Progesterone is quite the buzz word these days. Whether you’re in perimenopause and considering hormone replacement therapy (HRT), you’re newly pregnant and having levels tested, or you’re experiencing some menstrual irregularities attributed to imbalances between estrogen and progesterone, the term has likely come up for you. But, what is progesterone What does it do for the body How do you know if you have enough of it How can you test progesterone levels at home Read on to find answers to all these questions and more.

What is progesterone and how can you test progesterone levels at home?

Progesterone is a hormone primarily produced by the ovaries in women, particularly after ovulation during the second half of the menstrual cycle. After ovulation, a gland called the corpus luteum forms which secretes progesterone. If you don’t ovulate, you can’t make progesterone because you won’t have a corpus lutem. You need progesterone because it plays a crucial role in regulating the body’s functions, including:

1. Menstrual Cycle: Progesterone helps prepare the uterine lining for potential implantation of a fertilized egg. It also prevents the uterine lining from getting too thick or shedding too quickly.
2. Pregnancy: If pregnancy occurs, progesterone helps maintain the uterine lining, supporting the developing embryo. This is where progesterone gets its name from: pro-gest(ation)
3. Breast Development: It also protects breast tissue from too much estrogen and prepares the breasts for milk production during pregnancy.

In addition to its role in female reproductive health, progesterone is involved in other bodily functions, including mood regulation, sleep and maintaining bone density. (Because it’s so important, and because many providers don’t test levels in office, it’s helpful to know how to test progesterone levels at home.) It is also used in hormone replacement therapy and in various contraceptive methods. Let’s take a closer look:

Progesterone and Brain Health

Progesterone significantly affects the brain and mood due to its influence on neurotransmitters and brain function. Here are some key ways it affects mood:

1. Neurotransmitter Modulation: Progesterone enhances the effects of certain neurotransmitters, such as gamma-aminobutyric acid (GABA), which has calming effects and reduces anxiety.
2. Mood Regulation: Changes in progesterone levels during the menstrual cycle lead to mood fluctuations. Higher levels in the luteal phase (after ovulation) contributes to feelings of calmness, while lower levels pre-menstruation correlates with mood swings or premenstrual syndrome (PMS).
3. Anxiety and Depression: Studies show that progesterone protects against anxiety and depression, though the relationship varies from person to person. I describe estrogen as an “energizing” hormone, which motivates and gets you going. But all that energy, when not balanced by the cool, calming effects of progesterone, becomes anxiety and irritability. Knowing how to test progesterone levels at home is helpful when struggling with premenstrual symptoms like depression or anxiety. If you can track your levels, you can anticipate better how to support your mood.
4. Neuroprotection: Progesterone may have neuroprotective properties, potentially supporting brain health and cognitive function. Maintainin healthy progesterone levels throughout life decreases risk of brain fog and neurodegeneration.
5. Sleep Quality: Progesterone is also linked to improved sleep quality, which subsequently boosts mood. Insomnia is a problem for many perimenopausal women, and the most common prescription is estrogen hormone replacement therapy. However, progesterone actually is much more effective at improving sleep both in perimenopause and at other times of life.

Progesterone and Metabolism

Progesterone affects metabolism and blood sugar control in several ways:

1. Cortisol Interaction: Progesterone interacts with cortisol, the stress hormone. High levels of cortisol affect blood sugar levels and metabolism, and progesterone helps moderate some of these effects.
2. Reproductive Health: In women with polycystic ovary syndrome (PCOS) or other hormonal imbalances, therapeutic strategies that increase progesterone also help regulate menstrual cycles and improve metabolic outcomes. In many cases, low progesterone levels in early pregnancy can lead to miscarriage, which is why it’s helpful to know how to track progesterone levels at home (so you can advocate for yourself in a healthcare provider’s office!)

Progesterone and Thyroid Function

Progesterone affects thyroid function in several ways, largely due to its interactions with thyroid hormones and the overall hormonal balance in the body. Here are some key points:

1. Thyroid Hormone Regulation: Progesterone changes how and when the body makes thyroid hormone, influencing metabolism. It also helps support the synthesis of thyroid hormones and enhances their effects.
2. Binding Proteins: Progesterone affects the levels of thyroid-binding globulin (TBG), a protein that binds thyroid hormones in the blood. Increased levels of TBG can lead to higher total thyroid hormone levels, and increased metabolic rate/response.
3. Metabolic Rate: Progesterone benefits metabolic rate, partly by influencing thyroid hormone activity. This dramatically impacts energy levels and weight management.
4. Hormonal Balance: In women, fluctuations in progesterone during the menstrual cycle influences thyroid function. For example, low progesterone levels are associated with conditions like hypothyroidism and infertility.

Progesterone, Adrenal Function and Cortisol

Progesterone has several effects on adrenal function and cortisol levels, primarily through its interactions with the endocrine system. Here are the key points:

1. Stress Response: Progesterone helps modulate the body’s response to stress. It has a calming effect and counterbalances some of the stimulating effects of cortisol and estrogen.
2. Hormonal Balance: The relationship between progesterone, cortisol, and other hormones is complex. High cortisol levels can lead to a decrease in progesterone, contributing to hormonal imbalances that can affect mood, energy levels, and overall health.

Does the birth control pill have progesterone?

