“My labs are normal and my thyroid is fine, it must be my hormones”
One of my new patients had just been to her primary doctor for a physical and lab work because she didn’t feel well and suspected hypothyroidism. Then she was told that her labs were normal, yes, even her thyroid test.
I have heard the same story from many of my patients over the years and have great compassion for them. They know innately that something is not right and I believe it’s my job to find the cause of their symptoms.
Many patients suffer in silence with hypothyroidism because some conventional physicians just look at one thyroid marker, the TSH (thyroid stimulating hormone), when assessing the health of the thyroid. These hypothyroid symptoms can happen even when you are currently taking thyroid medication, if not monitored correctly.
Common symptoms of hypothyroidism include:
In functional medicine, we know that it is extremely important to look at the full thyroid panel to understand what is really going on with the thyroid gland and it’s communication with the entire body and brain. The TSH can be within normal range but the body may not be able to use the thyroid hormone effectively.
There are 6 different types of thyroid dysfunction: primary hypothyroidism, under-conversion of T4 to T3, over-conversion, pituitary dysfunction, thyroid hormone resistance, thyroid binding dysfunction and autoimmune disease.
It is surprising that only one of these these types of hypothyroidism require thyroid hormone replacement. The 5 other types of hypothyroid (or low function) depend on proper diagnosis and evaluation to treat each patient individually and restore the delicate brain (pituitary) – thyroid feedback loop. Now you can see why it is important to look beyond the thyroid and look at diet/lifestyle, stressors, food sensitivities, toxins, hormone levels, anemia and infections to find the right, personalized treatment to help you feel like yourself again!
If hypothyroidism or hyperthyroidism is suspected, it is important to look at the thyroid antibodies. Autoimmune hypothyroid disease (AKA Hashimotos thyroiditis) can cause the hormone levels to fluctuate from day to day, from a hyperthyroid to a hypothyroid state.
With Hashimoto’s thyroiditis, a patient’s TSH levels can go from low to high over the course of the month (even when taking thyroid medication). So you can experience symptoms of both hypothyroidism as well as hyperthyroidism over a short period of time, making you feel terrible and maybe a little crazy!
Hyperthyroidism can be caused from a different autoimmune condition called Grave’s disease. The source of Grave’s disease can be similar to Hashimoto’s thyroiditis. Hyperthyroidism can also be caused by a thyroid nodule, which are lumps or nodules in the thyroid gland that cause the thyroid to produce excessive amounts of thyroid hormones.
Common symptoms of hyperthyroid include:
Fatigue or muscle weakness
Increased frequency of bowel movements
It is important to understand that if you have been diagnosed with antibodies to your thyroid, you have an autoimmune disease and your treatment will consist of more than just thyroid hormone. If Hashimoto’s is diagnosed in it’s early stages, thyroid hormone may not be necessary.
Diet, stress levels, “leaky gut” and environmental toxins can exacerbate your autoimmune response and cause your symptoms to worsen because the thyroid gland is literally being attacked. We also know that once you have been identified to have an autoimmune thyroid, you are more likely to develop another autoimmune disease if not treated effectively.
How the Thyroid interacts with Estrogen and Progesterone
Are hot flashes always caused from the dwindling supply of estrogen in peri-menopause? Not always, in fact, hot flashes and night sweats can also be caused from an underlying thyroid or adrenal problem. The thyroid, adrenal and ovaries all play a part in temperature regulation. But it is important to get a salivary adrenal and hormone panel to find the cause of the symptoms.
Women who take hormone replacement therapy, either synthetic or bio-identical, need to be monitored closely if there is a thyroid condition suspected. The additional dosing of estrogen creams or pills can overwhelm receptor sites of the cells and limit how much thyroid hormone can enter. Even though there is plenty in the blood, these women will still have hypothyroid symptoms because they cannot utilize their thyroid hormones.
Progesterone and thyroid hormone are intricately connected as they rise and fall together during ovulation, this is why some women feel warmer during this time. Low progesterone levels will usually cause low T4 production with a normal TSH. Symptoms include: heavy periods, inability to lose weight, and headaches and depression premenstrually. Women with hypothyroid are at higher risk for infertility and miscarriage due to lower progesterone levels. But often you can boost the progesterone level and the hypothyroid symptoms will improve without thyroid intervention.
Working with a Functional Medicine Practitioner can help you understand and incorporate important dietary changes, mind-body exercises and key supplements you need so you can start to reverse your hypothyroid or autoimmune thyroid condition.
Sometimes hypothyroidism, hyperthyroidism or an autoimmune thyroid condition can mimic many of the same symptoms as peri-menopause. Symptoms like weight gain, insomnia, anxiety, and hot flashes or night sweats.