Do you struggle with exhaustion, weight gain, infertility, constipation, and brain fog? Maybe you’ve got thinning hair, depression, or cold hands? And have you been to see your doctor – perhaps more than one – only to be told that there’s nothing wrong? Or worse, to have your symptoms written off as a natural component of aging, as “woman problems” (if you’re a woman), perhaps told stress was to blame, or even made to feel as if it’s all in your head.
Regrettably, this scenario is far too common in conventional medicine. And, as I explain to my patients every day, it’s often an undiagnosed thyroid condition that’s behind your symptoms. I want you to know that you’re not crazy and that this is not okay. As a functional physician, I know that thyroid problems can strike people as young as their 20s, they can affect men as well as women, and that the symptoms you are describing are all too real. At least 27 million Americans have some form of hypothyroidism (an underachieve thyroid), the most common form of thyroid dysfunction. Furthermore, it is estimated that 60% of those with thyroid dysfunction don’t know they have it. You may be one of them.
Does this sound familiar?
Let me share a story about that may resonate with you.
Troy is a successful businessman in his late fifties who travels extensively for work. He owns a ranch in the northwest where he retreats to fish, hike, and reconnect with his family. When I met Troy, he couldn’t remember the last time he had visited the ranch. He complained of low energy, weight gain, brain fog, dry skin, and decreased libido. What’s worse, he had been suffering from these symptoms for many years – so many, in fact, that he had begun to accept this state as his new normal. Troy had already seen 4 doctors before our appointment. All of them assured him that his concerns were simply a natural part of the aging process; each doctor said that his labs were in the normal range. To address his symptoms, Troy had been prescribed a shocking array of medications: anti-depressants, anti-anxiety medications, ED meds, statins, and sleep aids.
Troy rightly wondered, how can I be fine when I feel this terrible?
After listening to Troy’s symptoms and hearing the hopelessness in his voice, I was determined to find a solution. So, I took a complete medical history, asked him about the medications he was taking as well as any supplements. In addition, I enquired about his quality of life. I wanted to know: Are you exercising? What activities do you enjoy? And, how about relationships and intimacy? Troy told me he no longer exercised – he was too tired. He didn’t really have much joy in his life. Even a trip to his ranch seemed exhausting. And intimacy? Only a few years earlier, he still enjoyed a vibrant sex life and the stamina of a youthful man. Now? Sex had lost much of its luster.
I ordered a comprehensive metabolic panel, and a complete thyroid panel as well as an assessment of essential micronutrients. At Troy’s follow-up, we saw that most of his thyroid labs were indeed in the low “normal” range but that’s not always good enough. What is “normal” for one person can be sub-optimal for another. In Troy’s case, we compared his current labs to his results from the age of 50. I saw a significant fall in his Free T3, the active thyroid hormone; his levels were far from optimal. His testosterone had also fallen to the low 200s – I like to see my male patients maintain T-levels of 900-1100. When your thyroid levels drop, your sex hormones fall right along with them. These declines explain Troy’s low energy, low sex drive, and poor quality of life. He had been suffering from functional hypothyroidism for many years without treatment. Troy’s thyroid dysfunction had not been detected sooner because his physicians were treating his lab results and not treating him as an individual.
Unfortunately, I see patients daily – men and women, young and old – who tell me similar stories. This is a real shame as the solution is actually relatively simple. I placed Troy on desiccated thyroid hormone, in his case NP-Throid, along with nutraceuticals to support his thyroid. Once we optimized his thyroid, not only did his thyroid function improve but his testosterone levels returned to normal on their own, so he required no testosterone replacement therapy. Three months later, Troy called me from his ranch to thank me. He had stopped taking all of the meds prescribed by his other doctors and he felt better than he had in years. He was energized and sleeping well and once again fly-fishing with his family. Best of all, Troy and his wife had rekindled their flame – it was like they were on a second honeymoon.