Progestins, the synthetic versions of progesterone used in many forms of birth control, differ from natural progesterone in several key ways:

1. Chemical Structure: Progestins are chemically modified molecules of testosterone that have been changed to interact with the human brain and ovaries. Although they are chemically similar, they are not exactly the same.
2. Hormonal Activity: While progestins mimic some of the actions of natural progesterone, they can have varying degrees of activity on progesterone receptors and other hormone receptors (like androgen and glucocorticoid receptors). This leads to side effects that are not typically associated with natural progesterone. The progestins in birth control contribute to insulin resistance, thyroid disorders and depression whereas natural progesterone prevents those things.
3. Side Effects: The side effects of progestins differ from those of natural progesterone due to their altered hormonal activity. Many experience mood changes, weight gain, or acne with artificial progestins, while these effects don’t occur with natural progesterone.
4. Impact on Menstrual Cycle: Progestins can affect the menstrual cycle in ways that natural progesterone does not, such as altering bleeding patterns, causing lighter or more irregular periods, or even stopping menstruation altogether in some users.

The biggest takeaway is that using artificial progestins, by design, prevents your body from producing its own progesterone. If you have progestins, you can’t have progesterone, and you’re therefore automatically progesterone deficient. In this case, it won’t be helpful to test progesterone levels at home.

How to Test Progesterone Levels

The first and most important thing is to determine if you’re ovulating. If you aren’t ovulating, you can’t make progesterone because you won’t have the corpus luteum gland we discussed earlier. It is impossible to “test” progesterone levels at home if you’re not ovulating because you will not have any meaningful level of progesterone in your body. That means that if you’re using oral ceontraceptives like the birth control pill, or other forms of hormonal drugs like the implant, the Nuva Ring, or certain types of IUD, you aren’t ovulating and subsequently are progesterone deficient.

However, other health conditions may also cause low progesterone because of anovulation, like thyroid disorders, hypothalamic amenorrhea (stress-induced anovulation and lack of periods), and PCOS to name a few. If you aren’t having ovulatory periods at least every month, you are likely deficient in progesterone.

1. How to Track Progesterone Levels at Home with Ovulation

To track your progesterone levels at home, you first need to find out if you’re ovulating and when. The most straightforward way to know if you’re ovulating is to track your cycle using basal body temperature. I wrote a blog post all about how to do this which you can access here. You also can track ovulation using prediction methods, such as urinary LH testing or tracking cervical fluid, though it’s important to note that these methods do not confirm ovulation. Rather, they predict when (generally) in your cycle you may be close to ovulation.

When tracking ovulation, mark the following…

• The day before your basal body temperature rises above baseline
• The day after you have a positive LH test strip
• The day before your cervical fluid transitions from watery/ewcm (egg white cervical mucus) to a thick, dry, gluey texture

2. How to Track Progesterone Levels at Home with Luteal Phase

Once you have identified the day of ovulation, the next step in learning how to track your progesterone levels at home is calculating your average luteal phase length. The luteal phase is calculated from the total cycle length (i.e. 28 days) minus the day of ovulation (i.e. day 14). In the example just given, a 28-day cycle minus ovulation day of CD 14 would be a 14-day luteal phase, which is optimal.

A short luteal phase, which is less than 10 days long, is a sign of progesterone deficiency.

However, tracking luteal phase at home also helps you to know when the optimal day to test progesterone levels is, whether using a urinary hormone test at home or you are visiting a lab facility to have a progesterone blood draw. The optimal day to test progesterone levels is 5 to 7 days before your next period. Obviously, if you have no idea how long your luteal phase is, you don’t know when to predict that optimal 5-to-7-day period. This is why it’s important to track cycle length, day of ovulation, and luteal phase length for several cycles before tracking progesterone levels at home. Testing on the wrong day might give results that make it seem like you have a less-than-optimal level of progesterone.

Basal body temperature charts can also give indication of progesterone levels. While they are an indirect measure, if you have an elevation of your body temperature above baseline that is less than 0.5 degrees Fahrenheit, it may be a sign of low progesterone levels.

3. How to Track Progesterone Levels at Home with Luteal Phase

After the corpus luteum makes progesterone, the body breaks it down into a progesterone metabolite called Pregnanediol Glucuronide (PdG) which can be measured in urine, similarly to urinary LH test strips. While it is not exactly the same as progesterone, it reflects progesterone production and levels in the body.

PdG test strips can be purchased inexpensively over the counter, such as Easy @ Home, Proov and Inito (a comprehensive fertility hormone testing system that also includes estradiol, LH and FSH levels). Using urinary PdG, a level of 5 ug/mL indicates successful ovulaiton, which is roughly equivalent to a serum progesterone level of 10 ng/mL. The optimal levels for urinary PdG and blood serum progesterone would then be 7.5 ug/mL (urinary) and 15 ug/mL (serum) respectively.

How to Track Progesterone Levels at Home with Signs and Symptoms of Progesterone Deficiency

While clinical symptoms don’t confirm progesterone deficiency, they may serve as a clue that you are low on progesterone and should consider starting to test your progsterone levels at home. These include:

• Irregular Menstrual Cycles: Changes in cycle length, missed periods, or very light or heavy menstrual bleeding.
• PMS Symptoms: Increased premenstrual syndrome (PMS) symptoms, such as mood swings, irritability, and bloating.
• Mood Changes: Anxiety, depression, or mood swings that are more pronounced around the menstrual cycle.
• Sleep Issues: Difficulty sleeping or insomnia.
• Hot Flashes: Symptoms resembling those of menopause, including hot flashes and night sweats.
• Weight Gain: Unexplained weight gain or difficulty losing weight, often due to changes in metabolism.
• Low Libido: Decreased sexual desire or changes in sexual function.
• Fatigue: Increased fatigue or low energy levels.
• Breast Changes: Tenderness or changes in breast tissue, including fibrocystic changes.
• Hair Loss or Thinning: Changes in hair growth, including thinning hair or hair loss.

