Thyroid Testing

The thyroid is one of the most important areas to look at to improve your energy and overall health. Our testing measures the full panel of thyroid markers, giving you a complete picture of your thyroid function and it’s role in other health complaints.

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Thyroid Testing London

Thyroid is a vital endocrine gland that affects many aspects of our metabolism.

According to the British Thyroid Foundation, 1 in 20 people in the UK suffers from thyroid disorders. However, this doesn’t tell the whole story as thyroid disorders often go undiagnosed. 

Identifying thyroid dysfunction early is crucial as it may help safeguard against the development of chronic diseases such as diabetes, obesity, heart disease, and depression. Thyroid hormones also play central metabolic roles in sexual and reproductive health in both women and men.

How do I get my thyroid checked in the UK?

There is a great deal of debate in the medical literature about thyroid testing. Doctors have been relying on testing TSH (thyroid stimulating hormone) levels to diagnose and treat patients with thyroid disorders. However, TSH alone or even combined with T4 does not provide the full picture. There are so many other markers related to thyroid function that could lead us to the correct treatment of our patients. It is also important to note that the current reference range is too broad, preventing preclinical diagnosis of thyroid disease. An important part of recognising and treating thyroid dysfunction is early diagnosis as there is so much that can be done before the patient reaches diseased state.

Furthermore, it is likely that just looking at a laboratory value like TSH, while useful, is not the only data that should be relied upon. The standard medical approach often forgets that the treatment should be individualised to each patient rather than putting everyone in the same box. As thyroid dysfunction is such a multifactorial disease and has many factors contributing to it, it is vital that all pathways and body systems are explored and that we work upstream to find the cause.

The standard blood test available on the NHS currently looks at one, possibly two markers. One is TSH and the other one is T4. Testing for such a limited number of markers often leads to under-diagnosis or misdiagnosis and the patient often walks away thinking their thyroid function is fine. Additionally, they may be given statins to control their cholesterol or antidepressant to correct low mood, both of which are strongly associated with thyroid dysfunction. 

The problem with this approach is that thyroid physiology is complex. The production, conversion, and uptake of thyroid hormone in the body involves several steps. A malfunction in any of these steps can cause hypothyroid symptoms but may not show up on standard lab tests. 

Here are 5 major thyroid patterns that won’t show up on standard medical tests:

1. Hypothyroidism caused by pituitary dysfunction. This pattern is often caused by elevated cortisol, active infection, blood sugar imbalance and chronic stress. It means that the pituitary gland sends the incorrect messages to the thyroid. With this pattern TSH level is within the normal range but if tested T4 may show up below the optimal range.

2. Under-conversion of T4 to T3. This common pattern is often caused by inflammation and stress but can also be caused by nutrient insufficiency. TSH and T4 will be normal but the patient is experiencing symptoms of underactive thyroid. 

3. Hypothyroidism caused by TBG. Thyroid binding globulin is the protein that transports thyroid hormone through the blood. When the thyroid hormone is bound to TBG, it is inactive and unavailable to the tissues. When TBG levels are high, levels of unbound (free) thyroid hormone will be low. This presentation is often linked with high oestrogen levels often associated with birth control pills.  This pattern will show normal TSH and T4 levels.

4. Hypothyroidism caused by decreased TBG. This is the mirror image of the pattern above. It’s caused by increased levels of testosterone. In women, often associated with Polycystic ovarian syndrome and/or insulin resistance. Again, TSH and T4 would be presented as within range.

5. Thyroid resistance. In this pattern, both thyroid and pituitary glands are functioning normally but the hormone can’t get to cells where they are needed. This pattern is usually associated with chronic stress, high cortisol and homocysteine. All markers will be presented as normal.

At the London Clinic of Nutrition, we take a functional medicine approach and we’ll test for the appropriate thyroid markers and run other blood tests based on your symptoms and history.

 

What is the best test to check for thyroid problems?

The thyroid gland is vital to the metabolic activity of almost every cell in the body and is extremely sensitive to any change and imbalance, so we must consider a system-wide approach when looking at thyroid function. 

A comprehensive functional test for thyroid health should include many markers and elements to assess key patterns. The type of test and the markers being investigated will be based on the patient’s history, triggers and symptoms. 

