4 Ways to Diagnose Hypothyroidism – What Your Doctor Doesn’t Know
Are you having a hard time getting a doctor to diagnose you with hypothyroidism? Let me guess – you’re feeling horrible. You have no energy to the point of extreme exhaustion. Your face is puffy and you have a 30 pound weight gain that came out of nowhere. You have memory loss and issues concentrating at work. You’re constipated with cold hands and feet, and you can’t sleep to save your life. You are irritable and your moods are all over the place.
Despite being told your blood work is normal and that there is nothing wrong with you, you continue to use every tiny ounce of energy that you can muster to try to find answers. After all, what have you got to lose? Your career is in jeopardy. Your relationship with your husband is suffering. You can’t be there for your children. You decline offers to meet up with friends because you are just too tired. You’re thinking that this can’t be what you have to look forward to for the rest of your life or you will lose everything you love and have worked for. So you google your symptoms, visit patient forums and now you are sure that you DO have hypothyroidism. So what do you do next?
Please know that you are not alone. Millions of women are hitting this same diagnosis roadblock. Our experts are here to help you get the right answers so that you can go from feeling miserable to feeling like you again.
Here is what our experts have to say about the 4 ways to diagnose hypothyroidism properly:
Dr. Hotze: Hello. I’m Dr. Steve Hotze. Have you ever approached your physician with complaints of fatigue, difficulty losing weight, sensitivity to the cold, inability to focus or think clearly, depressed moods, insomnia, menstrual abnormalities or loss of libido among other symptoms? Did you ask your physician if these symptoms might have something to do with hypothyroidism? Did your physician run a blood test and after the blood test came back, it told you that everything was within the normal range?
At the Hotze Health & Wellness Center, we take a multifaceted approach to diagnosing and treating hypothyroidism. With me today to discuss four ways to diagnose hypothyroidism are Dr. David Sheridan and Dr. Don Ellsworth. Thank you both for joining us today.
There are four ways to diagnose hypothyroidism. One, determine the clinical symptoms. Two, determine the physical signs which are the objective findings a physician has on physical examination. Determine the body temperature and get a good family history. Dr. Ellsworth, would you discuss with us the clinical symptoms that you might find in a patient with hypothyroidism?
Dr. Ellsworth: Thank you, Dr. Hotze. It bears repeating that thyroid hormones do govern the ability of our cells to produce and use energy. Therefore, the effects of hypothyroidism are going to be very broad. For example, we might have low energy. We might have weakness. We might have trouble losing weight. We might have cold sensitivity, our hands and feet in particular, decreased mental sharpness or brain fog, slow thought process, sluggish speech, sluggish bowel function, depressed moods or mood swings.
Some folks have anxiety attacks, joint and muscle pain sometimes called fibromyalgia, headaches, migraines, burning or tingling or the numbness of our hands and feet, trouble with recurrent infections, weak immune system, shortness of breath, angina, heart pain from the blockage of the coronary arteries.
Dr. Hotze: Those are key clinical symptoms and for a patient to describe those, that really takes quite a bit of time in a doctor’s office. A doctor has to be attuned to those problems, don’t they?
Dr. Ellsworth: It certainly does.
Dr. Hotze: Now, the first way to make a diagnosis or begin to make a diagnosis of hypothyroidism is to get a good clinical history, determine the clinical symptoms. What about the physical signs, the objective signs a doctor finds on physical examination, Dr. Sheridan?
Dr. Sheridan: There are also things that are showing physically. You get hair loss, especially in women. Hair can also be coarse. You can get loss of the lateral third of the eyebrows that’s called Hertoghe’s sign, and an enlarged tongue. You get scalloping of the lateral borders of the tongue or the tongue swells and pushes against the teeth. The skin tends to be pale. People tend to be puffy, have pasty skin, loss of body hair, and ridges in the fingernails.