Perimenopause

One of the hallmarks of perimenopause is a shortening luteal phase length, shorter menstrual cycles and less progesterone. Estrogen also takes off on a roller coaster ride. You can diagnose perimenopause with an elevated FSH level in combination with a normal or increased LH level, or with increased LH and FSH in combination with having had a menstrual period in the last 12 months. Being age 40 or above is also a good sign that your progesterone levels are changing.

Test for Progesterone with Lab Testing

Of course, the only way to know for sure that you have low progesterone levels (provided that you are ovulating) is to test them. A progesterone level of at least 4.44 ng/mL (this may vary slightly depending on the lab) is required to confirm ovulation. However, what we care most about is the peak progesterone level achieved in the luteal phase. Because normal luteal phases typically range from 10-14 days, you need to test your progesterone level between 5 and 7 days before the start of your next period.

If you have regular menstrual cycles and track ovulation with basal body temperature, you know exactly when you’ll reach the midpoint of your luteal phase. If you don’t know when you ovulate, look at the average length of your menstrual cycles. If your cycles are between 24 and 28 days long, I’d recommend scheduling a blood draw 5 days before your next expected period. If they are 29 days or longer, I’d recommend scheduling a blood draw to be 7 days before your next expected period. Note that this isn’t a perfect algorithm; it’s possible to have a 14-day luteal phase in a 24-day cycle and a 10-day luteal phase in a 33-day cycle. However, particularly in the case of perimenopause, a short cycle is more likely to be accompanied by a relatively shorter luteal phase. The target is at least 15.0 ng/mL at the peak progesterone production, however higher is always better. (Note: non-pregnant cycles rarely exceed 28 ng/mL)

Not having enough progesterone leads to a range of health risks and complications, particularly in women. Symptoms include irregular periods, heavy bleeding, or amenorrhea (the absence of menstruation). This hormonal imbalance also exacerbates premenstrual syndrome (PMS) symptoms, leading to heightened mood swings, anxiety, and irritability. Additionally, progesterone deficiency is associated with an increased risk of endometrial hyperplasia, a condition where the uterine lining becomes too thick, potentially raising the risk of endometrial cancer. It also affects bone health, as progesterone plays a role in maintaining bone density; low levels may contribute to osteoporosis over time. Furthermore, inadequate progesterone leads to fertility issues, as it is essential for preparing the uterine lining for implantation of a fertilized egg. Overall, a lack of progesterone significantly impacts physical and emotional well-being, so if you are concerned about your progetserone levels, be sure to seek care from a functional medicine physician.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Test Progesterone Levels at Home appeared first on Dr. Alexandra MacKillop.

Resources abound for hypothyroidism online. After all, it is one of the leading hormonal imbalances affecting women, and rates are rising faster than ever. But for those dealing with a different condition—or really, quite the opposite condition—of hyperthyroidism caused by Graves’ Disease, it can feel lonely and isolating when nobody is talking about, or offering help for you.

Well, you’re in the right place.

Doctors use the term hyperthyroidism to refer to a condition in which the thyroid gland is producing too much thyroid hormone, increasing metabolic rate to debilitating and sometimes dangerous levels. There are classically two main autoimmune conditions that can cause this: Graves’ Disease and Hashimoto’s Disease. While both Graves’ Disease and Hashimoto’s Disease are autoimmune conditions affecting the thyroid, they are different from each other. They are diagnosed differently, treated differently, and have different long-term health implications.

Let’s start by explaining autoimmunity.

Autoimmunity refers to the abnormal immunological process of producing antibodies against a person’s own self. Antibodies are like little soldiers made by the immune system for the purpose of fighting off foreign invaders like germs. If the body starts mobilizing soldiers against itself, that leads to problems ranging from inflammation to organ damage and even death. Graves’ Disease and Hashimoto’s Disease both involve the abnormal production of antibodies targeting the thyroid gland, but they produce hyperthyroidism in different ways.

What Is Hashimoto’s Disease?

Hashimoto’s Disease is the most common autoimmune diseases affecting the thyroid. Classically, however, it is thought of as causing hypothyroidism, and that’s because most cases do eventually result in a hypothyroid state. However, in the early stages, it can cause hyperthyroidism, or an overactive thyroid, too.

In Hashimoto’s Disease, the body makes antibodies (anti-thyroglobulin and anti-thyroperoxidase antibodies) that destroy elements of the thyroid gland. This causes swelling and inflammation of the thyroid gland. The inflammation itself is what can cause periods of thyroid overactivity because the provocation from the antibodies and resultant inflammatory processes may trigger the thyroid gland to produce even more hormone.

However, over time, as enough damage is wrought on the thyroid resulting from this autoimmune-driven inflammation, the thyroid may stop functioning as well as it should, or perhaps even may stop functioning altogether. As a result, hypothyroidism develops and while it can sometimes be improved through functional medicine, Hashimoto’s Disease that is diagnosed too late may lead to permanent hypothyroidism.

What Is Graves’ Disease?

Graves’ Disease is very different. Whereas Hashimoto’s Thyroiditis is the most common cause of hypothyroidism (ultimately), Graves’ Disease is the autoimmune disorder that is the most prevalent cause of hyperthyroidism. It occurs when the immune system produces antibodies that bind to the thyroid-stimulating hormone receptor (TSHR), leading to excessive thyroid hormone production. Under normal circumstances, the brain makes TSH (thyroid-stimulating hormone) for the purpose of binding to these receptors and stimulating the thyroid to produce thyroid hormone. In Graves’ Disease, thyroid-stimulating immunoglobulins (antibodies) bind to these receptors. In other words, the immune system mimics the brain and triggers the thyroid to make antibodies.

How Does Graves’ Disease Cause Health Problems?

