Maintaining adequate thyroid function should be priority #1 for thyroid patients.
Unfortunately, the standard way to approach measuring thyroid function, which is often done solely with thyroid lab tests, is not as accurate as most people believe (including doctors).
And this is probably why we see such a huge number of thyroid patients who continue to express concern over their symptoms despite having “normal thyroid lab tests”.
These patients are told that their thyroid is “normal” when in reality their thyroid function is lower than the average healthy person.
This is also most likely why we see higher levels of obesity, cholesterol, and cancer rates in thyroid patients.
It has little to do with the direct side effects of their condition and more to do with how well they are being treated.
The good news is, you don’t have to rely solely on thyroid lab tests to get a measure of how well your thyroid is functioning.
There are many other health metrics that you can start tracking right now which can give you an overall idea of how well your thyroid is functioning and what that means for your overall health.
If you want to live a long and healthy life, free of chronic diseases, then these are 5 thyroid-related health metrics you need to start tracking and optimizing for.
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#1. Basal Body Temperature.
Basal body temperature is defined as the lowest natural temperature recorded after a period of rest and it’s far more useful than you might think.
This is because there aren’t very many things that exert a powerful influence over this metric.
Women have been using basal body temperature tracking to identify ovulation for fertility purposes (1) and it’s also used as a natural method of contraception.
It just so happens that basal body temperature also tracks with thyroid function, which is what we care about in this discussion.
One of the main symptoms of hypothyroidism is a low body temperature and one of the primary symptoms of hyperthyroidism is an elevated body temperature.
In a healthy state, your thyroid regulates your body temperature perfectly without swings up or down (2).
But in the dysregulated state, you can easily see changes in body temperature which allows you to better understand your thyroid function.
Imagine a scenario in which you are taking thyroid medication, and you’ve been told you have normal labs, but upon testing your basal body temperature you find that it’s chaotic, unstable, and much lower than it should be.
This would heavily imply that you are being undertreated and that you should make adjustments to your thyroid medication dose.
The testing of your basal body temperature is certainly not a perfect measure of thyroid function by itself, but it can give you a whole lot of useful information when combined with other things like thyroid lab testing.
Tracking your basal body temperature is also really helpful if you are using any thyroid medication that contains T3 thyroid hormone or if you have a suppressed TSH.
If your body temperature starts to climb too high, that’s a good sign that you are probably taking too much thyroid medication.
Monitoring your basal body temperature is super easy to do.
All you need to do is purchase a sensitive basal body temperature thermometer and place it by your bed along with a notebook or an app on your phone.
The next step is to simply measure your temperature first thing in the morning before you get out of bed, and write down the result.
You will then rinse and repeat every day while making note of any changes to your thyroid medication dose, or anything else you are doing to support thyroid function.
You’ll know if what you are doing is working if your basal body temperature becomes stable and consistent.
As an added bonus, if you are still menstruating then you may also notice more consistency in ovulation as thyroid hormone helps to better regulate your sex hormones.
This means it’s a lot easier to get pregnant if that’s your goal.
#2. Resting Heart Rate.
Another really easy way to approximate thyroid function is by assessing your resting heart rate.
I love using this metric, especially with thyroid patients who are just starting out on thyroid medication because it’s incredibly cheap and easy.
Here’s how it works:
Similar to basal body temperature, your thyroid helps to set your resting heart rate which is tied to your basal metabolic rate (AKA your metabolism).
When thyroid function is low, such as in the case of hypothyroidism, your heart rate will be SLOW.
When thyroid function is high, such as in the case of hyperthyroidism, your heart will be HIGH.
The average resting heart rate ranges from about 60 to 90 beats per minute but you really want yours around 70 beats per minute or less.
Many thyroid patients are walking around right now with resting heart rates in the 50s which can sometimes give people a false sense of security.
After all, a slower resting heart rate is seen in athletes and people with well-conditioned cardiovascular systems.
But in the case of hypothyroid patients, their heart rate isn’t there because of their fitness level, it’s there because of their low thyroid function.
And having a low heart rate due to low thyroid is NOT a good sign and will not protect your heart like it would if you were a conditioned athlete.
In fact, it will do the opposite by increasing your risk of heart disease, heart attack, and other heart problems.
I’d recommend this route because you can set it and forget it and they will do all of the measurements and averages for you.
You’ll even get the added benefit of tracking your heart rate during exercise which is also beneficial for monitoring your thyroid (learn more about that here).
You can also opt to go the completely free route by learning how to take your pulse and doing some basic math.
All you need to do is take your pulse when you first wake up and before you get out of bed for 15 seconds.
Whatever number you get from that 15-second interval you then multiply by 4 to get a rough estimate of your resting heart rate.
Since both basal body temperature and resting heart rate should be taken first thing in the morning it makes sense to do both at the same time.
#3. Cholesterol Levels.
The next metric you really want to be aware of as a thyroid patient is your cholesterol level.
This is because, just like the other metrics we’ve discussed, your thyroid regulates your cholesterol.
It does this by inducing the enzyme HMG-CoA reductase which is the same enzyme that statins target (4).
T3 also impacts LDL receptors and HDL levels indirectly.
