Thyroid Function
Approximately 40 million Americans have some thyroid dysfunction, and many of them are not diagnosed. The vast majority of Americans with thyroid issues are woman.
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Symptoms Hypothyroidism |
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Deficient thyroid hormones Low T4 and T3 with High TSH
Constipation Feel Cold or have cold hands or feet Fatigue Lack of motivation Weight gain
Infertility or mis-carriages Irregular menses Hair loss or thinning Wake up tired Dry skin or dry hair Depression or low mood Bradycardia – slowed heart rate
Brain Fog-memory or concentration problems Puffy face |
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Symptoms Hyperthyroidism |
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Excess thyroid hormones High T4 and T3 with low TSH
Diarrhea Feel hot, heat intolerance, sweating Hyperactive Anxiety, irritability, nervousness Weight loss despite an increased appetite Infertility or mis-carriages Menstrual irregularities Hair thinning Wake up wired and tired Dry skin, dry eyes Restless and irritable Tachycardia – rapid heart beat or palpitations Disorganized and unfocused Tremors (especially the hands) Insomnia |
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The Western Medicine approach is mostly restricted to thyroid gland function. Treatment is very limited, and ignores the complexity of other glands, and organs like the liver, large intestines, adrenal glands, and gallbladder. Functional Medicine expands the scope of testing, diagnosis and treatment beyond the thyroid gland itself.
There are many conditions that affect the thyroid function beyond the thyroid gland. The Functional Medical approach does the full range of diagnostic work to identify all the possible causes of low thyroid function.
Comprehensive testing is needed to do this expanded diagnosis. Insurance does not often cover these expanded tests.
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Western Medical perspective of Hypothyroidism (focused on the thyroid gland) |
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low Thyroid Gland function causes
1 Thyroid gland doesn’t produce enough thyroid hormones to meet the body’s needs. These hormones (thyroxine -T4) and (triiodothyronine -T3)—help regulate metabolism, energy levels, temperature, heart rate, and more. Without enough of them, body functions slow down.
2 Too low a dose of thyroid hormones were prescribed
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Functional Medical perspective of Hypothyroidism (focused on multi organ and gland function)
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Low Thyroid Multi Gland Function – condition that includes:
1 the hypothalamus and pituitary dysregulation of the thyroid gland 2 low Thyroid Gland function 3 Too low a dose of thyroid hormones 3 Low metabolism of T4 and T3 by the liver and large intestines 4 Excess or deficient estrogen and testosterone 5 Auto-immune thyroid issues 6 Deficiency of iodine and or selenium 7 Dysbiosis – depleted friendly bacteria in the microbiome 8 Inflammation from food and beverages 9 The effects of low hydrochloric acid in the stomach 10 The effects of low iron or Vitamins B12, B6, Folate 11 Vitamin D deficiency 12 Elevated blood sugar or insulin 13 Cortisol and/or DHEA dysregulation |
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Western Medical perspective of Hypothyroidism (focused on the thyroid gland) |
Functional Medical perspective of Hypothyroidism (focused on multi organ and gland function)
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low Thyroid Gland function causes
1 Thyroid gland doesn’t produce enough thyroid hormones to meet the body’s needs. These hormones (thyroxine -T4) and (triiodothyronine -T3)—help regulate metabolism, energy levels, temperature, heart rate, and more. Without enough of them, body functions slow down.
2 Too low a dose of thyroid hormones were prescribed
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Low Thyroid Multi Gland Function – condition that includes:
1 the hypothalamus and pituitary dysregulation of the thyroid gland 2 low Thyroid Gland function 3 Too low a dose of thyroid hormones 3 Low metabolism of T4 and T3 by the liver and large intestines 4 Excess or deficient estrogen and testosterone 5 Auto-immune thyroid issues 6 Deficiency of iodine and or selenium 7 Dysbiosis – depleted friendly bacteria in the microbiome 8 Inflammation from food and beverages 9 The effects of low hydrochloric acid in the stomach 10 The effects of low iron or Vitamins B12, B6, Folate 11 Vitamin D deficiency 12 Elevated blood sugar or insulin 13 Cortisol and/or DHEA dysregulation |
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Western Medical Treatment Hypothyroidism It is usually levothyroxine, a pure T4 synthetic hormone |
Functional Medical Treatment Hypothyroidism Treatment usually is a T4 and T3 Combo hormone that is bio-identical |
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Additionally 1 Liver inflammation is reduced 2 Estrogen, Progesterone, Testosterone, Cortisol, and DHEA is normalized 3 Iodine and selenium is provided 4 Vitamin B12, B6, Folate or Vitamin D is provided if deficient 5 Auto-immunity is addressed via lifestyle adjustments 6 Dysbiosis is improved 7 Blood sugar is normalized 8 Iron and Ferritin is normalized |
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Western Medical Perspective of Hyperthyroidism |
Functional Medical Perspective of Hyperthyroidism |
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1 The thyroid gland produces too much T4 and / or T3, causing the body’s metabolism to speed up. This can affect many systems in the body and lead to a wide range of symptoms 2 Grave’s Disease may be causing hyperthyroidism – most common 3 excess thyroid hormones may have been prescribed 4 Medications can cause this as a side effect 5 Thyroid or pituitary nodules
Grave’s Disease can be tested with a blood test 1 Usually TSI test is done – Thyroid Stim Immunogloblin Limited testing may cause a person with Grave’s disease to be misdiagnosed
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1 The thyroid gland produces too much T4 and / or T3, causing the body’s metabolism to speed up. This can affect many systems in the body and lead to a wide range of symptoms 2 Grave’s Disease may be causing hyperthyroidism – most common 3 excess thyroid hormones may have been prescribed 4 Medications cause this side effects 5 Thyroid or pituitary nodules Grave’s Disease can be tested with a blood test 1 Usually TSI test is done – Thyroid Stim Immunogloblin 2 Thytropin Receptor Antibody test is also needed and often not done FreeT3, Reverse T3 must be tested Additional causes Hyperthyroidism Excess stress Inflammatory diet Hormones imbalances Liver inflammation
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Why do hypothyroid (low thyroid ) symptoms persist?