A Functional Thyroid Is Essential – It is Your Master Hormone
Show me a person with a happy body and a great attitude and I can almost guarantee that he or she has a healthy thyroid. Most of us do not appreciate the degree to which our overall body function is dependent on our thyroid. The hormones produced by the thyroid gland create power for every cell in your body. Every cell in the body has a thyroid receptor because every cell requires thyroid hormone to properly function. Your thyroid is the key that turns on each and every cell and determines the speed at which the cell’s DNA can do what it’s genetically programmed to do.
Although the thyroid’s primary role is the secretion of thyroid hormone and the regulation of weight, thyroid hormone affects every cell in your body. It turns your food into energy. Without precisely the right amount of thyroid hormone, your organs cannot perform at optimal levels and your cells cannot produce properly. But, that’s not all. The thyroid gland is critical for the production of sex hormones, as well. So, if your thyroid is out of whack, your testosterone and estrogen levels will follow suit. This is exactly what happened to my patient Troy. Once you’ve gone down this slippery slope, your quality of life has long been on the decline.
6 Things Your Doctors Don’t Get About Your Thyroid Diagnosis
If Troy had been tested properly for thyroid dysfunction and received appropriate treatment earlier, he would have gotten better within months instead of slogging through his days for years on end. The fact that he had hypothyroidism that was left undiscovered absolutely infuriates me. What’s more, his case is the norm not the exception. Patients will walk into their doctors’ offices complaining of fatigue, weight gain, and depression, and their doctors will write prescriptions for anti-depressants and sleeping pills and send them out with instructions to exercise more, instead of recognizing the underlying thyroid problems. Many conventional physicians end up prescribing diet pills and ADD medications rather than diving in to find the root of the disease causing these symptoms.
I always remind myself that my patients do not want to feel bad; and, I am obliged to uncover the source of the problem. I want my patients to love their lives not simply tolerate them – and an untreated thyroid problem is one sure way to be miserable. If you suspect you have a thyroid problem, or, if you’ve gotten a diagnosis but you’re not seeing any real improvements, here are 6 things I want you to keep in mind:
1. They don’t run a complete panel
TSH, or thyroid stimulating-hormone, is typically the first and only test ordered when a patient with thyroid symptoms is evaluated by a physician. The problem is that, in isolation, your TSH levels reveal little about your thyroid health. Using only TSH to screen for hypothyroidism misses 80% of cases. Let that sink in; that’s most of the time. The TSH screen misses far too many diagnoses, leaving patients needlessly suffering. As a functional physician, I know that TSH represents only one-fourth of the picture. It is imperative to always test for all the functional thyroid studies, which include: TSH, Total T4, Free T3, and TPO (Thyroid Peroxidase). If I had looked solely at Troy’s TSH levels, he would not be fly-fishing at his ranch anytime soon.
2. They overlook an important marker
As many as 80% of people diagnosed with hypothyroidism actually suffer from Hashimoto’s, an autoimmune condition where your immune system attacks your own tissue. Despite what your conventional doctor may tell you, Hashimoto’s isn’t actually a problem of your thyroid; it’s a problem of your immune system. If you have Hashimoto’s, your immune system is malfunctioning and attacking your thyroid, causing it to underproduce its hormones and slowing down all of your metabolic processes. And, in these instances, you can have symptoms for years and have no idea.
Patients get all kinds of inaccurate “diagnoses” for a broad range of diseases – from autoimmune conditions to major psychiatric disorders. But, in reality, Hashimoto’s may be to blame. Hashimoto’s is a leading cause of hypothyroidism, yet mainstream medicine fails to test patients for thyroid antibodies that indicate the diagnosis. Every patient who presents with thyroid symptoms should have their TPO (Thyroid Peroxidase) levels screened. This simple blood test is all you need for a diagnosis.
3. They don’t augment with iodine
Iodine is a relatively rare element but it’s found in abundance in the ocean. Unless you live on the east or the west coasts, you are likely iodine deficient – end, even if you do, chances are still good. In fact, 72 % of the world’s population is deficient in iodine. Why should you care? This micronutrient is essential to every cell in the body and is necessary for the production of all hormones, including thyroid. Iodine is one of the building blocks of your thyroid hormones. Similarly, every hormone and every cell in your body require micronutrients for optimal function. If you want to learn about the supplements you need to keep all of your hormones happy, you can read more here. For now, if you’ve been diagnosed with hypothyroidism and your physician does not recommend iodine supplementation, you may notice no improvement whatsoever even if you’re taking thyroid hormone.
