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What I Tell My Patients Who Want To Support Their Thyroid

Robin Berzin, M.D.
Doctor & Founder Of Parsley Health By Robin Berzin, M.D.
Doctor & Founder Of Parsley Health
Robin Berzin, M.D. is a functional medicine physician and founder of Parsley Health. She received her master's from the Columbia University College of Physicians and Surgeons, and was later trained in Internal Medicine at Mount Sinai Hospital.

As many as one in eight women in the U.S. will develop some kind of thyroid disease in their lifetime.

Even more shocking, this stat doesn't capture the millions of people who suffer from symptoms of low-grade and transient thyroid imbalances and never get diagnosed with disease.

This often happens because conventional doctors typically only test TSH, or thyroid stimulating hormone, the hormone from the brain that is elevated when the thyroid is low. But for many people the active thyroid hormones, T4 and T3, can be low for reasons such as pituitary, or central, hypothyroidism, or because they are unable to convert T4 to T3.

In these cases, even though TSH might be within the normal range, a person may experience the symptoms of clinical hypothyroidism. These include:

  • Weight gain
  • Constipation, gas, and bloating
  • Dry skin
  • Depression or low mood
  • Muscle pain or body aches
  • Brain fog

If you think you might have a thyroid issue, your first step should be to work with a functional medicine doctor or doctor who will test you for blood markers for TSH, free T3, free T4, reverse T3, and antibodies to two proteins called thyroglobulin and TPO.

There are also some simple steps you can take right now, that may help improve thyroid function.

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1. Consider taking vitamin D3/K2.

Vitamin D is not just a vitamin but a hormone, the full implications of which we are just beginning to understand in science. If you are low on vitamin D, you do not convert free T4 to free T3 as well. Free T3 is the active thyroid hormone at the level of the cells, and many people, while they might have normal TSH and free T4 levels, will be low on T3 and have symptoms of hypothyroidism.

2. Eat seaweed.

Kelp is a great source of iodine, which is important for thyroid hormone production—but many people don’t get enough of it in food. You can also consider taking potassium iodide daily as a supplement.

3. Find out which foods you are sensitive to.

Because food sensitivities can cause chronic inflammation, they could be affecting your thyroid. Doing an elimination diet to pinpoint which food might be to blame, with guidance from a health coach or doctor, can be better than any blood test available. Make sure to cut out frequent culprits like gluten, dairy, and soy.

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4. Support your microbiome.

The population of bacteria in our bodies, primarily living in the digestive tract, is known today as the microbiome. These bacteria are important for maintaining the intestinal barrier, and modulating the immune system. When the microbiome is out of balance, intestinal permeability is more likely and that can kick off a cycle of immune activation and inflammation that can suppress the thyroid.

Shifting the microbiome takes time, the right supplements, and the right diet—but it can make a big difference. Consider working with a health coach who has been trained in functional medicine and can help guide you.

5. Take stress seriously.

Most of us don’t like to admit we are chronically stressed, but our on-the-go lifestyles mean we're often more stressed than we realize. Chronic stress lowers the conversion of free T4 to free T3 — meaning you have less active thyroid hormone to work with. Severe chronic stress at the level of the brain can depress the thyroid centrally. And for some people, stress is so chronic that they develop high reverse T3, a hormone that acts like a brake on the thyroid.

Learn how to manage stress better, or consider this course that I created for mindbodygreen that walks you through the essential steps of handling a busy life, without compromising your health.

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Robin Berzin, M.D.
Robin Berzin, M.D.
Robin Berzin, M.D., is a functional medicine physician and the founder of Parsley Health. She...
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