Thyroid Health: A Guide to Understanding TSH, T3, and T4

Blog post by Steven Van Keuren - Published at May 09, 2023

Thyroid Health: A Guide to Understanding TSH, T3, and T4

1. Introduction 

The thyroid is a small, butterfly-shaped gland that sits at the base of the neck. This gland produces hormones that regulate metabolism, body temperature, heart rate, and weight. When the thyroid gland doesn’t produce enough hormones, it’s called hypothyroidism. When it produces too many hormones, it’s called hyperthyroidism.

The thyroid gland produces two main hormones: thyroxine (T4) and triiodothyronine (T3). T4 is inactive and must be converted to T3, which is the active form of the hormone and it regulates the body’s metabolism.

Thyroid-stimulating hormone (TSH) is produced by the pituitary gland and helps to regulate the thyroid gland.

There are many different thyroid disorders that can occur when this gland is not functioning properly and these can be caused by a variety of factors, including autoimmune disease, infection, stress, and certain medications.

2. TSH- what is it and what does it do?

Thyroid-stimulating hormone (TSH) is a hormone produced by the pituitary gland to regulate the thyroid gland. TSH triggers the production and release of both T3 and T4 hormones.

The TSH tests measure the amount of TSH in the blood. High levels of TSH suggest hypothyroidism and low levels suggest hyperthyroidism. The test can also help diagnose rare conditions such as Graves’ disease and Hashimoto’s thyroiditis. It is important to keep in mind that TSH test results are only one factor in diagnosing thyroid disorders and other factors, such as symptoms and family history, should also be taken into consideration. 

3. T3- the "active" thyroid hormone 

T3, also called triiodothyronine, is the most active of the thyroid hormones. It plays a major role in regulating metabolism, stimulating cell growth and division, and is important for development and maturation in children. 

T3 is synthesized from the T4 hormone. Likewise, T4 is produced by the thyroid gland but its role is mainly to be converted to T3 in the body's cells. T3 is normally converted from T4 in the liver, kidney, and other peripheral organs. This conversion is regulated by another hormone, reverse T3, which is produced in the body in response to various stimulations. 

Circulating levels of T3 can inform doctors whether the body is getting enough or deficient amounts of thyroid hormones. If T3 levels are low, hypothyroidism may be present; if it is high, hyperthyroidism may be present. Decreases in the production or utilization of T3 can lead to various symptoms, such as fatigue, constipation, depression, weight gain, and dry skin.

T3 is the main regulator of metabolic activity, so it is important to ensure that enough is available to the body. Working with a doctor to check T3 levels and take action if needed is a major step in maintaining healthy thyroid function.

4. T4- "The storage hormone"

T4, also known as the storage hormone, is the main thyroid hormone that is produced by the thyroid gland. This hormone is mainly responsible for keeping the body's metabolism steady and regulating body functions like breathing, heart rate, weight, and muscle strength. 

T4 is stored in the thyroid gland until it's needed. Most of the hormone is converted to the active form, T3. It is done by deiodinases, a family of enzymes that help convert T4 to T3 in the body's tissues. 

The conversion of T4 to T3 is essential in maintaining healthy thyroid hormone levels. If the conversion of T4 to T3 is inhibited, there can be a decrease in the active thyroid hormone, leading to hypothyroidism. On the flip side, an increase in the conversion of T4 to T3 can lead to hyperthyroidism. 

Therefore, it is important to check T4 levels in order to correctly diagnose and treat thyroid problems. T4 can be easily tested via a blood draw, and understanding the results can help guide treatment and provide insight into how the thyroid is functioning. Working closely with a doctor to monitor T4 levels can ensure that the correct amounts of thyroid hormones are present in the body.

5. Why are all three thyroid hormones important? 

All three of the primary thyroid hormones – T3, T4, and TSH – play different roles in the body and are each important for maintaining healthy thyroid function.

T3 is the active form of the hormone and is responsible for the majority of the metabolic hormone functions. It is responsible for regulating the body’s metabolism, temperature, heart rate, weight, and muscle strength and how quickly it breaks down carbohydrates and fats.

T4 is the storage and backup hormone and is mainly responsible for maintaining steady hormone levels. It is deposited in the thyroid gland and is later converted to T3 for the body to use.

TSH, or thyroid stimulating hormone, is secreted by the pituitary gland and is responsible for stimulating the thyroid gland to produce and secrete T4 and T3. If levels of TSH rise, it signals the thyroid gland to increase production, while low levels prompt the gland to reduce production.

Maintaining healthy levels of all three of the primary thyroid hormones is essential for normal body functioning. Checking TSH, T3, and T4 levels is important in order to correctly diagnose and treat thyroid problems.

6. Signs and symptoms of an imbalanced thyroid 

An imbalance in the levels of any of the three primary thyroid hormones – T3, T4, and TSH – can cause many symptoms. Here are some of the signs of a thyroid hormone imbalance: 

• Difficulty losing weight – Low T3 and T4 levels can make it difficult to lose weight and lead to weight gain.  

• Changes in appetite – Low levels of T3 and T4 can lead to an increase in hunger and sudden changes in appetite.

• Fatigue – Low levels of T3 and T4 can lead to an overall feeling of fatigue and exhaustion. 

• Difficulty sleeping – Imbalanced T3 and T4 levels can impair the body’s ability to relax and fall asleep. 

• Hair loss – Deficient levels of T3 and T4 can result in an increased rate of hair loss. 

• Unexpected changes in mood – When T4 is low, the body may experience mood swings, anxiety, and depression. 

• Slowed heart rate – Low T3 levels cause the heart rate to slow down, leading to a decrease in energy. 

• Dry skin – Low T3 and T4 may result in dry, itchy, and irritated skin. 

• Muscle and joint pain – An imbalance in the levels of T3 and T4 can cause pain and discomfort in the muscles and joints. 

7. Diet and lifestyle changes for thyroid health 

Your diet and lifestyle have a great impact on thyroid health. A healthy diet is important for everyone, but for people with thyroid disorders, it is especially important to monitor your intake of foods that are known to interact with thyroid hormones. Here are some tips to keep in mind:

• Consume plenty of iodine-rich food.

• Avoid goitrogens found in peas, soy, and cruciferous vegetables like kale, cauliflower, and Brussels sprouts.

• Eat plenty of dietary fiber to promote healthy digestion.

• Consume omega-3 fatty acids.

• Choose whole grains, nuts, and seeds over refined grains and processed foods.

• Drink plenty of water to prevent dehydration and support thyroid function.

• Exercise regularly to maintain a healthy weight and promote normal hormone production.

It is essential to maintain a healthy lifestyle, including avoiding alcohol and tobacco products, to provide optimal health for your thyroid. In addition, it is important to get adequate rest and recovery to reduce stress and its negative effects on your thyroid.

8. Key takeaways

Thyroid health is an important part of overall health and well-being. To maintain optimal thyroid health, getting regular check-ups, being aware of any unusual symptoms, and practicing an overall healthy lifestyle are essential. Below are some key takeaways to remember when considering thyroid health: 

- Regular exercise and a healthy diet are important for healthy thyroid functioning; however, a thyroid disorder may require medical or hormonal intervention. 

- Speak to a healthcare provider about any unusual symptoms or thyroid health concerns you may have. 

- Get your thyroid levels checked on a regular basis, including TSH, T3, and T4 tests. 

- If treatment is necessary, be sure to take any prescribed medications or therapies as directed. 

Steven Van Keuren

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