As mentioned above, there are two markers that the NHS routinely tests:  TSH and T4. But to fully understand and treat the root cause of thyroid complaints, we often check other markers in your blood:

  • T3 is the active part of the thyroid hormone. This test isn’t offered routinely on the NHS.

  • Thyroid antibodies: There are many reasons why the body may start producing thyroid antibodies. Once this process starts, the antibodies attack the thyroid and affect its function which ultimately leads to thyroid autoimmunity. These markers include anti-thyroid peroxidase antibodies and anti-thyroid globulin antibodies.

  • Reverse T3 levels: Reverse T3 mimics T3 in the body but does not perform the same function. It is influenced by high cortisol levels, which can arise from adrenal stress, heavy metal exposure, chronic illness and vitamin and mineral deficiencies.

  • Free T3 and T4: This is the only portion of the hormone that exerts its effect at cellular level. It is important to consider this marker and it also gives an indication of sub-clinical manifestations of thyroid dysfunction.

Full thyroid test London

When lab results for thyroid function come back as “normal,” it’s easy to assume that everything is functioning well. However, there are several different reasons these results can be misleading. As discussed above a “normal” lab result may not always mean optimal thyroid function. This is where functional medicine offers a much thorough and comprehensive approach and fully investigates this multifactorial and global disease. 

Here are just some of the many thyroid tests we provide at London Clinic of Nutrition:

 

Thyroid plus Screen 

This blood test provides a thorough analysis of thyroid gland activity including thyroid production and secretion, thyroid conversion and autoimmunity. The markers measured are: Thyroid- stimulating hormone (TSH), Total thyroxine (T4), free T3, free T4, anti-thyroglobulin antibodies (Anti-TG), anti-thyroid peroxidase antibodies (anti – TPO) and Reverse T3.

 

Thyroid Vital (FDX)

This thyroid test includes a full blood chemistry panel containing all the thyroid markers plus an additional 50 markers that give vital clues into how the body’s systems and processes are functioning. These markers provide information on inflammation, oxidative stress, nutrient deficiencies, infection and pathogenic load, toxicity and resilience. This is one of the most common and useful tests that we use in the clinic.

 

Private thyroid-related tests London

At the London Clinic of Nutrition, we take a functional medicine approach to assessing your thyroid health and our practitioners often find that further lab tests can be useful in identifying possible causes and related mechanisms. Our approach is always personalised and keeps the patient’s specific needs and lifestyle in mind.

Here are some of the tests we may consider during your visit:

1. Gluten sensitivity/Celiac: Several studies show a strong link between autoimmune thyroid disease (both Hashimoto’s and Graves’) and gluten intolerance. Strangely, the connection is explained by mistaken identity. The molecular structure of gliadin, the protein portion of gluten, closely resembles that of the thyroid gland. When gliadin breaches the protective barrier of the gut, and enters the bloodstream, the immune system tags it for destruction [1]. 

2. Gut-thyroid connection - Poor gut health can suppress thyroid function and trigger Hashimoto’s disease, and low thyroid function can lead to an inflamed gut and potential food intolerances.

3. Blood sugar and metabolic syndrome. There are several studies suggesting there is a strong correlation between insulin resistance, obesity and poor thyroid function [2] and therefore investigating and treating blood sugar is an integral part of our approach.

4.  Adrenal stress is probably the most common problem we encounter in functional medicine and the thyroid is no exception. Adrenal stress can manifest in many ways, leading to autoimmunity, thyroid resistance, reduced conversion of T4 (non-active) to T3 (active), disruption to the endocrine system.

5. Nutritional status testing. The most crucial nutrients include Iodine, Selenium, Zinc, and vitamin A, B, C and tyrosine. These nutrients are often included in a comprehensive thyroid panel.

6. Infection. Viral infections such as Epstein-barr can be a potential trigger for poor thyroid function, so an important consideration whilst investigating thyroid health.

7. Toxicity. Some of the common toxins, particularly heavy metals, are often included in the more comprehensive thyroid tests, as they seem to be key triggers in the development in thyroid disease. 

There are a wide range of tests available and only your practitioner will be able to determine the most suitable test for you following an initial consultation. We have a large team of thyroid specialist practitioners who specialise in thyroid health and would be more than happy to help.

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