Thyroid disorders go undiagnosed or misdiagnosed for ten plus years
How to identify if you have a thyroid disorder
Can no one figure out why you have numerous symptoms?
Have you been told it is “all in your head”?
Do you struggle to lose weight even though you eat very little?
Does your doctor run labs and tell you, “Everything looks great; there is nothing wrong with you.”
Your thyroid and metabolic processes
Your thyroid produces T3 (triiodothyronine) and T4 (thyroxine). Only a small amount of T3 is created in the thyroid, and the rest is created in the liver once T4 is released from the thyroid. The T4 travels via the bloodstream and enters the liver, where it converts to T3 by removing one iodine molecule (hence 4 to 3). Adequate iodine intake is critical for thyroid function.
T3, the active thyroid hormone, deposits small amounts of iodine throughout the body to activate mitochondria in your cells. Therefore, T3 cannot do its job correctly without enough iodine. The downstream effects can impact many bodily systems since all cells contain mitochondria (except RBC). Some cells, such as your muscles and brain, contain more mitochondria than others. This makes sense then why someone with thyroid dysfunction may feel tired with brain fog.
The hypothalamus-pituitary-thyroid axis is a negative feedback system in which the hypothalamus will send signals to the pituitary gland to release more or less thyroid-stimulating hormone (TSH). TSH will signal the thyroid to reduce or increase T3 and T4 to normalize hormone levels. Optimal thyroid function is vital for metabolic control of many bodily processes.
When the thyroid is not functioning optionally, it can lead to inaccurate communication and signaling, resulting in weight gain/loss, feeling too cold or too hot, rapid or slow digestive process, delayed or fast bowel emptying, racing heartbeat, brain fog, anxiety, and depression.
What can cause thyroid dysregulation
Things can go array when dysregulation occurs. This can be due to many factors, and the person may have more than one cause for thyroiditis. This can include excess fluoride intake and other halogen exposure such as bromine and chlorine, low or excessive iodine intake, dysbiosis and intestinal permeability, heavy metal exposure such as mercury, nutrient deficiencies, especially iodine but also selenium, magnesium, copper, and zinc or consuming a high raw goitrogenic diet.
Hypothyroidism is more common than hyperthyroidism. In hyperthyroidism, you may have too much T3, which can over-energize the mitochondria but can cause burnout due to the constant overexcitement of the mitochondria. Hashimoto’s thyroiditis (HT) is the most common form of thyroid dysfunction in the United States. This is an autoimmune (AI) condition in which the self sees the thyroid gland as a foreign invader and destroys the thyroid tissue.
Why is thyroid dysfunction so difficult to diagnose?
Thyroid dysfunction is misdiagnosed by allopathic medicine because doctors often spend 15 minutes or less with their patients, may interrupt the patient within the first 60 seconds, and may not order the proper tests. If a conventional doctor does not spend time listening to you describe your symptoms and does not order a full thyroid panel, then a diagnosis can easily be missed. Additionally, thyroid dysfunction can look like many other health conditions. Therefore, in this case, proper testing is warranted to rule out thyroid dysfunction.
Therefore, signs such as elevated cholesterol or an expressed symptom of depression may result in a prescription for a stain and antidepressant, neither of which will help address the underlying problem. The doctor may notice you are overweight and suggest you need to “go on a diet.”
Iron deficiency can also look like hypothyroidism with similar signs and symptoms such as feeling cold, hair loss, and low energy. However, it is not uncommon to present with hypothyroidism and iron deficiency.
Getting the proper diagnosis
Thyroid dysfunction cannot be diagnosed without proper testing. If your signs and symptoms point to a potential thyroid issue, you should ask for a FULL thyroid panel, not just TSH, which includes antibody testing for HT and Graves, and other thyroid markers such as free T4, total T3, and free T3. Along with this panel, you should ask your medical professional for a full iron panel (iron, ferritin, % saturation rate).
