When Thyroid Labs Are Normal But Symptoms are Raging

How often have I heard this lament from client’s with hypothyroidism:                                  I feel terrible but my doctor says my thyroid labs are still in the normal range.  I can’t get off the coach!

It has been my experience that  endocrinologist frequently turn a deaf ear to symptoms and concentrate on lab results.  I have heard doctors say, “The labs are normal, let’s wait another 6-8 weeks and see what happens.  Meanwhile, the patient is struggling, probably feels exhausted, maybe loosing hair and experiencing weight gain.

Thyroid lab results often are not a true reflection of what is going on.  If someone has been stable on their medications and then starts complaining of symptoms, it is reasonable to think there has been  a change in thyroid function.  If the labs haven’t moved outside the normal range, the majority of doctors won’t make any changes to medication, even when quality of life is affected.  One of my clients was told to exercise more.  It is a difficult request when the fatigue level has increased and any activity is exhausting.

It is not just hypothyroid patients that suffer but hyperthyroid also.  People who are sliding into hyperthyroidism, are at great risk of serious and life threatening complications. To say to a patient,  let’s wait till your labs go just a bit further into the hyper range, is not medically sound.  Having hyper symptoms includes the risk of high blood pressure, diarrhea, vomiting, severe headache and memory loss.

I don’t know what the hesitation is to treat or adjust medication when someone complains of increased symptoms. The medical community has come to rely too much on the lab results.  It is my belief that the approach to thyroid disease needs to be changed to include lab results and symptoms.

I tell clients, if your doctor doesn’t want to hear about your symptoms, find one that will.  Could this approach to thyroid disease be evidence based medicine run amuck?  In this case, the standards of care as evidence based medicine are doing more harm than good.