Your thyroid is the queen of all hormones, commanding control of every cell of your body. It helps regulate everything from your brain, heart, hair, nails, and sex drive to your metabolism and digestion. No other hormone can claim that power.
It's no surprise then that when your thyroid isn't working well, nothing is working well.
Thyroid physiology is complex and unique to the individual. If you have low thyroid symptoms such as fatigue or weight gain, you might simply be given a thyroid hormone replacement drug or told by your doctor that you're "just getting older." In some cases, you may have low thyroid symptoms despite "normal" labs.
But there’s no such thing as a magic pill for everyone, and we need to get a comprehensive diagnosis to gain insight into why someone is struggling with the symptoms they have.
Here are six hidden thyroid problems we need to start talking about, and what to do about each one:
1. Autoimmune thyroid problems
Research estimates that up to 90 percent of all cases of hypothyroidism are autoimmune in nature, with the most common being Hashimoto's disease. In this case, your thyroid is not the source of the problem but the victim of the immune system attacking it, mistaking your thyroid for a virus.
In mainstream medicine, you typically receive the same thyroid medication whether you have true primary hypothyroidism or an autoimmune disease attacking your thyroid. In functional medicine, understanding the cause determines the solution.
Labs to run: Thyroid peroxidase and TBG antibodies
What to do: I find that there's a lot you can do to naturally manage the condition. I recommend healing the gut with tools such as the elimination diet, as well as natural compounds such as Baicalin to promote regulatory T cell (Treg), balancing the immune system.
2. Thyroid resistance
This thyroid dysfunction is also not a thyroid problem but a cell receptor issue. Every cell of your body depends on thyroid hormones to function the way they should. If your cells receptor sites are blunted because of inflammation or toxins, your body will feel the effects of hypothyroidism despite having adequate hormones. In the case, your TSH will be "normal" but you'll feel miserable.
Labs to run: Markers such as CRP and homocysteine as well as reverse T3 will give us a look at the inflammation and hormone receptor site availability. In addition, look for high triglycerides and low HDL, which is a gauge for insulin resistance that typically goes along with thyroid resistance.
What to do: Liposomal turmeric and resveratrol are two of my favorite ways to dampen inflammation.
3. Thyroid-binding globulin elevation
This pattern is common with excess estrogen levels and women using birth control pills or estrogen creams. All hormones get transported throughout the body on protein carriers. The thyroid's specific transport carriers are called thyroid-binding globulins (TBG). When TBG levels are elevated, this could cause an increase of protein-bound thyroid hormones, which can't be used by your body.
Labs to run: TBG, Free T3, and T4 as well as an expanded female hormone panel.
What to do: Clear excess hormones by supporting your detoxification pathways with herbs such as milk thistle, and methylation pathways with activated B vitamins.
4. Hypothyroidism secondary to pituitary hypofunction
This pattern is associated with chronic stress levels or chronic infections. Your thyroid only does what your brain tells it to do. The hypothalamic-pituitary-thyroid (HPT) axis is the communication lines between your brain and thyroid. In this pattern the pituitary gland, which sits at the base of your brain, isn’t communicating with your thyroid gland. There’s nothing wrong with the thyroid itself; it’s just not being told to get to work!
Labs to run: Look for low levels of T4 and T3 despite a normal-to-low TSH. Also consider viral labs, such as Epstein-Barr virus (EBV).
What to do: I recommend natural brain-immune support tools, such as astragalus, olive leaf, rubidium, sage leaf, L-lysine, zinc, and vitamin C. For more recommends, read "Signs You Might Have A “Leaky Brain” + What To Do About It."
5. Thyroid underconversion
This pattern, also called low T3 syndrome, is common with chronic adrenal stress and elevated cortisol. The majority of thyroid hormone is in the form of T4, which is largely metabolically inactive and has to be converted to T3 for use in the body. It's estimated that 80 percent of thyroid conversion happens in your liver and 20 percent in your gut. Through this process a special enzyme called 5' deiodinase takes one iodine molecule off of T4 to make it the active T3. This pattern has been covered in medical literature for years but is not effectively alleviated by thyroid replacement hormones. Most thyroid drugs are synthetic T4, which isn’t the problem in this pattern.
Labs to run: Free and total T3, liver enzymes, microbiome testing, and nutrient testing of selenium, magnesium, and zinc
What to do: In addition to getting your adrenal fatigue, gut, and liver health under control, foods rich in selenium, zinc, and magnesium help make the enzyme needed for healthy thyroid conversion. Brazil nuts and shellfish, such as oysters, are some of my favorite options.
6. Thyroid overconversion
This thyroid pattern is sometimes found in people with elevated testosterone levels, insulin resistance, type 2 diabetes, and in women with PCOS (polycystic ovarian syndrome). You would think that if the body produces more T3, the metabolically active form of thyroid hormone, it would be a good thing. But too much of a good thing will overwhelm your cells and lead to a resistance pattern.
Labs to run: Free and total T4 and T3, free and serum testosterone, fasting blood sugar Hbg A1c.
What to do: In addition to eating a clean diet consisting of vegetables, fruits, meats, and healthy fats, I also recommend natural medicines such as alpha-lipoic acid, chromium, and cinnamon as blood sugar balancers.
As for general thyroid health, sea vegetables such as dulse, nori, and arame are great nutrient sources, including the vitally important iodine. You need iodine from foods to fuel thyroid hormone production.