Comprehensive thyroid testing could save your life

There are more than 300 symptoms associated with thyroid disease — and I look for every single one during an evaluation. Needless to say, I see a lot of patients with this illness.

But I can only imagine how many more fly under the radar, underdiagnosed and undertreated. All because of conventional medicine’s stubborn commitment to treating numbers and not people.

Obviously, it’s a problem. Untreated thyroid disease can be the culprit behind a huge range of issues that leach your quality of life — like fatigue, depression, anxiety, and weight problems, to name a few.

But ignoring the signs of an over- or underactive thyroid also sets you up for much bigger trouble behind the scenes. In fact, as one new study shows, even supposedly “normal” thyroid hormone levels can pave the way to lethal problems.

Specifically, this research showed that high and normal-high levels of thyroid hormone thyroxine — free T4, or FT4 for short — are linked to hardened arteries and cardiovascular death among older patients. Even after accounting other heart-related risk factors, like elevated cholesterol and high blood pressure.

It’s not the first this alarm has sounded, either. Previous research has linked high thyroxine — a warning sign of hyperthyroidism — with atrial fibrillation (that is, a dangerously irregular heartbeat) and sudden heart death, too.

This latest finding came from the Rotterdam Study — the long-term Dutch equivalent of our Women’s Health Initiative or Physician’s Health Study. Researchers looked at subjects’ levels of both thyroid stimulating hormone (TSH) and FT4. Then they investigated further for links between these levels with events and deaths attributed to atherosclerosis (the hardening and narrowing of the arteries).

Follow up lasted nine years, on average. And data revealed some pretty concerning trends.

Like the fact that subjects with rising FT4 levels were twice as likely to have high coronary artery calcification scores — a surefire indication of hardening arteries. These subjects also faced an 87 percent higher risk of heart events linked to atherosclerosis. And more than double the risk of death related to atherosclerosis.

Clearly, high FT4 levels are a life-threatening red flag. But the sad fact is that most doctors don’t even bother to test for them.

You see, all too often, doctors only order a bare bones thyroid panel — typically nothing more than a TSH test. And if that number is in the normal range, most docs will tell you there’s nothing wrong and send you on your way.

Trouble is, that’s not always true. There’s so much more to thyroid health. And you can’t know what’s really going on until you have a complete and accurate view of the entire picture.

But, I digress. The bottom line is that a TSH test alone won’t always tell you if your thyroid is in trouble — or your heart is at risk. And considering the fact that atherosclerotic disease remains a leading cause of death worldwide, primary care docs really should be taking note.

If yours insists on cutting corners with thyroid testing, ask for a more thorough workup. Ask to have your levels tested for the following: thyroid autoantibodies, TBG, reverse T3, and T3. If they can’t — or won’t — order tests that actually tell you something, it’s time to find a doctor who will. And more importantly, one who knows what to do with the results.