This is the first post in a series about women and hypothyroidism. I include conventional diagnosis and treatment briefly, so you can learn about it. However, this series is largely about integrative approaches.
According to the American Thyroid Association:
- One in eight women will develop a thyroid disorder during her lifetime.
- 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.
It is remarkable that up to 60% of women with thyroid disease are unaware of their condition.
The “one in eight women will develop a thyroid disorder” includes not only hypothyroid, but also hyperthyroid and thyroid cancer. This series is specifically about hypothyroidism, which is the most common thyroid disorder.
Hypothyroidism is when your thyroid gland does not make enough thyroid hormones.
You may suspect you are hypothyroid. Or you may already have a diagnosis. Either way, you can learn a whole lot more about your condition here. You can find out what to do about it besides 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.
First of all, what are hypothyroid symptoms?
- 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
- 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 hypothyroid diagnosis and treatment
Most licensed medical practitioners can order thyroid labs. which along with symptoms, is the way to diagnose hypothyroidism. Conventional practitioners 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 Functional Medicine can fill in the gaps.
A Functional Medicine take on Hypothyroid
When women come to me with a hypothyroid diagnosis, I first want to know if they have autoimmune hypothyroidism (Hashimoto’s). Over 80% of the time, my patients don’t know. This is because they haven’t been tested for it, or they simply haven’t been told. The first thing I do is find out, by testing thyroid antibodies.
In conventional medicine, it doesn’t matter whether or not you have unexplained hypothyroid or Hashimoto’s, because the treatment is the same for both: monitoring thyroid hormones, and prescribing hormone replacement. In Functional Medicine, unexplained hypothyroid is an entirely different condition than Hashimoto’s.
Unexplained hypothyroidism is often straightforward. We try to find the root cause(s), then treat them. You may not have to take thyroid hormones for the rest of your life.
Many women are able to fix hypothyroidism and avoid long-term thyroid replacement hormones.
Hashimoto’s autoimmune hypothyroidism needs an entirely different approach. It’s important to know if you have Hashimoto’s, so that you can take steps to slow the progression, and perhaps go into remission. You can prevent further autoimmune diseases, because if you have one, your chances of developing more of them increases.
After finding out what type of hypothyroidism you have, it’s imperative to find out what to do! Most women do not understand their thyroid condition. I aim to fix that in this series of posts. Please read the next post about Functional Medicine hypothyroid assessment.