Overproduction of thyroid hormone in Graves’ Disease accelerates metabolism and can result in symptoms such as weight loss, rapid heartbeat, anxiety, tremors, and eye problems like bulging eyes (Graves’ orbitopathy). Additionally, Graves’ Disease poses risks for people who are trying to get pregnant (or stay pregnant,) who struggle with anxiety, or who have cardiac conditions. It also may be challenging to function with Graves’ Disease because it often also brings other symptoms that affect quality of life, like body aches, sleep problems, and panic attacks. The immune side of Graves’ Disease is also problematic, as it can bring on episodes of full-body hives. If you’ve ever experienced this, you know just how overwhelming it can be.

How Is Graves’ Disease Diagnosed?

Diagnosis typically involves:

• Blood Tests: Measuring levels of thyroid hormones (T3 and T4), thyroid-stimulating hormone (TSH), thyroid-stimulating immunoglobulin (TSI) and thyroid-stimulating hormone receptor antibodies (TRAb) is an essential piece of diagnosing Graves’ Disease.
• Ultrasound: Assessing the size and texture of the thyroid gland. Thyroid nodules can also produce thyroid hormone, so it’s important to understand the root cause of hyperthyroidism and not simply assume that the root cause is Graves’ Disease.
• Radioactive Iodine Uptake Test: Determining how much iodine the thyroid absorbs, which is often elevated in Graves’ disease.

The Role of Gut Health in Graves’ Disease

Emerging research indicates a significant connection between gut microbiota and Graves’ disease. Studies have shown that individuals with Graves’ disease exhibit reduced gut microbiota diversity compared to healthy controls. Specifically, there is a decrease in the abundance of Firmicutes and an increase in Bacteroidetes, suggesting an imbalance in gut bacteria that may influence autoimmune responses.

Furthermore, certain gut bacteria have been found to share structural similarities with thyroid proteins, potentially triggering immune responses that lead to autoimmune thyroid diseases like Graves’ disease. The functional medicine perspective recognizes that gut health, and balancing the gut microbiome, is essential for managing Graves disease.

Functional Medicine Strategies for Managing Graves’ Disease

Functional medicine emphasizes a holistic approach to managing Graves’ disease, focusing on diet, supplementation, and lifestyle modifications to support thyroid health and overall well-being.

1. Functional Medicine Testing

• Gut Health: Gut health plays a crucial role in regulating the immune system, as a large portion of immune activity occurs in the gastrointestinal tract. An imbalanced gut microbiome or increased intestinal permeability (“leaky gut”) triggers immune dysregulation, contributing to autoimmune reactions like Graves’ disease by allowing toxins or antigens to enter the bloodstream and provoke an inappropriate immune response. Functional medicine offers testing methods for identifying the status of the microbiome including specific strains of microbes that are or are not present, allowing tangible, specific tests for treatment and rebalancing.
• Food Sensitivities: Food sensitivities overstimulate the immune system by triggering chronic, low-grade inflammation each time reactive foods are consumed. In individuals with autoimmune conditions like Graves’ disease, this constant immune activation may exacerbate symptoms or contribute to flare-ups by increasing the overall inflammatory burden. Identifying and eliminating trigger foods can help reduce immune system stress and support more balanced immune function. Functional medicine offers testing methods for IgG and IgA-mediated food sensitivies as well as Ig-E mediated food allergies.
• Histamine:Histamine intolerance occurs when the body cannot properly break down histamine, leading to an overload that triggers inflammation and immune system activation. This heightened immune response worsens symptoms in autoimmune conditions like Graves’ disease by increasing systemic inflammation and aggravating thyroid dysfunction, especially symptoms like heart palpitations, hives and anxiety. Histamine is a routine part of functional medicine testing, as well as other pathways of the body involved in histamine production and detoxification.

2. Dietary Strategies

• Anti-inflammatory Diet: Incorporate whole foods rich in antioxidants, such as fruits, vegetables, and fatty fish, to reduce inflammation. Many patients also experience food sensitivities to eggs, gluten or dairy, so testing and elimination of these reactive foods is also important.
• Limit Iodine Intake: Excessive iodine can exacerbate hyperthyroidism; it’s important to limit high-iodine foods unless testing demonstrates that you’re deficient in iodine.
• Avoid Stimulants: Reduce or eliminate caffeine and high-sugar foods to prevent overstimulation of the thyroid.
• Regular Meals: Eating at consistent times helps stabilize blood sugar levels and support metabolic function. It also helps prevent exacerbation of Graves’ symptoms, like anxiety, racing heart, or feeling dizzy.

3. Herbal and Supplement Support

• 1. Bugleweed (Lycopus europaeus)
  Action: Inhibits thyroid hormone synthesis and reduces TSH receptor activity.
  Evidence: Shown to reduce thyroxine (T4) levels and may help manage mild hyperthyroidism.
  
  2. Lemon Balm (Melissa officinalis)
  Action: Competes with TSH for receptor binding and may help reduce symptoms like anxiety and palpitations.
  Evidence: Traditionally used to reduce hyperthyroid symptoms; more robust human trials are limited.
  
  3. L-Carnitine
  Action: Acts as a peripheral antagonist of thyroid hormone activity and may relieve symptoms like muscle weakness and fatigue.
  Evidence: Effective in reversing hyperthyroid symptoms in both overt and subclinical cases.
  
  4. Selenium
  Action: Antioxidant that protects thyroid tissue and modulates autoimmunity.
  Evidence: Supplementation improves quality of life and reduces thyroid autoantibody levels in Graves’ disease.
  
  5. Vitamin D
  Action: Modulates immune function and lowers autoimmunity risk.
  Evidence: Low vitamin D is associated with increased thyroid autoimmunity and more severe Graves’ disease.
  
  6. Omega-3 Fatty Acids
  Action: Anti-inflammatory effects and immune modulation.
  Evidence: Helps regulate immune response and may reduce autoimmune thyroid inflammation.
  