4. They don’t focus on the right thing
Optimizing your thyroid is increasingly significant as we age. In order for you to feel well, you must convert T4 to T3. The older you get, the harder it is for your body to convert T4 to T3. Why is this important? Since T3 is the most active useable form of thyroid hormone that can be used in the cells of the body, Free T3 is critically important. Unfortunately, most mainstream doctors do NOT test for Free T3 levels. Over time, the amount of thyroid hormone decreases as a result of a decreased production by the gland. Additionally, age-related loss of effectiveness at receptor sites causes low thyroid symptoms in spite of “normal” blood levels. The only successful treatment for thyroid disorders is prescribing T3 and T4 combination-thyroid hormone along with key nutrients to support the thyroid. If your physician isn’t recommending this course of action, then find a new one.
5. They rely on old ranges
Even if your doctor does order a complete thyroid panel, they’re usually relying on “normal” reference ranges that are too broad and often inaccurate. It’s very important to know that your thyroid levels can be “normal,” just like Troy’s, and you can still have thyroid symptoms. That’s why I use optimal reference ranges when evaluating your thyroid labs.
- Broad reference ranges– Ranges were created using people who go to the doctor (i.e. sick people), not healthy ones. So, the reference ranges are far too broad to catch minor variations in thyroid health.
- Non-standardized reference range– Not only is the reference range too broad, but it can vary from state to state, lab top lab, and even doctor to doctor. This mans it’s possible that you can have a thyroid disorder in one state, but not another. That’s not good science and it’s definitely not good medicine.
So, even though your doctor tells you that your thyroid labs are just fine, if you’re still experiencing symptoms, get a second opinion—and a third, if necessary.
6. They miss the big picture
Everyday life in our modern world robs you of important nutrients that are essential for healthy thyroid function. And it’s key to screen for micronutrient levels because they play a major role in optimizing thyroid function. This is why I assessed Troy’s essential micronutrient levels at our first appointment. When you take medications, when you eat certain foods, when you’re exposed to certain chemicals found in everyday products, your thyroid is compromised. The culprits are nefarious and pervasive and include things like soy, gluten, dairy, and refined sugars, as well as the chloride in your water, fluoride in your toothpaste and mouthwash, and bromides in bread, make-up, and hair color. All of these bad actors also affect your gut health. This matters because there is a direct correlation between your gut, your microbiome, and thyroid function. About 20% of the conversion from T4 to T3 (the active form) happens in the gut. If you have an unhealthy microbiome, you’ll lose that 20%. Plus, your overall nutrient absorption will diminish and many of the nutrients that play a pivotal role in thyroid function will also be low.
How can you be sure you’re getting the best thyroid care?
You walk into the doctor’s office with telltale physical signs of hypothyroidism, including swelling of your face, signs of fatigue, thinning of your eyebrows and hair, pale dry skin, red irritated dry eyes, cold hands and feet, dulled reflexes, hoarseness of voice, and over 200 more obvious symptoms. Your doctor has no idea your physical symptoms are due to hypothyroidism. You are a walking talking billboard for hypothyroidism, but your doctor does not notice. To top it off, not only does the typical conventional physician not run a full thyroid blood panel, but many fail to fully investigate the patient’s medical history, symptoms, family history and conduct a thorough physical exam. I do not believe that patients are to blame for this.
Physicians should get up to speed and stop practicing medicine like it’s forty years ago. In their defense, I will point out that it typically takes 20-30 years for mainstream medicine to incorporate new medical research. However, it is crucial that physicians stay abreast of new science such as longevity science and precision medicine.
Patients: you have to be your own best advocates. Research your physician before your appointment – look for doctors who practice functional medicine because they understand thyroid physiology. And come armed with this list of 6 things that most doctors don’t get about your thyroid diagnosis. Now that you get them, you will be in a better position to get the best care.