Hypothyroidism – everything you need to know

Did you know that…?

Underactive thyroid is quite often misdiagnosed or diagnosed too late. A lot of doctors test TSH and T4 only. It’s not enough to asses your thyroid health. Many people are sent back home told that the results are normal, yet they are still feeling unwell. Are you one of them?

Hypothyroidism, also referred to as underactive thyroid or low thyroid, is a very common disorder.  As the name itself suggests, your thyroid gland does not produce enough thyroid hormone.

What your thyroid is responsible for?

Living with underactive thyroid can be troublesome as the thyroid hormones control your metabolic rate and basically thousands processes in your body including:

  • Metabolism and weight control
  • Cognitive functions like mental clarity, focus and memory
  • Regulating your sleep, menstrual cycle and body temperature.
  • Digestion, absorption and energy use
  • Maintaining hormonal balance, bone mass and muscle strength.
  • Heart function and keeping cholesterol in a healthy range and much more

Symptoms of under active thyroid:

It’s a tiny gland but yet so powerful and also very sensitive. If you have underactive thyroid you may experience range of symptoms. The most common is fatigue (especially on waking up in the morning), weight gain (no matter how much or how little you eat), hair loss and low mood. The list is longer though. If you struggle with hypothyroidism, you may also experience:

  • Feeling sleepy and tired
  • Digestive issues, constipation, bloating
  • Cold hands and feets
  • Dry skin and skin problems, thin hairs, britlle nails
  • Muscle cramps, joint pain and stiffness
  • Insomnia and poor sleep
  • Lack of concentration, poor memory
  • High cholesterol
  • Abnormal menstrual cycles
  • Mood changes, anxiety, depression
  • Swelling around neck, arms, legs
  • Goitre

How your thyroid gland works?

Your thyroid is part of the endocrine system. The thyroid produces hormones that are released into the blood. The thyroid produces the T3 and T4 hormones using iodine and tyrosine (amino acid) making those two critical to the health of your thyroid. More than 99 percent of these hormones are bound to blood proteins known as TBG

This renders them inactive. Only free T3 and T4 hormones have any effect on your body. It’s vital that your body maintains the right levels of T3 and T4 hormones, and the job of retaining this balance is performed by the hypothalamus and the pituitary gland.

When your levels of these hormones are too high or low, the hypothalamus creates the TSH Releasing Hormone (TRH). This hormone signals the pituitary, which increases or decreases the levels of another hormone called the thyroid stimulating hormone (TSH). When TSH levels are high, the thyroid produces more hormones, and when they are low, hormone production in the thyroid slows.

What can cause low thyroid function?

Usually, it’s a combination of multiple factors, the most common are:

  • Iodine and other nutrient deficiencies
  • Excess of soy and goitrogenic raw vegetables like spinach, kale, broccoli etc
  • Chronic stress
  • Adrenal exhaustion
  • Gut dysbiosis 
  • Toxic and heavy metals overload (from food, beauty and cleaning products, tap water and environment)
  • Excessive and intense exercise
  • Hashimoto’s thyroiditis
  • Menopause
  • Pregnancy
  • Certain medications, especially used to treat cancer, psychiatric conditions and heart problems.
  • Pituitary gland or hypothalamus disorder

How to diagnose hypothyroidism and what test to run?

Underactive thyroid is quite often misdiagnosed or diagnosed too late. A lot of doctors test TSH and T4 only. It doesn’t provide you full picture of your thyroid gland. Moreover, TSH standard lab range is between 0.3 and 4.2. The problem is that for optimal health and thyroid function it should be between 1 and 2. That’s why many lots of people are send back home hearing the blood results are “normal” while they are still not feeling well. The earlier low thyroid function is detected the quicker you can fix it. Ask your doctor to run full thyroid panel or do it privately on your own.  

Essential blood test to run for underactive thyroid: TSH, FT3 and FT4. Additionally, it’s worth checking your thyroid antibodies as well and reverse T3 if your budget allows. In many cases low thyroid function is caused by autoimmune condition Hashimoto’s that’s why at least once you should run thyroid antibodies to rule this out. 

