Hypothyroidism
The thyroid gland controls metabolic rate and is the energy powerhouse of every cell in your body. Proper thyroid function influences digestion, circulation, brain chemistry, skin quality, energy, and much more. Think of thyroid hormone essentially being the gas pedal that drives metabolism. If that gas pedal eases off, it slows down the function of your whole body.
Approximately 30 million women and 15 million men in this country have been diagnosed with hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone. Common symptoms of hypothyroidism include fatigue, weight gain, poor memory, difficulty concentrating, constipation, low libido, intolerance to cold, dry skin, hair loss, depression, gynecologic issues, cardiovascular conditions, skin problems, and lots more.
There are several theories as to why hypothyroidism is so prevalent. Potential contributing factors include environmental toxins like Bisphenol A (BPA) from plastics, heavy metals like mercury and lead, living in our fast-paced high stress society, and pesticides and fungicides in our food supply.
Subclinical Hypothyroidism
Currently, the most accurate way to diagnose hypothyroidism is to measure the amount of thyroid stimulating hormone (TSH) in the blood. For overt cases of hypothyroidism the TSH is a reliable test. The problem with this test however is that it does not identify people in the grey area with less pronounced disease. Hypothyroidism is not a condition of you either have it or you don’t. Many people have an under-functioning thyroid gland with many symptoms of hypothyroidism but their lab tests come back normal. We classify these people as having “subclinical hypothyroidism.” In my experience, people experiencing hypothyroid symptoms with a TSH between 3.0 and 5.0 (within the normal range) often profoundly benefit from thyroid treatment.
Hashimoto’s
Hashimoto’s Thyroiditis is the most common cause of overt hypothyroidism. It is an autoimmune condition where the body’s own immune system is attacking the thyroid gland and through this destruction, causes a decrease in thyroid hormone production.
Anyone newly diagnosed with hypothyroidism should be screened for Hashimoto’s with a simple blood test looking for thyroid peroxidase antibodies (TPO) and thyroglobulin antibodies. If you have Hashimoto’s make sure your physician is working with you to not only replace your thyroid hormone, but also to decrease your thyroid antibodies.
Treatment Options
To understand your treatment options for hypothyroidism you must first understand how thyroid hormone works in the body. T4 is the less active thyroid hormone and constitutes the majority of thyroid gland secretion. As T4 circulates throughout the body it is converted to T3, the more active form of thyroid hormone which drives metabolism. Along with T4, the thyroid gland also secretes some T3 as well as the less recognized hormones T1 and T2.
The most widely used treatment for hypothyroidism is replacement with synthetic T4 hormone. Some people do fine on this replacement and never need another option. Others will see their labs normalize, but they do not feel significant improvement in their symptoms. I have found the majority of these people will feel much better with desiccated thyroid hormone that contains 80% T4 and 20% T3 as well as trace amounts of T1 and T2.
Conclusions
If you are experiencing fatigue, brain fog, difficulty losing weight, or other symptoms of hypothyroidism and your thyroid labs have always been within the normal range, you may have “subclinical hypothyroidism.”
If you are taking synthetic thyroid replacement but still do not feel well, you may benefit from a trial of dessicated (natural) thyroid hormone which contains all four thyroid hormones instead of just T4.
Hashimoto’s is a very common cause of hypothyroidism and can sometimes be overlooked in the initial work-up of hypothyroidism. If you are hypothyroid make sure your physician has tested for thyroid antibodies. If you have Hashimoto’s make sure your physician is working with you to decrease your autoimmune response as well as treat your low thyroid function.
In Health,
Naturopathic Medical Doctor at Root Natural Health, Flagstaff, Arizona
Root Natural Health's Blog 
Posted by Ellen on April 4, 2012 at 7:35 am
Dear doctor,
Maybe the next article can be interesting for children with
subclinical hypothyroidism. A diet supports the thyroid with everyday food and about 70% of the elevated TSH levels normalize!
http://www.scirp.org/journal/PaperInformation.aspx?paperID=17977
Posted by Root Natural Health on April 14, 2012 at 9:41 am
That is a great suggestion for our next article, we will surely be writing more about hypothyroidism soon. The following abstract that you sited is great. As doctors it is important for us to not solely watch the TSH, but also watch changes in the free thyroid hormones (T4 and T3) along with clinical symptoms. Unfortunately, the TSH is not a stand alone perfect lab test for thyroid function and if we treat solely on TSH than we find clinically that not all (subclinical) hypothyroid patient start feeling better. Our goal is to treat the cause of (subclinical) hypothyroidism and have our patient feeling healthy and happy.
Posted by Rhoda from college of naturopathic medicine on October 29, 2012 at 12:29 am
Well done for all your hard work in providing this high quality blog.Thanks for sharing such a useful information.
Posted by Clarisa Zirin on February 3, 2013 at 9:42 am
hypothyroidism can also lead to other diseases if it is not treated at the earliest..