The degree to which these markers are influenced depends on the degree to which your thyroid is dysfunctional.
The more dysfunction in your thyroid, the worse your cholesterol will be.
But there’s a big problem, two actually:
The first problem is that high cholesterol is so common that most cases don’t really get investigated.
Doctors just recommend a statin and move on without further testing.
And the second is just a lack of awareness from doctors regarding this connection.
The physiology and the connection between thyroid function and cholesterol metabolism are taught in medical school, but like many other things can be forgotten or discarded.
This means most doctors aren’t in the habit of connecting cholesterol lab test results to thyroid lab test results.
The silver lining is that cholesterol testing is so common that you’ve probably been tested a number of times even if you weren’t really paying attention.
Keeping an eye on your cholesterol level is another great way to indirectly assess thyroid function and to see if your current thyroid regimen is working.
If it is, you should see your cholesterol levels normalize as you take thyroid medication or use other natural treatments.
Normalizing your cholesterol is huge because it imparts a massive benefit on cardiac risk factors like a heart attack (5) later in life.
But beware, there are plenty of other things that cause high cholesterol aside from your thyroid including a lack of exercise and a poor diet.
In my experience, it is very often the case that thyroid patients suffer from high cholesterol from both their thyroid and their lifestyle so keep that in mind as you test.
If you are otherwise healthy and have high cholesterol, though, then your cholesterol is a cleaner measure of thyroid function.
#4. Blood Sugar Levels.
Many people are acutely aware that sugar is a problem if consumed in high quantities.
The sugar that you eat from your diet makes its way into your body where it impacts a hormone called insulin.
With enough overstimulation of this hormone, you’ll end up with insulin resistance and all of its unwanted associated conditions including:
- Weight Gain
- Heart disease
- Eye disease
- Kidney disease
- Pre-mature aging
- And the list goes on and on
In other words, maintaining healthy blood sugar is really important if you want to avoid all of these nasty conditions.
Most people who want to optimize their blood sugar focus primarily on their diet, which is certainly important.
But as a thyroid patient, you need to be aware that your thyroid influences your blood sugar by influencing insulin.
T3, the most powerful thyroid hormone, enhances insulin activity and sensitivity (6).
So you could be avoiding sugar from your diet but still experience issues related to insulin because of your thyroid function.
For this reason, and because of the serious consequences associated with high blood sugar levels, it makes a lot of sense to keep track of this metric as a thyroid patient.
You can do this by assessing your hgb A1c and your spot blood sugar level.
The Hgb A1c is a better long-term measure of blood sugar and pairs well with the more immediate spot blood sugar level people often see on their labs.
These tests should automatically be ordered by your doctor but in case they aren’t, you can grab them the next time you get your thyroid labs drawn.
#5. Body Composition.
The next measure you need to be familiar with is body composition.
Body composition is different from your weight because it attempts to approximate and separate your muscle mass, fat mass, and water weight.
As a thyroid patient, I don’t need to tell you that it’s really easy to gain weight and really hard to lose weight.
This is because your thyroid influences your metabolism.
When thyroid function is low, you will gain weight. It’s that simple.
Thyroid patients know this which is why they often pay a lot of attention to their weight as it is measured on a standard scale.
But this is really a bad way to measure your fat mass and muscle mass which is what you should really care about (7).
As a thyroid patient, your weight can fluctuate dramatically because of the impact your thyroid has on fluid levels and bowel movements.
You can easily gain several pounds in a day due to constipation and edema or water retention.
But this weight gain usually isn’t due to an increase in fat mass, but it can appear that way if all you use is a scale.
Measuring your body composition solves this problem by giving you a much more accurate measure of the things that actually matter: your fat mass and your muscle mass.
You can measure body composition in a number of different ways that range from cheap to expensive and accurate to inaccurate.
I think a cheap and easy way to measure body composition is to combine body measurements with weekly pictures.
If you are losing weight and optimizing your thyroid, you will see your body measurements decrease and you will see a noticeable improvement in how you look.
The key is to keep track of these measurements and pictures over months and to evaluate them over time and not week to week.
These measurements are an amazing way for you to track your thyroid function but they don’t take the place of thyroid lab tests.
If you want to make sure you are getting all of the necessary lab tests to really see how well your thyroid is working then check out this article next.
- Certain health metrics can be used to indirectly assess thyroid function and these can give you more insight than thyroid lab tests alone.
- These metrics also provide useful information about your overall health and your risk of developing various chronic diseases.
- Standard thyroid lab tests such as the TSH are often inaccurate when used alone and should be combined with other measures of total body thyroid function.
- When tracking thyroid-related health metrics, make sure to also keep track of when you start therapies to better understand how they impact your body and thyroid.
- Focus on long-term tracking, not short-term tracking as the variance from day to day can cause confusion. Long-term tracking provides a more stable and consistent picture.
Now I want to hear from you:
Were you aware that thyroid lab tests don’t provide a complete picture of thyroid function?
Are you planning on measuring or tracking any of the metrics discussed here? Why or why not?
Were you already tracking or keeping an eye on these metrics prior to reading this article?
Leave your questions or comments below!