Hypothyroidism: The Testing Controversy
Way back in February of 2000, The University of Colorado released “The Colorado Thyroid Disease Prevalence Study,” which sought to determine the prevalence of hypothyroidism. If you are interested in reading such studies, it is not very long (9 pages), and a PDF copy can be downloaded here.
Otherwise, I will digest it for you, and tell you that the conclusion of the study was quite simple:
“Thyroid dysfunction is common, may often go undetected, and may be associated with adverse health outcomes that can be avoided by serum (blood) TSH measurement.”
The study also determined that testing for hypothyroidism was so woefully inadequate, that approximately 40% of all cases went potentially undiagnosed – and ladies, 40% is a large number if you happen to be one of those 40 people!
As I shared with you previously, Nurse Practitioner, and author of the book The Female Brain Gone Insane, Mia Lundin, believes that the bigger issue causing such large numbers of cases of hypothyroidism to be undiagnosed is that the majority of healthcare practitioners rely primarily on testing for TSH (thyroid stimulating hormone) levels, and ignore testing for active levels of the thyroid hormones T4 and T3.
Mia also believes that testing for hypothyroidism should include not only blood TSH levels, but active levels of T4 and T3, in addition to what she calls “reverse levels” of T3, TPO (thyroid peroxidase antibodies), and anti-thyroid antibodies.
Again, as a layperson, it does seem pretty self-evident that the more information you have, the greater the chances are of an accurate diagnosis.
Another factor in the problem of testing for hypothyroidism is the issue of what is considered “normal.” Dr. Steven F. Hotze (also referenced in my last post) states in his book, Hormones, Health & Happiness, that what is considered normal thyroid function is a statistically determined, arbitrary value that is so broad that when tested, 90 to 95% of the population will fall into the range.
In fact, the Thyroid Disease Prevalence study corroborated this fact, stating, that 13 million patients were potentially undiagnosed for hypothyroidism because their test results fell within this “normal” range.
So, again, what does all of this medical mumbo-jumbo mean for you, a woman in perimenopause who is suffering with heart palpitations, panic attacks, and anxiety? It means that if you have been told your thyroid function is “normal” but you still think something is wrong, statistically speaking, the chances are it probably is.
I do not expect, however, that you should just simply take my word for it. I wouldn’t be so presumptuous. But I hope I’ve given you enough information about the possible causes of heart palpitations, panic attacks, and anxiety in perimenopause, that you can at least ask your physician more questions. If you find you are not satisfied with the answers, then I also hope you will have the confidence to find a healthcare provider who is better able to meet your needs.
Magnolia Miller is a certified healthcare consumer advocate in women's health and a women's freelance health writer and blogger at The Perimenopause Blog.