Why do you still have hypothyroid symptoms while you are taking thyroid hormones, and your provider says your lab values are normal?
I find many patients are not tested using the full range of thyroid markers, so their diagnosis is minimized. This is particularly true of auto-immune thyroid diseases. Insurance may not cover these additional tests. From my perspective, unless you do the full range of all the thyroid markers, “NORMAL” lab values are not complete. There is also controversy about what normal levels are. I look at typical lab ranges and functional lab ranges that are more sensitive.
Typically the following blood test are not done: Free T3, T3, Reverse T3, TPO antibodies, and Thyroglobulin antibodies. Stool tests are rarely done to evaluate the microbiome. Iodine and Selenium are not usually considered.
When it comes to blood sugar, insulin is rarely measured, so the entire blood sugar condition is not complete.
Cortisol and DHEA (adrenal hormones) can also affect thyroid function. These are commonly dysregulated due to chronic stress.
When it comes to evaluating inflammation CRP, Homocysteine, and GGT is often not measured. These additional markers are very important.
Liver function is often not considered when evaluating the thyroid function, even though a major thyroid metabolic step occurs in the liver. I always look at liver function and thyroid function simultaneously.
Insurance reimbursement is a major facto regarding what testing is done. My approach is to get all the testing needed, so the full range of function can be identified.
Commonly undiagnosed thyroid related conditions:
These conditions need to be evaluated at the same time the thyroid is evaluated.
1 Hashimoto’s Disease (auto-immune)
2 Under conversion of T4 to T3 in the liver and large intestine
3 Iodine and/or selenium deficiency
4 Excess or deficient estrogen
5 Excess or deficient testosterone
6 Grave’s Disease
7 Dysbiosis (depleted friendly bacteria is the microbiome)
8 Chronic food sensitivities (inflammation)
9 Anemia (low iron, low ferritin, low B vitamins, bleeding)
10 Insomnia (often due to cortisol imbalances from stress)
11 Vitamin D deficiency
12 Vitamin B12, B6 or folate deficiency
Thorough lab testing, thorough health history and an examination can reveal these treatable conditions.
We approach Thyroid symptoms from the perspective of Functional Medicine and consider all aspects of your life and all systems in your body.
Your thyroid hormones are associated with every gland, organ and function and have broad effects beyond the common understanding.
I have successfully diagnosed and treated patients for thyroid dysfunction and Hashimoto’s for over 25 years.
How to live in a toxic stressful world and maintain good thyroid function
1 We will provide the benefits and risks of Bio-identical hormones vs synthetic hormones. Many of my patients have better results with bio-identical hormones.
2 We will discuss the risk and benefits of Iodine, and why deficiency has become common again. Iodine is an essential mineral for thyroid function.
3 We will discuss what lab tests are needed and how much they cost.
4 We will discuss the affect of inflammatory food on your thyroid function.
5 We will discuss the role does the liver and large intestines play in thyroid metabolism.
6 We will discuss auto-immune diseases (Hashimoto’s and Grave’s) if you are diagnosed with either of them. Auto-immune thyroid accounts for a high per centage of patient’s symptoms, and is often not tested.
7 We will discuss how to identify and minimize toxic exposure.
8 We will discuss the effect other hormones have on your thyroid function.
9 We will discus how obesity affects thyroid function.
10 We will discuss the effect of hypothyroidism with regard to fertility.
There is a tendency to minimize the causes of hypothyroidism or minimize the effects of hypothyroidism.
I have learned to do expanded testing and treat expanded imbalances.