  7. Ahnjeonbaekho-tang (AJBHT)
  Action: Traditional Korean herbal remedy shown to reduce thyroid hormone levels.
  Evidence: Clinical trials demonstrate improvement in T3/T4 levels and TSH normalization.
  

4. Lifestyle Modifications

• Stress Management: Chronic stress can exacerbate autoimmune conditions; practices such as meditation, yoga, and adequate sleep can help manage stress levels.
• Regular Exercise: Engaging in regular physical activity can improve cardiovascular health and support metabolic function.
• Avoid Environmental Toxins: Limit exposure to environmental toxins that may trigger or worsen autoimmune responses. It’s also important to avoid using hormonal contraceptives, as in my experience, these are a common trigger for new onset of Graves disease.

Graves’ disease is a complex autoimmune disorder with significant implications for thyroid health. Understanding its pathophysiology, recognizing the role of gut health, and implementing functional medicine strategies can provide a comprehensive approach to managing the condition. Always consult with a healthcare provider before making significant changes to diet, supplementation, or lifestyle to ensure safety and efficacy.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

Love this post Share it!

• Facebook
• Pinterest
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Want more Grab a copy of my new book, The Postpartum Check-In !

Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

References

1. ZUFRY H, ZULFA PO, HARIYANTO TI. The gut microbiota and its role in Graves’ Disease: a systematic review and meta-analysis. Biosci Microbiota Food Health. 2024 Jun 7;43(4):300–308. doi: 10.12938/bmfh.2024-020. PMID: 39364132; PMCID: PMC11444861.
2. Kiseleva EV, Kiseleva EV, Kiseleva EV. Gut Microbiota May Play a Significant Role in the Pathogenesis of Graves’ Disease. Front Endocrinol (Lausanne). 2020 May 5;11:301. doi: 10.3389/fendo.2020.00301. PMID: 32416683; PMCID: PMC7210420.
3. Lee YJ, Lee YJ, Lee YJ. An alternative therapy for graves’ disease: clinical effects and mechanisms of an herbal remedy. J Ethnopharmacol. 2008 May 28;118(3):409-13. doi: 10.1016/j.jep.2008.04.014. PMID: 18479224.
4. Komosinska-Vassev K, Olczyk K, Kucharz EJ, Marcisz C, Winsz-Szczotka K, Kotulska A. Free radical activity and antioxidant defense mechanisms in patients with hyperthyroidism due to Graves’ disease during therapy. Clin Chim Acta. 2000 May;300(1-2):107-17. doi: 10.1016/S0009-8981(00)00306-5. PMID: 10727685.
5. Ross DS, Burch HB

The post Functional Medicine for Graves’ Disease (Hyperthyroidism) appeared first on Dr. Alexandra MacKillop.

My patients share this nearly famous quote from their primary care providers all the time. That’s how they end up in my office, of course. Because they’re not fine. They feel terrible, with their hair falling out, gaining weight for no reason, freezing all the time, debilitating fatigue, brain fog. They look and act like a walking, breathing hypothyroidism textbook and yet…their other doctors say they’re “normal.”

What gives?

As a functional medicine doctor, thyroid disease is one of the main problems I treat in my office. While some patients walk in already knowing they have a problem and what it is (they’re looking to slow progression of their condition, or treat it without prescription medication), the majority have never gotten a diagnosis to finally explain their symptoms and start treating them at the root cause.

Why do thyroid problems so frequently go undiagnosed?

In my experience, there are typically three (categories of) reasons that my patients fail to receive an accurate diagnosis for their symptoms when they see other doctors. These are the three reasons that they might get told they’re fine when, in reality, they are struggling with thyroid disease. They might be told it’s in their head or (gasp!) probably perimenopause because, as if they didn’t realize it already, “You’re in your 40’s now…”

In my opinion, making an accurate diagnosis is not hard. Sure, the years of schooling that teach healthcare providers how to screen for all these different conditions and what they mean can be very challenging indeed. But, once you know the information, you just need to do the thing.

So, without further ado, here are the three reasons that my patients receive a misdiagnosis or have a missed diagnosis of a thyroid condition:

1. They’re not running comprehensive enough tests

This might sound obvious, but if you don’t test your thyroid you’re never going to accurately confirm a thyroid problem.

Unfortunately, most doctors don’t actually test thyroid function on screening labs. Sure, they run Thyroid-Stimulating Hormone (TSH) but fail to acknowledge that TSH does not actually test thyroid function.

TSH is a hormone the brain makes to tell the thyroid what to do. The thyroid is then, in turn, supposed to produce T3 and T4, which are the main thyroid hormones. The liver is supposed to make proteins called thyroid-binding globulins to carry these hormones through the blood stream to tissues, acting as a reservoir for these important hormones. The tissues themselves (gut, liver) are supposed to conver T4 into T3 as needed, per-diem to run metabolic functions in cells.

All of these functions are testable. Yet, most healthcare providers don’t test them.

Why?

They fail to recognize that TSH isn’t the full picture. Our brains are smart, but they’re even smarter than we give them credit for. Meaning, on account of other cellular processes going on in the body, the brain might be perfectly fine with an underfunctioning thyroid, thank-you-very-much, and carry on its normative signaling despite underfunctioning of our main metabolic regulator.

If you don’t test the full thyroid panel, you don’t get the full information. And if you don’t have full information, you can’t rightfully rule in, or out, a thyroid condition.

There are seven different main patterns for hypothyroidism, and I explain them all in my post titled: The Root Cause of Hypothyroidism. Check if out if you are curious what might be going on behind the scenes.

If you aren’t working with a functional medicine doctor, I’d encourage you to ask your PCP to run the full list of tests for you.