TSHThyroid stimulating hormone is produced by the pituitary to instruct your thyroid gland to produce thyroid hormones. 
Free T4T4 and T3 are your body’s main thyroid hormones. Free T4 measures the bioavailable (unbound) hormone produced by the thyroid gland. Low T4 is a marker of low thyroid function.
Free T3T4 is converted to T3 in the peripheral tissues like your gut and liver. Free T3 is also known as the “gas” that fuels all the processes performed in your body. It’s the active form of your thyroid hormones that you need the most at the end of the day. A low level of T3 can indicate low thyroid function, or just a problem with conversion
Reverse T3Less known but useful if everything else looks “normal” and you still feeling unwell. Reverse T3 is also known as the “breaks” and it inactivates your active free T3. High levels of reverse T3 can be responsible for symptoms of hypothyroidism, since it competes with free T3 for cell receptor sites. This is an additional marker to help determine what’s going on and indicate the root cause of your thyroid problems
Thyroid Peroxidase (TPO) and Thyroglobulin (TG) antibodiesThese are two markers that will help you determine if you have autoimmune condition or not. The thing is that you don’t have to have abnormal basic thyroid markers to have Hashimoto’s. You may start seeing TSH, FT3 and FT4 outside the range once there is more severe thyroid damage. That’s why in my opinion it’s important to run full thyroid panel in terms of early detection and also prevention

If you are not sure if your thyroid is at the optimal level and how to interpret your blood test results, click here and download my thyroid test cheat sheet with standard and functional medicine lab ranges.

Standard vs holistic treatment:

Conventional treatment is simply hormone replacement therapy. Levothyroxine and Synthroid are two the most common synthetic T4 hormones that are usually prescribed. The problem is that they don’t solve the issue with your thyroid, why it slowed down in the first place and why it’s not producing enough hormones. The biggest problem with synthetic T4 is that many people don’t see much improvement and a lot of them feel even worse. 

Alternative medicine approach on the other hand looks for the root cause first and based on that applies the appropriate solution which is usually combination of diet and lifestyle to correct nutritional deficiencies among others. Holistic healing focusing on providing what your body was lacking so it can work properly again and produce enough of your thyroid hormones.

Why you may still not feel better even though taking medication?

Medication is prescribed without examination the root cause. Think about it like (give analogy).

With underactive thyroid sometimes it’s not the problem with the hormone production itself but how your body is converting it to the active form, are your cells accepting the thyroid hormones and allowing it to get inside the cell to perform all the necessary functions and are you managing your physical and emotional stress well so the optimal levels of your active T3 hormones can be maintained?

With underactive thyroid there are many bits and pieces so running one single marker without thorough investigation of symptoms, family history and personal experience is usually not enough.

Thyroid adrenal connection, how stress and “being busy” ruins your thyroid.

What is often missed when treating thyroid is importance of adrenals and managing your stress (both physical and emotional). Your adrenals produce stress hormones cortisol and adrenaline to cope and adapt to different life situations and challenges

Every time you feel stressed, something annoys your or you are angry, you are in the “flight or fight” mode and your adrenals produce cortisol. Doesn’t matter if you are facing actual threat, running extra mile on the treadmill or just “fighting with your thoughts”, your body will release cortisol. When you are in the “fight or flight” state other body’s function like digestion, immune response and thyroid hormone production are shutting down until the stress has passed. The problem is that due to our busy lifestyle a lot of people will experience chronic stress that never passes as we constantly worrying about something, jumping from one call to another, rushing from one place to another, meeting deadlines and taking care of family and friends on the top of that.

Chronic stress overworks your adrenals leading to adrenal exhaustion over time. It means that you adrenal can’t perform its function, and high cortisol levels may prevent you from rest and repair. When your body is exhausted, its ability to handle the stress associated with normal bodily functions and energy requirements is often compromised. As results your thyroid slows down to preserve that energy that is required to maintain the hormonal balance. In other words, malfunction or imbalance in one area will cause dysfunction in other. Our body functions as a whole with all organs interconnected that’s why it’s important to look on all imbalances and look for root cause, otherwise trying to fix symptom only may bring short term relief but not long-term health and wellbeing.

Gut, liver, inflammation and hypothyroidism.

Stress can also throw your gut microbiome out of balance and weaken your gut barrier. Thyroid hormone conversion from T4 to active T3 happens in your gut and liver so poor gut and liver function may also slow down your thyroid. Moreover, liver is responsible for processing and clearing all hormones. 

If the liver is overloaded you may experience other symptoms related to low under active thyroid and hormonal imbalances. Additionally stress and elevated cortisol interfere with oestrogen metabolism. Excess oestrogen can impair thyroid function and cause weight gain especially around your belly. Lastly, stress is contributing to chronic inflammation making your cells less sensitive to thyroid hormones. In other word your cells don’t recognise your thyroid hormones as something important and needed and don’t allow the hormones to enter the cell to perform all necessary functions.

Finding the root cause is the key

As you can see thyroid is pretty complex and connected with other organs and systems in your body. Running the full thyroid panel is the first step to assess your thyroid health. That in combination with your symptoms and your past history will help to determine the right approach. Medication only won’t solve the underlying problem that caused low thyroid in the first place. Only by providing what your body needs and removing what is harmful you can truly heal and regain your vitality. 

If you are interested in finding out more or ready to take action to improve your thyroid and feel better again, contact me and we can have a chat how I could help you:)