's just talk about this word subclinical. Now, according to Dr. Google, I wanted to get the very straight definition of subclinical. Subclinical basically means anything related to or denoting a disease, which is not severe enough to present definite or readily [00:12:00] observable symptoms.
So subclinical means, you're having symptoms but not enough to move the needle on the blood testing. Right? And here's the thing. When it comes to the thyroid, subclinical hypothyroidism can exist for seven years before lab numbers are affected. So you can have thyroid symptoms for seven years before anything shows up on blood testing. So think of what that, seven years of fatigue, seven [00:12:30] years of weight gain, seven years of poor sleep, dry skin, hair falling out, all those things, before it shows up on a blood test.
Now here's the question. Should you have to suffer with these symptoms for that long, just waiting for your numbers to change? It sounds ridiculous, but that's the very same thing that many women go through when their thyroid starts to slow down because it's subclinical. And this is what I want to hammer home the point on this is, [00:13:00] so why does it take so long for those blood numbers to change? And it's because of something that's called receptor site sensitivity. And that's important to understand. So I'll explain that.
Now, imagine every cell in your body has little receptors, like little antenna. And what they do is they transmit the signal from the hormone outside the cell to inside the cell. So you can have a [00:13:30] normal amount of hormone circulating in your blood, but the hormone isn't having the same effect on the cell because the receptors are damaged. The receptors are no longer working the way they should. And that happens with the thyroid. But by the way, we talk about this all the time, the same thing happens with insulin.
Dr. Martin Sr.: Yeah, absolutely.
Dr. Martin Jr.: The cells become resistant to a certain extent to insulin. Well, the cells stop. They don't respond to [00:14:00] thyroid hormone the same way. And here's what's interesting. One of the major ways that receptors or those little intend to get damaged is inflammation. And what's a major cause of inflammation in the body? We call it an accelerant all the time.
Dr. Martin Sr.: Yeah. Cortisol.
Dr. Martin Jr.: Cortisol. A problem with your adrenals can destroy your thyroid gland.
Dr. Martin Sr.: Yeah.
Dr. Martin Jr.: In a sense that it destroys the receptors and how they work, meaning [00:14:30] you have normal thyroid hormone levels according to your blood tests, but your cells aren't responding to it. That's receptor site sensitivity. That's a problem. So you will have normal tests for now, because things change.
Dr. Martin Sr.: Eventually, they will come out-
Dr. Martin Jr.: For seven years you can have normal tests.
Dr. Martin Sr.: That's a long time to wait.
Dr. Martin Jr.: And that's what's so frustrating about it. And the symptoms can get worse over time, but yet you're still producing enough of the hormone, or it's [00:15:00] been such a microscopic change that it doesn't even register or it's just still within a normal range on the blood test. So you can see why that's frustrating, which is why we talk a lot about even the effect that cortisol, so stress kills your thyroid. If you're stressed long enough, or your body has a cortisol problem for a long time, your thyroid, especially if you're a woman, your thyroid is going to be a victim. We wrote a book on this years ago, 'The serial killers: Two hormones that want you [00:15:30] dead.' And elevated cortisol is a serial killer. One of the victims is to absolute your thyroid. It absolutely will take your thyroid with it.
So that's what happens. So that's the second reason. So the first was your thyroid is small, it's tiny, secretes a teaspoon of thyroid hormone a year. And the second one is subclinical hypothyroidism. You can have a receptor, you're a little antenna on the cells can be damaged. You're making enough hormone, but your cells aren't getting it. So it's reacting like you're not getting any or not getting [00:16:00] enough, and you have sluggish thyroid symptoms. So that's the second reason.
Now, the third reason is something that you and I have talked about a lot, and that's what we call the metabolic storm, because the thyroid-
Dr. Martin Sr.: Not independent.