2. They don’t test frequently enough

You don’t need a medical degree to know that our metabolic needs when we’re sleeping differ dramatically form when we’re running a marathon. We also have different metabolic needs when we are resting versus when we are stressed. Our thyroid needs likewise differ when we’re sick, when we’re tired, when it’s winter versus summer, and according to the menstrual cycle. In fact, TSH levels on blood work even differ throughout the day! (They’re typically highest in the morning.)

If you’re concerned you have hypothyroidism, your doctor is going to be looking for an elevated TSH level. Remember that TSH is thyroid-stimulating hormone, meaning it’s released in order to stimulate the thyroid’s production of thyroid hormone. If the thyroid is under functioning, the brain will send a stronger and stronger signal to get the thyroid to pick up the pace, akin to an angry boss yelling at a lazy employee.

In many cases of hypothyroidism, the deficiency is subtle, with the TSH level only sometimes exceeding the reference range, typically only in the morning when TSH levels are highest. (That is, not to mention, that many labs and subseqently, many physicians, use a reference range that is far too broad; but that’s a different post for a different time.)

So, if you only test TSH (which most physicians do) and only test it once per year (which is the current standard “screen”) and don’t remind patients to remain off biotin supplements (which many physicians forget about) and don’t require a morning, fasted draw (which most don’t) then there is a good chance you will miss the elevated TSH level and your doctor will wrongly tell you that your thyroid is “normal” when it ism in fact, not.

But of course, you knew that, because your symptoms and intuition are hard to ignore.

3. They forget about the immune system

The most common cause of hypothyroidism is an autoimmune condition called Hashimoto’s Disease. But, here’s the thing: you can have Hashimoto’s and not yet have hypothyroidism.

Hashimoto’s as an autoimmune disease means that a person’s immune system is wrongly attacking their thyroid. The immune system is supposed to produce antibodies aimed at fighting off infections, like COVID or Epstein-Barr virus, or strep throat. But, with Hashimoto’s, the immune system instead starts making antibodies against thyroid tissue, called anti-thyroperoxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies.

The result is thyroid inflammation and evnetual thyroid tissue destruction, accompanied by all the immune symptoms that make you feel sick, like fatigue, brain fog, joint pain, hair loss, depression and…do I sound like I’m describing hypothyoridism yet?

Remember that TSH does not screen for Hashimoto’s Disease, yet Hashimoto’s Disease is the number one cause of hypothyroidism. Also keep in mind that while Hashimoto’s Disease often leads to destruction of the thyroid gland and eventual resulting hypothyoridism, it doesn’t always; but it still produces symptoms of its own accord that notoriously accompany hypothyroidism. Because of these symptoms, Hashimoto’s sufferers often feel too unwell to exercise, or eat well and likewise gain weight just as they would with full blown Hashimoto’s hypothyroidism.

Maybe you’ve already been tested for Hashimoto’s and told you don’t have it, but your symptoms are so suspicious that you’re not sure you believe the diagnosis. Of course, it’s possible that you don’t have Hashimoto’s or other thyroid disease, and you need to keep advocating for yourself and digging to find that answer.

But then again, remember this: most people with Hashimoto’s weren’t born with it. Rather, they were born with a genetic predisposition that was triggered by something, such as Epstein-Barr virus, COVID, gluten sensitivity, or, notoriously, hormonal and immune shifts such as those seen in puberty, pregnancy, postpartum and perimenopause. This means that even if you were previously tested for Hashimoto’s and the result was negative, that may have changed at some point throughout your life. My own doctor even incorrectly told me that if the antibodies are negative, they’re negative and there’s no point in retesting. I’m grateful that I had the knowledge to advocate for myself and get the appropriate lab work.

I want that for you, too.

So, friends, remember that you are the one who knows your health best. If something feels off, it definitely is; it’s just a matter of testing for it. (And that means running the right tests, running them frequently enough, and remembering to be comprehensive!)

I hope this helps you to get the best posible healthcare. You deserve it!

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Did Your Doctor Say Your Thyroid Is Fine (Three Reasons for a Missed Diagnosis) appeared first on Dr. Alexandra MacKillop.

“Okay, okay, hypothalamo-whatta-whatta?“

If that’s what you’re thinking, you’re in good company. The hypothalamic-pituitary-adrenal-thyroid-gonadal axis is quite the tongue twister. But don’t worry, it sounds more confusing and overwhelming than it is. In short, the HPATG-Axis is the system of hormone balance in our bodies. To understand how to balance hormones naturally, we need to first understand what hormone balance looks like through this great, big web of connections.

In a nutshell, the HPATG-Axis phrase refers to is the fact that a part of our brain called the hypothalamus communicates with our adrenal glands, thyroid, and ovaries (aka gonads) through a series of hormones produced by the pituitary gland (also located in our brain). In physiology, we often talk about those interactions separately, referring to them as the hypothalamic-pituitary-adrenal axis, or the hypothalamic-pituitary-thyroid axis. But in reality, they’re all connected, and this post will explain everything you ever wanted to know about how and why. (Okay, maybe not everything, but the basics…)

The HPATG Axis (AKA Endocrine Axis)

HPATG physiology can basically be summed up like this: the hypothalamus talks to our pituitary gland using hormonal signals, telling the pituitary gland when and how to stimulate our thyroid, our adrenal glands, and our ovaries. All of those glands send hormonal messages back to our brain with information about how much activity is going on, and whether or not there are any problems. In response, the brain tells the body to amp up activity in each of those sites, or tone it down. This is called a negative feedback loop.

