A Root-Cause Approach to Low Thyroid
Have you been diagnosed with hypothyroidism? Or, do you simply suspect your thyroid is underperforming? If so, you’re in the right place to learn more about low thyroid hormone production and what you can do about it with a functional root-cause approach. This is a big topic that we cover over a series of posts, starting here.
Things to know about hypothyroid
Hypothyroidism is widespread, especially in women. According to the American Thyroid Association:
- One in eight women will develop a thyroid disorder during her lifetime. This includes hypothyroid, hyperthyroid, and thyroid cancer. Hypothyroidism is the most common.
- Up to 60 percent of those with thyroid disease are unaware of their condition.
- Undiagnosed thyroid disease may put women at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis, and infertility.
- Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.
You may suspect you are hypothyroid. Or you may already have a diagnosis. Either way, you’ll learn a whole lot more about assessing and treating your condition here. You’ll find out that there are different types of hypothyroidism, with different root causes. You’ll learn how you can support your thyroid hormone production and function in a variety of ways other than taking medication (thyroid replacement hormone). You may need medication, but there are many other aspects of thyroid health to learn about and apply. This is also true for hypothyroid autoimmune disease, called Hashimoto’s thyroiditis.
What does hypothyroidism feel like?
- Can’t conceive, or recurrent miscarriage
- Sluggish metabolism and constipation
- Other intestinal problems: food intolerances (especially wheat), indigestion, bloating, gas
- Obsessive-compulsive thoughts
- Can’t lose weight with doing “all the right things”
- Brain fog, can’t think straight
- Skin rashes
- Frequently getting sick
- Muscle and joint pain
- Menstruation is heavy, can be irregular, can wipe you out
Common misdiagnoses of these symptoms:
- Depression – this is #1.
- Unexplained infertility
- Chronic Fatigue syndrome (CFS)
- “It’s all in your head!”
Thyroid hormones simplified
Your thyroid produces a hormone called thyroxine (T4). It also produces some triiodothyronine (T3). T3 is the hormone that your cells use. All cells, organs and tissues in your whole body use T3. Most of your T3 comes from the conversion of T4 into T3.
TSH stands for thyroid stimulating hormone. Your pituitary gland, in your brain, secretes TSH when thyroid hormones are low. TSH signals your thyroid to put together raw materials, such as iodine and tyrosine, to make T4 and T3.
Conventional doctors usually just test TSH and T4, and sometimes just TSH. Usually, it’s your symptoms that warrant the lab investigation. It may be your general practitioner, or your gynecologist, who first tests your thyroid. These practitioners can choose to manage your condition if it is positive, or they may refer you to an endocrinologist. It’s always good to have an endocrinologist on your team, to properly assess your thyroid for nodules.
If you do have hypothyroidism, your practitioner may first take a “watch and wait” approach. If needed, she will prescribe thyroid replacement hormone. This is the standard care of treatment. The hormone is usually a synthetic T4 (levothyroxin). This treatment assumes that you convert T4 to T3 without a problem. Unfortunately that is not always the case, which I’ll cover later in this series.
When conventional practitioners step outside of the box with thyroid replacement, they may prescribe synthetic T3 in addition to T4. Or you may take T3 alone, although this is less common. Alternatively, you may take thyroid hormone derived from porcine (pig) thyroid such as Naturethroid, Armor, or Westhroid. Another option, which is arguably the best, is a compounded T4-T3 thyroid medication.
Your conventional practitioner typically won’t give you much education about the type of hypothyroidism you have, or what to do about it other than taking thyroid hormone replacement. This is a case when integrative or functional medicine can fill in the gaps.
An integrative approach
When women come to me with a hypothyroid diagnosis, the first step is to understand their type of hypothyroid and then investigate the root causes. What can you expect from this approach?
- Learn if you have Hashimoto’s which takes an immune approach
- Find out if your hypothyroid is due to poor conversion of T4 to T3
- Discover if you are low in iodine or other thyroid nutrients
- See if your hypothyroid is driven by adrenal issues
In conventional medicine, it doesn’t matter what type of hypothyroidism you have, because the treatment is the same: monitoring TSH and T4 and prescribing hormone replacement. However, all types of hypothyroidism can be improved or even reversed!
Please read the next post about a comprehensive hypothyroid assessment. Need help with your thyroid? Please reach out!
Please chime in below,
I was diagnosed with hypothyroidism by blood test and was prescribed synthoid 25 MG a day. I have been taking this medication from 8/17 through present day and none of my medical dr have ever checked my thyroids since then or the thyroid medication levels to make sure there not to high or to low. Should those levels be tested as well as the function for my thyroid after being prescribed medication
First of all, with a hypothyroid diagnosis, it’s important to find out if it’s caused by Hashimoto’s autoimmunity or not. They are different entities, both of which can be addressed from root-cause approaches. To answer your question, yes your thyroid hormone levels should be checked on a regular basis while medicated.
I have a confirmed diagnosis of Hashimoto’s thyroiditis. I take 90 mg daily if armour thyroid and various supplements like selenium, oregano iodine oil etc… I am gluten free. I have tested positive for wheat sensitivity, but do not have celiac disease. I would like to know your thoughts. Best. Barbara
I write a lot about Hashimoto’s here, which reflects my thoughts. Did you have a specific question about this post?