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By Raphael Kellman, M.D., Kellman Center for Functional and Integrative Medicine NYC

New patients often come in with a plethora of gastrointestinal complaints that they can’t seem to overcome no matter what new treatment they try, gastrointestinal specialists they see or foods they eliminate.  It can be wildly frustrating and also painful to remain stuck in the grips of these life-altering ailments that don’t seem to have a permanent resolution. For many it’s like being on a rollercoaster they can’t get off of.  Short periods of some relief may be followed by long periods of pain and symptoms that cycle again and again. 

There is a general failure on the part of mainstream medicine to make connections between systems that seem unrelated yet, are deeply connected. Very often patients are stuck in these patterns because the underlying cause was missed.  In GI disorders that usually means thyroid disease and often it’s a type that is not diagnosable by the routine TSH test.

Common digestive and intestinal disorders like heartburn, constipation, bloating, gas, malabsorption, diarrhea, Colitis, Crohn’s disease, severe food intolerance, inadequate stomach acid and even bacterial overgrowth can all be traced back to an underactive thyroid which is frequently missed. Sometimes the reason is as simple as a doctor not connecting the dots. In most cases, there is a gross failure to do a full, comprehensive evaluation of the thyroid. 

In my practice, the TRH stimulation test is at the center of my diagnostic tool kit. This one test can give deep and highly accurate information about the function of the thyroid in real time.  When used in combination with a full panel including levels of TSH, Free and total T3, Free and total T4, an inflammatory marker called Reverse T3 and the all-important TPO, TGB and TSI antibodies, patients can be truly diagnosed.   

I have written many blogs on the downfalls of solely relying on the routine TSH test.  There are issues with the laboratory ranges being set too high to catch a large portion of cases but there are much bigger issues.  Many of the causes of low thyroid, manifest in a way that does not affect the TSH or actually works to suppress it making routine testing completely ineffective for conditions like early autoimmune disease, long term inflammatory conditions called NTIS, T4-T3 conversion problems, suppression of signaling within the brain and cellular issues like thyroid hormone resistance.  There are many many causes of low thyroid-all of them are extremely common and none of the ones I just mentioned can be diagnosed by strictly using the routine TSH test!  None. 

As a doctor with a desire to help as many people as possible, I find it deeply frustrating that improved testing has not become mainstream as of yet.   Autoimmune conditions are the #1 cause of low thyroid today.  Denying patients at least this test is ignorant and downright negligent.       

I am proud to offer the most comprehensive thyroid testing available to date.  With these methods, we are able to improve overall body function, metabolism and energy levels helping patents to resolve long term health conditions from the bottom up.  By improving the overall function of the whole body, people are able to heal.