When we face periods of stress (or rather, when we face too much stress for too long), our HPATG axis is completely intercepted. This is where we can run into imbalances in our thyroid hormones (such as hyperthyroidism or hypothyroidism), adrenal hormones (such as “adrenal fatigue”), or fertility problems, (such as hypothalamic amenorrhea). These problems can occur one at a time, or all at once, leading someone to feel really sick, and probably also really confused! Stress is a biggie when it comes to a properly functioning HPATG axis. In most cases, if you’re wondering how to balance hormones naturally, we need to start by addressing stress because stress is the single most powerful influence over the HPATG axis.

Stress and Stress Management

When we think about stress, we typically think about the psychological or emotional—deadlines at work, an overly packed schedule, a bad breakup, or a death in the family. But stress comes in many forms, and can even be triggered by good life events…

• Under eating (not enough calories or carbs)
• Nutritional deficiencies
• A significant/sudden change in diet/eating habits (especially yo-yo dieting)
• Over exercising (or a sudden change in the type of exercise)
• Lack of sleep or change in sleep schedule (i.e. night shift)
• Illness or injury (including surgery)
• Travel (even if it’s fun!)
• Moving
• Starting a new job or educational program
• Getting married
• Certain medications, or drug use
• Depression or anxiety
• Emotional distress (like the loss of a loved one)
• Psychological distress (like work deadlines or studying for exams)

Many of these things are normal parts of life, and when we are following a pattern of self care, our bodies are able to accommodate the stressors without falling into dysfunction. But when our self-care routine falls out of balance (or we begin struggling with disordered eating) we detract from the foundation of health. When that happens, everything else starts to crumble. One of my favorite ways to explain this relationship between stress and self-care is the bucket analogy:

Self-care fills our bucket, but stress drains our resources. When the bucket gets low, we start to notice symptoms of burnout. When the bucket gets empty, it leads to hormonal disaster, interrupting our whole HPATG axis at a biochemical level in our brains (big red stress arrow on the infographic at the top of this post). Ultimately, learning how to balance hormones naturally means learning how to identify and cope with the small, daily stressors in our lives.

Dysfunction, one axis at a time

The reason we often talk about the HPATG axis in terms of its separate components (HPA, HPT, HPG axes) is because unilateral dysfunction is common. For example, an autoimmune disease called Hashimoto’s Thyroiditis can lead to destruction of the tissue of the thyroid gland and subsequent hypothyroidism. When this happens, the thyroid loses its ability to produce thyroid hormone. When the pituitary gland realizes that thyroid hormone levels are so low, it amps up its secretion of thyroid-stimulating hormone in an attempt to tell the thyroid to do a better job. The problem is, the thyroid itself has been damaged—it can’t do its job until the autoimmune reaction is addressed. (Here’s where stress pops up again: if you’re wondering how to balance hormones naturally in terms of your thyroid hormones, you still need to pay attention to the stress piece because stress is one of the primary drivers of autoimmune disease.)

Low levels of thyroid hormone create a further stress response in the body, signaling back to the brain that something’s off. This consequently affects the signaling between the pituitary gland and the adrenals/ovaries as the body tries to balance things out. Low levels of thyroid hormone, for example, creates a dangerous environment for a growing baby, and so the reproductive system is one of the first to get shut down (via the HPATG axis). On the other hand, pregnancy causes the body to re-prioritize its hormonal resources. When a woman is pregnant, the body needs different levels of thyroid hormone, cortisol, and other hormones to carry the pregnancy to full-term. These body signals these changes through the same negative feedback loop. (All of this takes place without us ever having to think about it. You’ve got to admit, God’s design is pretty amazing!)

The HPATG Axis and Healthcare

When a patient complains of problems like fatigue, weight gain or weight loss, thinning hair, or irregular periods (just to name a few), the solution is never as simple as writing a prescription for birth control pills or Synthroid. There’s always more to the story, and that’s why its so important to identify the root cause of the problem when considering how to balance hormones naturally. In my practice, I do this primarily by talking with my patients in detail about their health history, and taking a closer look at the lab work. From a functional medicine perspective, it’s never safe to assume that the other components of the HPATG axis are functioning properly, even if we’ve already identified that one of them is out of sync. That’s why holistic healthcare means addressing the whole person, and not just using a symptom-by-symptom, band-aid approach.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Balance Hormones Naturally (Understanding the HPATG Axis) appeared first on Dr. Alexandra MacKillop.

One of the most common questions I get as a functional medicine doctor is how to treat hypothyroidism naturally. This question is understandable because for one, hypothyroidism is becoming extremely common. And for those affected by it, unfortunately the only option offered from a primary care doctor is synthetic thyroid hormone replacement therapy, levothyroxine (Synthroid). But what this generic prescription misses is the fact that no two cases of hypothyroidism are exactly the same. Therefore, there’s no straightforward answer for how to treat hypothyroidism naturally. In order to treat it, you need to first understand the root cause of hypothyroidism.

In the world of functional medicine, we categorize “hypothyroidism” in seven different ways. In a traditional doctor’s office, that isn’t the case, which leads to the multitude of diverse and unique patient cases getting treated exactly the same. (Read: hormone replacement therapy) For those with primary hypothyroidism, AKA “underactive thyroid,” or a thyroid that just isn’t doing its job of producing adequate hormone, replacement therapy is appropriate. But what if the reason someone has low thyroid function doesn’t begin and end with the thyroid In fact, most of the time, the diagnosis and solution aren’t so linear. In functional medicine, understanding the root cause of hypothyroidism means exploring each individual thyroid case through the lens of seven different subtypes.

