Hashimoto’s – How Often Should I Have My TSH Checked?

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They the uh the the holy grail of the medical community relative to your thyroid
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uh dysfunction and we're going to talk about tsh and hashimoto's okay so tsh it's kind of interesting
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i've been in this for a long time probably since the very beginning of of the understanding that hashimoto's
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was causing most of these thyroid problems i i've had the opportunity
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to um to be involved in the evolution of thought on several things well should you take thyroid medication should you
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not uh the tsh isn't enough you don't bother to do it because it really doesn't tell
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you anything other than about about the immune system and and the whole evolution of understanding tsh
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eventually i'm going to do a talk on on um thyroid peroxidase enzymes the tpo enzymes
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uh and and just the evolution of thought on all those so just keep that in mind if i have if you
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saw something in some of my other videos that are going to contradict what i say right now
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because it's kind of the latest stuff okay thyroid stimulating hormone basically people come in and they go i
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have low thyroid and i go you have low thyroid or do you have low thyroid stimulating
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because low thyroid stimulating hormone um uh means that you have high thyroid
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function and vice versa and without getting into all of that it seems counterintuitive
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but when your thyroid the important point is is when your thyroid function
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is going down you're not making as much thyroid hormone so that so there's this part of your brain
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that sends out a a signal to another part of your brain to send out something called
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thyroid stimulating hormone tsh to stimulate this lazy thyroid or this thyroid that's
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being destroyed so that it makes more hormone so when you have high tsh
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it's because your thyroid is like this and it can't make hormone and it's trying to stimulate it to make more
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hormone that's a key understanding now historically in the beginning
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tsh was mainly a function of our understanding was it was a function of hypothyroid which was the
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medical understanding for the last hundred years however it's taken on kind of a new
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understanding in that thyroid in hashimoto's thyroid tissue is being damaged if i could show you
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some pictures of a i should do that if i can show you some pictures
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of a thyroid being damaged that's been excised and it's being down it would blow your mind
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as to how it looks and it's the damage that's being done and every time you're getting attacked sometimes you're
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getting a little teeny bit of damage sometimes you're getting full blown damage those of you are having swelling
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those of you are having swelling that goes up and down you're getting a lot of anxiety
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you're getting a lot of damage and so so the tsh can be used to measure that damage if the if the
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thyroid stimulating hormone one of the things that thyroid stimulating hormone can tell you if you get it measured
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regularly is how much is damage being done it's pretty simple
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if you've been at this for 10 years and your tsh has been going like that every year
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it goes higher and higher and higher that means every year from the one time that you got let's say
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from 2019 to 2020 it went higher there was damage taking place over that
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entire period of time and you're the person who they continue giving you a higher dosage of thyroid
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medication so that tsh is a measure of of that if the person who has who has thyroid stimulating
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hormone every year your thyroid hormone just stays the same
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your tsh is or stays the same that's a very stable thyroid even though you have hashimoto's
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it means that the damage is pretty baseline it's like not it's not a ton so you might be the
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person who goes like hashimoto's but i don't i only have a few of those symptoms in my and
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and you know my labs look good and and but i have these other symptoms and and well the other symptoms are from
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other things that are happening from your thyroid say slowing down your liver or slowing down
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the ability to make blurred blood cells or slowing down the ability to make
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hydrochloric acid in your stomach so tsh can be very valuable the answer to the question is how often
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i should have it done if you are in a more hyperactive state
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so if you have let's say i just had one yesterday and and and it was a lady who's whose
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thyroid was swelling and we had made a couple of suggestions to her
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uh early on in treatment and she followed those suggestions and her thyroid has gone down like 60
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already okay a thyroid that can swell and go down swell and go down maybe you
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get glands and at the same time we get heart palpitations maybe get anxiety and we're trembling insomnia night
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sweats that type of stuff that's a thyroid that is um very unstable
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um it's a thyroid that is very active and and that and that thyroid is creating a lot of destruction
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that immune response is creating a lot of destruction because you're getting all of those when your thyroid is
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is destroyed cells are destroyed they go they they go out into your bloodstream along with
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the t3 and the t4 that's in them and then you have too much thyroid in your system
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and the next thing you know the next thing you know you're getting these these uh
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um symptoms along with the fact just the fact that you're that your immune system is flared up but
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so you're getting a lot of destruction you want to get that thyroid checked if
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it's in treatment you might want to get the tsh checked every six weeks because the tsh is going to go
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into uh it's it's going to go it's going to go up the more damage that there is okay so you want to check damage
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frequently especially if you're in treatment most of our treatment protocols are anywhere
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from like like six weeks to four or five months just depending on how many how many
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triggers how many things you got to go after or how many organs the person's missing how
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many drugs they're taking all that type of stuff so you would want to do it kind of maybe
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every six to at least at the very least you would want to do it every three months
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i say this because most of you know as i'm about the same question you go to the doctor they attack you and they'll
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see in a year during that period of time you may go from being stable to being unstable and
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you won't know it so i recommend my patients get if they're if they're relatively stable
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and let's say we're done with treatment and they're doing well and they're relatively stable i recommend they get
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their tsh checked every six months i just think a year is too long
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maybe somewhere around six months something happens maybe they get a new food sensitivity food sensitivities come
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and go maybe they get a new food chemical senses things come and go um you know things happen we're the
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societal issue right now of so many things happening with the covid political upheaval all these things
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people are stressed that actually that actually can fire things up
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and that could maybe the threshold where now you start getting damage to the thyroid
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you want to know that you want to know that if so if that happens so we're done with care and that starts
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happening at six and a half months we want to know that because there's a way to dampen
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that response as quickly as possible so the tsh really gives us a powerful tool
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to to manage hashimoto's for those of you who watched it you you probably heard me say
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hashimoto's is multifactorial there's a lot of moving pieces to it there there's multiple webs involved
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like the brain and the thyroid and the gut they got in the thyroid and the gut in in the immune system and and and
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all these different things that relate to the thyroid that have to be worked up and then gotten under control well once
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you've got them under control that's called putting that person in remission you haven't the goal is not to
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cure you because i don't know anybody who knows how to cure hashimoto's yet and so the goal is
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to get you in remission and keep you there and then teach you how to keep it there
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one of the most powerful tools to understand how to keep it in remission is to understand whether
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it's whether it's turned active or not and the tsh is is the best way uh there there's other
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ways there there's there's other tests there are much more they're much much much more expensive they're like in the
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400 and some dollar range called tnb lymphocytes and natural killer cells and
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you can run that but the tsh is like it's a cheat thing people they run it every day in lab core they
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run a zillion of them a day the more you run in a lab the less expensive it is so if you run
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like 100 tmp lipocytes or 100 tshs every day long we run one every week of
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the tmb lymphocytes that one's going to be much more expensive that's how they decide those
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things so the tsh really can be a valuable valuable tool
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for those who understand it it can be a valuable tool to to to manage your thyroid during
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treatment it can be a valuable tool to manage your thyroid when you're
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in remission and catch things before they start to get out of control before they get
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or after they've been triggered by a stress or by a pregnancy or by a surgery or by an infection or something like
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that so we're finding it is it is useful in so many more ways for the hashimoto's
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patient than just its tsh your tsh is normal by it was nice knowing you talked to in a year
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so that's tsh and hashimoto's and we'll probably talk to you sooner than a year