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Why Sub-Clinical Hypothyroidism Is A Problem

By Expert HERWriter
 
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Have you ever gone to the doctor with all the symptoms of hypothyroidism and are told your labs are “normal?” What if they were technically normal but not exactly optimal? That’s called sub-clinical hypothyroidism and it too can cause a whole host of problems.

When your thyroid is sub-clinical, it means it is able to function but not at its best. Imagine you after 8 hours of good solid sleep versus 4 hours of interrupted sleep. You’re still considered normal, just not optimal.

Women with lower thyroid (but not all out low) tend to have symptoms of fatigue, weight gain, dry hair and skin, hair thinning or loss, cracked/weak nails, constipation, and muscle and joint pains. Additionally, cholesterol markers start to turn for the worse while triglycerides start to clime. Heart contractility decreases and the risk for atherosclerosis increases. There is increased risk for depression, miscarriage, menstrual irregularities such as longer days between periods, long periods or heavy periods.

All these symptoms are the same for full-blow hypothyroidism, just not as severe. For example, your cholesterol might be elevated, but not as elevated as if you were fully hypothyroid. Your hair loss might be minimal compared to losing large clumps.

Either way, none of these symptoms are fun and should not be ignored by your healthcare practitioner. When asking for thyroid testing, request that you get the basic screening test, Thyroid Stimulating Hormone (TSH) along with the Free T4, Free T3, and check for autoimmune thyroid such as Thyroid Peroxidase Antibody and Thyroglobulin Antibody.

The generally accepted range for TSH is 0.5 – 5.0mIU/ml, however in 2003, the American Association of Clinical Endocrinologists put out a statement that any TSH above 3.0 mIU/ml should be addressed. Depending on how your practitioner treats, they may not know about this statement or not agree with it.

The National Academy of Clinical Biochemistry believes optimal TSH levels should be between 0.4-2.5 mIU/ml however most labs still report an upper level of 5.0 mIU/ml.

Bottom line is to ask for the actual numbers once you get your thyroid tests back (don’t settle for ‘low,’ ‘high,’ or ‘normal’) and if you are symptomatic, make sure it is being addressed, regardless of the numbers. Finally, if you do fall above the 2.5-3.0mIU/ml range, discuss treatment options with your practitioner.

References:
1) American Association of Clinical Endocrinologists. "January is Thyroid Awareness Month~ 2003 Campaign Encourages Awareness of Mild Thyroid Failure, Importance of Routine Testing." January 2003.
2) Surks, et. al. "Controversy in Clinical Endocrinology: The Thyrotropin Reference Range Should Remain Unchanged," Journal of Clinical Endocrinology and Metabolism 90(9)/5489-5496
3) Wartofsky & Dickey, "Controversy in Clinical Endocrinology: The Evidence for a Narrower Thyrotropin Reference Range is Compelling," Journal of Clinical Endocrinology and Metabolism 90(9)/5483-5488

Add a Comment5 Comments

EmpowHER Guest
Anonymous

I learned the hard way the lack of awareness about hypothyroidism, especially subclinical hypothyroidism. I was diagnosed with hypothyroidism following the birth of my first son in 2006 and experienced many of the symptoms you have listed. I trusted my doctors completely assuming they knew everything there was to know about this disease, especially when I became pregnant again in late 2008. How wrong I was! Under their care my TSH, the gold standard for measuring thyroid function, rose high above the safe range for pregnancy and I miscarried. I vowed to myself that I would research everything there was to know about hypothyroidism and warn other women. I fulfilled my vow and launched my blog Hypothyroidmom.com in memory of the baby I lost to hypothyroidism.

October 21, 2012 - 6:08am

Follow-up on my ealier post: My thyroid tests are very normal now. This is very confusing since I'm not on any thyroid meds anymore. Happy but confused...

September 23, 2009 - 7:20am
EmpowHER Guest
Anonymous

How should someone with this condition treat themselves?

September 11, 2009 - 9:25am

Thank you for this VERY helpful info. I have been in denial about having hypothyroidism and not taking meds because my levels were so close to the upper range. Now, if the upper range is actually lower, I can see that I really do have a problem. I just had another lab test so I'll take the results more seriously.

September 11, 2009 - 8:00am

Dr. Jones,
Thank you SO much for this post. I had my thyroid checked and was told it was in the "normal" range, yet I have nearly all the symptoms you describe. I don't have my actual numbers but I will check with my doctor and discuss them with her.

So many of the symptoms of perimenopause are the same as symptoms of hypothyroidism that it's a little difficult to know where to begin. So thank you again for this advice.

September 9, 2009 - 8:23am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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