Back in 2012, I used to suffer from heart palpitation, weight gain, decreased libido, brain fog, depression & anxiety in the past. I eventually “figured” things out when I went for Functional Medicine Courses and was diagnosed with Hashimoto.
I understand how confusing it can be to live a life with hypothyroidism and also how we can overcome it with functional medicine. If you are looking for a guide to clear out the confusion for you, this article is the one you need.
Conventional medicine is usually only testing the thyroid with TSH and prescribing T4 replacement medication, or levothyroxine. Although TSH will result in a “normal” range, most of them do not feel good and still have a variety of hypothyroidism symptoms such as brain fog, gained weight, high blood pressure, constipation, depression, cold extremities, hair loss, etc.
As a result, many people with hypothyroidism symptoms are either been left untreated or incorrectly diagnosed.
In my conventional medicine experience, I “often” get complaints from my colleagues’ providers, and endocrinologists, that I “unnecessarily” treated and ordered lab tests for hypothyroidism.
The conventional medicine approach for hypothyroidism is “outdated”, following recommendations from more than 30 yrs old of hypothyroidism practices.
The functional approach and method for hypothyroidism make more sense and are logical.
In my years of conventional medicine school, Hashimoto thyroiditis is the MOST hypothyroidism affecting the majority of the US population and yet, in conventional medicine, we “DO NOT” need to check thyroid autoimmune markers.
HASHIMOTO THYROIDITIS
It is an autoimmune disease in which your white blood cells (lymphocytes) attack your thyroid. An overactive immune system eventually destroys the thyroid gland. Hypothyroid conditions that are improperly addressed can have long-term consequences, reduced quality of life, and increased risk of cardiovascular disease.
In the early phase of Hashimoto, the person may start noticing symptoms of hypothyroidism, some with mild hypothyroidism and other thyrotoxicosis (too much thyroid hormone) can be present.
“Subclinical” hypothyroidism is defined as an increased TSH accompanied by “normal” T4 and T3 levels. Progressively, as more thyroid tissue is destroyed, the thyroid loses the ability to compensate and the person becomes deficient in thyroid hormone. Eventually, this results in thyroid hormone becoming atrophic and considered the end stage of Hashimoto thyroiditis.
People with Hashimoto may experience both hypothyroidism & hyperthyroidism symptoms because as the thyroid cells are destroyed, stored hormones are released into the circulation, causing a toxic level of thyroid hormone in the body also known as thyrotoxicosis
In Hashimoto, there are 2 types of self-reactive antibodies. More than 90% of people with Hashimoto’s have thyroid peroxidase antibodies (TPOAb) and about 80% have thyroglobulin antibodies (TgAb).
Hashimoto affects more women compared to men, as hormonal fluctuation may contribute to the development of Hashimoto, which usually peaks around puberty, pregnancy and menopausal.
Screening test
TSH is used as a screening test for thyroid function, but this test does not always catch thyroid abnormalities. TSH will not become permanently elevated until Hashimoto advances. People with a normal TSH for years can experience unpleasant thyroid symptoms.
T4(thyroxine) and T3(triiodothyronine) are 2 main thyroid hormones. T4 is a prohormone, 300% less biologically active than T3, the main biologically active thyroid hormone. Total hormone levels measure all of the thyroid hormones in the body, but they may not picture the accuracy of the hormones. “Free” hormone levels measure the hormone available to do its job in the body. Thus, tests for Free T4 & Free T3 are the main actual thyroid hormones available.
Some Hasihoto’s patients are unable to properly convert T4 to T3. Interestingly, many Hashimoto patients are often zinc-deficient. In stressful situations, T4 is converted to ReverseT3 instead of T3. Reverse T3 is an inactive molecule related to T3 but without any physiological activity (useless). In the case of elevated reverse T3, adding a combination T4/T3 or T3 alone can help ensure the right hormone is getting to the right receptors.
Recommendation for thyroid function tests:
TSH, TPO antibodies, Thyroglobulin antibodies, FreeT4(FT4), FreeT3(FT3), Reverse T3(RT3)
Misdiagnosis
Many hypothyroid or Hashimoto are nonspecific and often disregarded by the medical community during the initial stages. Patients are dismissed as having depression, stress, or anxiety. Thyroid patients are prescribed antidepressants or anti-anxiety medications without consideration of ordering “complete” thyroid function
High concentration of TPO antibodies has been associated with depression, OCD, anxiety, bipolar disorder or schizophrenia when actually suffering from thyroid imbalances.
Factors that inhibit T4(prohormone) to T3 (active hormone) conversion:
Nutrient depletions, stress, aging, alcohol, obesity, chemotherapy, gut dysbiosis, cigarettes, diabetes, fasting, goitrogens, pesticides, radiation, surgery, kidney and liver disease, heavy metal, growth hormone deficiency, low progesterone, excess iodine.
If you have elevated TSH or thyroid symptoms (without elevated TSH), you may want to talk to a practitioner who knows how to treat hypothyroidism. There is no need to suffer while you search for the root cause of your condition. Optimizing thyroid medication may be the first step toward feeling well with Hashimoto
My course launches in 2025, that is custom-made to help you gain your freedom from hypothyroidism. So, keep an eye out for the announcements on my IG handle @hormonefixer