“I have been diagnosed with hypothyroidism, my TSH is normal but I still feel cold all the time, I have brain fog and I can’t lose weight.”  Sound familiar? It sure sounds familiar to me.  I hear this sentiment all the time from my patients with hypothyroidism.  Sometimes thyroid balance can be tricky.  I used to think it was the easiest condition to treat.  I would diagnose hypothyroidism based on symptoms and lab abnormalities and I would simply start levothyroxine (thyroid hormone replacement) for my patient and call it a day.   Little did I know at the time that I was just scratching the surface.  Often patients would come back saying that they still did not feel right.  I would recheck the TSH and if it was in normal range I really had no more advice to give.  Once I started studying functional medicine, I began to realize that there was a lot more to it.  I never thought to ask WHY my patient’s thyroid levels were abnormal.  Most thyroid imbalances are related to an autoimmune condition called Hashimoto’s Thyroiditis.  Sometimes it can be related to deficiencies of the nutrients and minerals it takes to make thyroid hormone. Most often our immune system has become confused and has misidentified our own self as an enemy.  Over time hypothyroidism or a under-active thyroid causes symptoms.  It is really important to distinguish if thyroid imbalances are related to immune system problems because it will affect our approach.   My basic three step approach is the following:

Step #1 Determine if your thyroid issue is related to autoimmunity. If not, it could be related to deficiencies or other hormone imbalances (usually our stress hormones).  I am always surprised by how many patients come in not knowing whether their thyroid issue is related to their immune system.  Most likely it is, but not always.  Sometimes part of the thyroid was removed surgically due to a nodule or even cancer but even then, it is important to think about why that happened.   Sometimes the issue is mineral deficiencies and sometimes imbalances relating to our stress hormones.  It is really important to consider the medical history as well as pay attention to life events surrounding the diagnosis.

Step #2 Balance your hormones. Check all of the thyroid markers, including the TSH, T3, T4 and work on finding balance with your doctor.  This may mean trying different forms of thyroid hormone replacement or helping your body better balance T3 and T4.  Depending on your age and symptoms, you may also want to investigate adrenal hormone testing such as cortisol as well as some of the sex hormones too.  It is important during this  process to take note on how you are feeling and not just “treat the numbers”.

Step #3 For autoimmune Hashimoto’s thyroiditis, look at root causes of immune system imbalances, this could be anything from infections, foods, toxins or traumas.  The timeline of the condition and your health history is key here.  If your antibodies are negative and you do not have autoimmune thyroid problems then testing to see if you are deficient in certain minerals such as zinc, selenium and iodine and then considering WHY you are missing these critical nutrients.

To learn more on how functional medicine can help you halt the hypothyroid havoc contact Dr Elisa Mercuro DO at Sparkle Health or visit www.sparklehealthnh.com.

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