How an “Almost Normal” Thyroid Test Nearly Missed Ellen’s Heart Condition
When Ellen first walked into our clinic, she carried a stack of lab reports all stamped with the same conclusion: “NORMAL.” Yet she felt anything but normal.
At 58, Ellen was experiencing concerning symptoms: fatigue that made even simple activities exhausting, unexplained weight gain despite careful eating, and most worryingly, occasional heart palpitations and elevated cholesterol that had recently earned her a prescription for statins.
“Every doctor tells me my thyroid is fine,” she explained during our first meeting. “But I know something isn’t right. My mother had thyroid problems, and my symptoms match everything I read about hypothyroidism. Why don’t my tests show it?”
A closer look at Ellen’s labs revealed the problem. While her TSH (thyroid stimulating hormone) was technically within the reference range at 4.2 (with many labs considering anything under 4.5 “normal”), it was far from optimal. More importantly, no one had measured her free T3—the active form of thyroid hormone that actually powers cellular metabolism.
Comprehensive testing revealed what standard panels had missed: while Ellen’s body produced adequate T4 (the storage form of thyroid hormone), she couldn’t efficiently convert it to active T3—a common but frequently overlooked pattern that directly affects cardiovascular function.
Ellen’s thyroid wasn’t just affecting her energy and weight—it was directly impacting her heart:
- Her “borderline high” cholesterol was largely driven by suboptimal thyroid function
- The palpitations she experienced were related to her body’s attempts to compensate for low metabolic energy
- Her blood pressure fluctuations correlated with thyroid hormone variations
- Her fatigue wasn’t just making exercise difficult—it was a sign her heart muscle wasn’t getting adequate metabolic support
With targeted support to optimize her thyroid function—not just bring it within “normal” limits—Ellen experienced transformation over the next few months:
- Her cholesterol improved without medication, dropping 42 points
- Heart palpitations resolved completely
- Energy returned, making exercise enjoyable again
- Sleep quality deepened, supporting heart recovery
- Persistent brain fog lifted, improving quality of life
“I had accepted that I would just feel tired and heavy for the rest of my life,” Ellen shared six months later. “Finding the connection between my thyroid and heart symptoms opened up possibilities I didn’t know existed. I feel like I’ve reclaimed years of my life.”
Ellen’s story illustrates a critical principle in functional medicine: “normal” doesn’t always mean optimal, especially when it comes to thyroid function and heart health. By addressing the underlying thyroid dysfunction—rather than simply treating the resulting cholesterol changes—we were able to create improvements in Ellen’s cardiovascular health that medication alone couldn’t achieve.
If you’re experiencing unexplained cardiovascular symptoms alongside fatigue, weight changes, or temperature sensitivity, your thyroid might be the missing piece of your health puzzle—even if standard tests fall within “normal” ranges.
As we conclude our Heart and Hormone Health month, remember that these systems work in concert. Addressing one without the others rarely produces optimal results.