If your lab tests show only your TSH level, this is like someone asking you to describe in detail a 1000-piece puzzle but only giving you 100 puzzle pieces. Your description may be wholly inaccurate, and you would have to make some guesses. An integrative/functional health professional with examine lab work via a different lens. For instance, if your T4 lab result is less than the middle range and you have signs and symptoms, you may need iodine and tyrosine either via diet or supplementation.
Before testing, if you take a biotin supplement, remove this from your regimen for five days before the test since it can alter your test results.
A functional approach versus an allopathic model
As a nutritionist, I may see the diagnosis in your labs, but I cannot be the one to diagnose you since I am not a medical professional. You will need your doctor to make this determination. However, this does not matter from a holistic perspective, as I will address underlying root causes to assist with thyroid balance and optimal function. For instance, if you had your gallbladder removed, you may think it has nothing to do with your new symptoms. However, fats are needed to make the T4 to T3 conversion and if the gallbladder is removed fats may not be broken down properly. This can result in not enough T3 production thereby slowing down metabolic processes. In this case, an intervention may be addressing fat digestion.
‘Protocols may include more or less iodine, minimizing raw goitrogenic intake, addressing food sensitivities, low HCL, and other gut imbalances and other nutrient deficiencies. Other root causes that may need to be explored include medication, geography (low iodine region of the country), previous thyroid conditions (i.e., thyroid tumors, thyroidectomy, thyroid radiation), changes after giving birth, trauma, unmanaged stress, chronic infections (i.e., SIBO, H-pylori, candida, Lyme), low stomach acid, endocrine-disrupting chemical exposure, chronic inflammation, moderate to excessive alcohol intake, other hormonal imbalances. What needs to be addressed depends on the individual.
Your PCP will likely refer you to an endocrinologist and prescribe thyroid medication.
Autoimmune thyroiditis
For Hashimoto’s or Graves to occur, three things must take place. You must have the genetics for this AI condition. However, just because you have the genes in your family for HT or Grave’s disease does not mean you are destined to get it. Other factors are involved in turning on the gene, including environmental factors and intestinal permeability. Environmental factors are wide-ranging, including root causes mentioned above, such as chronic stress, previous unresolved trauma, exposure to endocrine disruptors, nutrient-deficient diet, and food sensitivities. Even though the gene is turned on, a nutritionist can do much to help put your thyroid condition into remission so that you do not have to suffer from signs and symptoms.
Bottom Line
To understand the imbalances in the body, you need a health professional that will take the time to listen to you and understand where we need to look further and what needs to be done from a root cause perspective.
If you are ready to feel better, schedule a free 15-minute phone consult to see if my services are the right fit for you. I see clients in packages of four consults, by the hour and offer a one- and two-year concierge service. I see in-person clients in the Pagosa Springs, CO area and remotely all over the United States.
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References
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Chaker, L., Bianco, A.C., Jonklass, J. & Peeters, P. (2017). Hypothyroidism. The Lancet, 390(10101), 1550-1562. https://doi.org/10.1016/S0140-6736(17)30703-1 (Links to an external site.) (Links to an external site.)
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Hormones & Balance. (2016, Oct. 25). The gallbladder and hormone balance connection. And what does it mean when you don’t have a gallbladder. https://hormonesbalance.com/articles/gallbladder-hormone-balance-connection-mean-dont-gallbladder/
Hu, S. & Rayman, M.P. (2017). Multiple nutritional factors and the risk of Hashimoto’s thyroiditis. Thyroid, 27(5), 597-610. https://doi.org/10.1089/thy.2016.0635 (Links to an external site.) (Links to an external site.)
Lilifield, L. (2021, March 29). A functional medicine approach to autoimmune hypothyroidism (Hashimoto’s Thyroiditis). https://kaplanclinic.com/functional-medicine-hypothyroidism-hashimotos/ (Links to an external site.)
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