Dr. Martin Jr.: The person thinks they have a thyroid problem and they do. But they're actually in a metabolic storm, meaning they also have a problem with their adrenals and they also have a problem with their ovaries. And I know a lot of women are saying, "Yeah, but I don't have my ovaries anymore." Well then you definitely [00:16:30] have a problem with estrogen, and progesterone, which is what we're talking about when we talk about ovaries. But you're in the metabolic storm. And when you're in the metabolic storm, you have a problem with your adrenals, specifically, cortisol. You have a problem with your thyroid hormones and you have a problem with estrogen, progesterone. And it's creating this real hormonal problem and it's given you a ton of symptoms but not in enough in a sense to change the blood work on your thyroid because the adrenals are equally [00:17:00] involved and estrogen and progesterone are equally involved.
So they're actually in something that we call the metabolic storm. And we've talked a lot over the years about this. Over the years. We'd call it the Bermuda Triangle of hormones. You've talked a ton about that over the years and a lot of videos, but that's the third way and it's because it's the way they're connected those three. If you have a thyroid, a longstanding thyroid, you're going to have adrenals and ovary issues. Same thing. You can start off [00:17:30] with a lot of adrenal issues, a lot of stress, and as I mentioned, it can kill your thyroid. It can also affect how you make your estrogen and your progesterone. So it's a mess.
Dr. Martin Sr.: Yeah, it's a mess. And the thing is, unless you're thinking outside the box, unfortunately a lot of times is that doctors of all kinds just never pick up on that. People fall through the cracks with all these symptoms. And because they're not [00:18:00] looked at holistically in this metabolic storm or in the Bermuda Triangle, like you said, ovaries, the adrenals and insulin. Insulin, it's a food hormone and that can mess up. That's part of that storm too. So you've got to take it all into consideration when you look at the thyroid, because the thyroid, it's the orchestra leader. It really is. It's at the top of the food chain and it's the one [00:18:30] that it better be working otherwise you're in deep trouble. But it doesn't act independently of the things we talked about. And this is why a lot of people fall through the cracks for sure.
Dr. Martin Jr.: Here's the thing, we'll wrap up this episode by just kind of ... So if you have all these thyroid symptoms and your testing is normal or you have to keep adjusting your thyroid levels, there's a good chance that one of those three things are involved. [00:19:00] There's no question. And here's the thing on our website, Martinclinic.com we have a metabolic storm program that we've had for the last little bit. It's a video program, and a lot of women have gone through it. And the testimonials that we get of women going through this program and how it's helped them with their hormones and feeling better and getting her energy back, is unbelievable. It's completely a free program. You just got to go to our website and it's on our homepage and just sign up for it and watch [00:19:30] the videos.
And we talk a lot more about hormones in that video series. So that's one thing you can do. And also here's the question, and if you've been with us for while you know what this question is going to be. Here's the question that you have to be able to answer. When was the last time you felt fantastic, first of all. And how do you feel? If you have a lot of thyroid symptoms, then you want to address your thyroid nutritionally with nutrients, with diet, [00:20:00] because your thyroid is telling you it's a problem. It's flashing. The thyroid is telling you when there's a problem. You have thyroid symptoms for a reason. It doesn't necessarily matter what the blood testing is saying. There's still a lot you can do from a natural standpoint to help fix that issue.
Again, hormones are complicated, but you've been around dealing with them for a long time. We've tried to keep it as simple as possible. So we know we give a ton of information, which is why there's a lot of ways that you can get [00:20:30] ahold of us if you have questions. Again, we want to thank you for listening and have a great day.
Dr. Martin Sr.: Thanks for listening to the Doctors in Podcast from Martinclinic.com. If you have any questions, you can reach us at the info@MartinClinic.com. If you're a newsletter subscriber, you can hit to our website and sign up for free. We also have a private Facebook group that you can join. It's a community of awesome people. Finally, I do a Facebook [00:21:00] Live every Thursday morning at 8:30. Join us again next week for a new episode.