About half of low thyroid patients are overweight and get swelling in the face, paleness of the lips, non-pitting swelling of the extremities, cold hands, not just they feel cold but I can feel their hands and they’re cold. Blood pressure can go up, increasing the risk of coronary artery disease. Atherosclerosis is a common result of longstanding hypothyroidism. Cholesterol can be elevated. Body temperature is often low. There are a lot of things on physical exam that can give us a clue. Now, a given individual doesn’t have to have all of them, but the more you have, I feel the more likely you are to be low thyroid.
Dr. Hotze: I think that’s really a good point because sometimes, people will look at these symptoms and they say, “Well, I don’t have all the symptoms so I guess I don’t have it.” We have varying degrees of hypothyroidism. We have people that are just starting to become hypothyroid. They have a few symptoms and they have very mild symptoms whereas people that have had it for years or decades can have progressively more severe symptoms. Oftentimes, they may have all the symptoms and many of these, all the signs that we discussed here.
Dr. Sheridan: I think a classic error surrounds weight. Many people are told falsely by the doctor you cannot have a thyroid problem because you’re thin, but data shows us that only about half of low thyroid individuals actually have weight problems. We see a fair number of fairly thin or at least normally built hypothyroid patients.
Dr. Hotze: Interestingly enough and in some cases, people with hypothyroidism can be underweight. We’ve seen that.
Dr. Sheridan: Absolutely.
Dr. Hotze: It’s just the opposite of what you would expect. Now, we talked about basal body temperature as a third way or just the body’s temperature. Explain that to us. What does the body temperature have to do with helping in making a diagnosis on hypothyroidism?
Dr. Ellsworth: The body temperature is a reflection of our metabolism. The normal body temperature is 98.6. This is the temperature that is generated from our cell’s production of energy which is based upon the thyroid activity at the cell level. When thyroid hormone activities decrease, it is associated with a decline in our body temperature. As our body temperature consistently runs below 98.6, it increases the likelihood that hypothyroidism is present and a therapeutic trial of desiccated thyroid is in order.
Dr. Hotze: I’ve just pulled a study of the last 200 patients we’ve seen here at the Hotze Health & Wellness Center. What we found is that the average temperature in the office when they came in was 97 degrees. It should have been 98.6. That’s one and a half degrees below normal which is indicative of low energy production in the cells because the cells produce energy to drive the mitochondria and all the biochemical reactions in the body. The excess energy is given off as heat. If we have low production, that’s a good sign that we have low metabolism which directly relates to the thyroid. Now, the fourth way that would be an indication that a patient may have a thyroid problem, if they have all these signs and symptoms and a low body temperature, would be family history. Tell us what does family history have to do with thyroid problems.
Dr. Sheridan: Hypothyroidism tends to run in families. When you ask “did your mom or dad have a thyroid problem, or aunts, uncles, grandparents?”, this is telling again because it tends to run in families but also, I think it’s important to get a family history of coronary artery disease because that can be a sign of low thyroid and weight issues. Families share a gene pool. They also share the dinner table. Obviously, they eat alike but still, when you see things trend in a family, it’s a hint to what might be going on in the individual.
Dr. Hotze: One of the big points you made about family history is coronary artery disease because we know that hypothyroidism does lead to coronary artery disease. There are four ways to make a diagnosis of hypothyroidism. First, get a good clinical history and listen to the patient’s symptoms. Second, get a good physical examination and be aware with the physical signs of hypothyroidism more.
Third, look at the patient’s body temperature. If it’s running below 98.6 on a consistent basis, that’s indicative of low energy production, low metabolism and a hypothyroidism diagnosis. Finally, a good family history might put you in the direction that this patient does have hypothyroidism based on the fact that siblings, family members, parents or other relatives have had hypothyroidism. Thank you both, Dr. Sheridan and Dr. Ellsworth for joining us today.
If you are still looking for answers, our doctors can help. Give us a call at 281-698-8698. It’s time for you to get your life back.