The Seven Root Causes of Hypothyroidism

1. Primary Hypothyroidism (Underactive Thyroid)

The first root cause of hypothyroidism is the classic subtype: Primary Hypothyroidism. Primary hypothyroidism basically boils down to a thyroid gland that isn’t doing its job of manufacturing thyroid hormone. If thyroid hormone isn’t being made, it can’t carry out its function in the body. Thyroid hormones come in two basic forms, T3 (triiodothyronine) and T4 (tetraiodothyronine). Both of these hormones basically consist of an amino acid molecule (tyrosine) attached to three (T3) or four (T4) molecules of iodine. T3 is considered the “active” form of thyroid hormone, which floats around in the blood, doing its job. T4 has some direct effects on the body, but it’s most known for acting as a reserve for T3. When T3 start to drop, rather than simply making more T3 right away (this might take too long), an enzyme removes one of the four iodine molecules from T4, thereby converting it to T3, the “active form.” The thyroid produces these hormones in proportions roughly equal to 5% T3 and 95% T4, give or take.

Underactivity of the thyroid can result from two things. One, the thyroid might not have access to the raw materials needed to manufacture thyroid hormones (namely, tyrosine and iodine) or two, the machinery just might not work. To effectively treat an underactive thyroid, we would need to substitute either thyroid hormone or tyrosine/iodine, depending on which is needed.

2. Hypothalamic Hypothyroidism (Stress-Induced)

The second root cause of hypothyroidism is hypothalamic hypothyroidism, a type of stress-induced thyroid problem. Although thyroid hormones are made by the thyroid, the thyroid gland itself isn’t the control center. Rather, an area of the brain called the hypothalamus calls the shots. The hypothalamus secretes a hormone called TRH, thyrotropin-releasing hormone, which in turn signals to the pituitary gland to increase or decrease TSH, thyroid stimulating hormone, which is the hormone that directly tells the thyroid what to do. This whole process is referred to as the Hypothalamic Pituitary Thyroid Axis.

To make things more complicated, thyroid hormone production doesn’t quite begin and end at the hypothalamus, either. Although the hypothalamus acts as the control center for thyroid hormone regulation, other processes in the body can suppress the activity of the hypothalamus–namely, stress.

Stress comes in many forms (too much exercise, too little sleep, not eating enough, overworking ourselves, relationship problems, illness etc…) but they all affect the hypothalamus (and thyroid) the same way. If a patient’s hypothyroidism results from stress, hormone replacement therapy would help, yes. But is it the best way to help this patient heal No. The obvious answer would be stress reduction, and supporting the body in overcoming the dangerous effects of stress.

3. Hashimoto’s Thyroiditis (Autoimmune)

The third root cause of hypothyroidism is Hashimoto’s Thyroiditis. Autoimmune hypothyroidism is a subset of primary hypothyroidism in that the thyroid-hormone-making-machinery is malfunctioning. But the difference between Hashimoto’s thyroiditis and the type of hypothyroidism described in #1 is that the cause of the thyroid dysfunction is known: autoimmunity. In this case, the body mistakes the thyroid gland for a pathogen, and the immune system begins attacking and destroying the thyroid tissue, affecting its ability to produce thyroid hormone. Once again, hormone replacement therapy would help the situation, but the best solution would be to treat the autoimmune process and help prevent it from getting out of control.

Hashimoto’s thyroiditis, like other autoimmune conditions, has a genetic predisposition that can be triggered by factors in the environment. Sometimes stress can trigger the autoimmunity, as can nutritional problems, environmental exposure to toxins, viral infections, and more. Either way, the best solution is to treat the autoimmunity and teach the patient how to manage their condition.

4. Peripheral Conversion Defect (Thyroid Hormone Metabolism)

The fourth root cause of hypothyroidism is Peripheral Conversion Defect. As a quick refresher on what we’ve already discussed, T3 is the “active” form thyroid hormone, produced in small amounts. The thyroid produces T4, the “inactive” form at rates nearly 20x higher, which floats around in the blood stream to be converted to T3 as needed.

Mainly, the conversion of T4 to T3 takes place in the liver, but the digestive system, heart, muscle, and nerve cells all also are involved in the conversion process. However, sometimes this conversion process gets interrupted, leading to blood levels of T3 that are too low. The reason for this can be complicated, but some of the main drivers of this so-called peripheral conversion defect (or problem with thyroid hormone metabolism) include oxidative stress and nutritional deficiencies. Correcting nutritional deficiencies is pretty straightforward (change the diet, supplement, correct absorption problems) but oxidative stress is a whole other animal. Oxidative stress results from inflammation, which can be triggered by anything from chronic disease, to infections, to a high-stress lifestyle. Once again, this form of hypothyroidism is highly individual.

5. Hormone Receptor Competition (Toxins)

The fifth root cause of hypothyroidism is Hormone Receptor Competition. Once T4 has been converted into its active form of T3, it’s time for the hormone to do its job. Thyroid hormone is responsible for regulating body temperature, metabolism heart rate, digestion, cognitive function, fertility…you name it, thyroid hormone affects it. Thyroid hormone acts like an on/off switch in the body. When it binds to its receptors, it either amplifies or suppresses the ongoing response. If no T3 is around, the switch can’t get flipped.

But of course, nothing is quite as simple as flipping a switch (except, you know…flipping a switch.) Really, the relationship between the T3 hormone and our bodily systems is more like a lock and key mechanism. T3 is like the key, and the receptor is like a lock, which is only supposed to be accessed by its specially designated key. Unfortunately, there are quite a few molecules in the world that look a lot like T3, and can fit into the T3 receptor (like a keyhole). Unlike thyroid hormone, these molecules can’t actually turn on or off the switch, but they do fit nicely into the receptor, preventing T3 from accessing it.

These “look alike” molecules obviously aren’t supposed to be in our bodies. Typically, they’re toxins that result from contaminated food and water, poor quality air, exposure to mold/fungus, or hazardous chemicals. Unlike some of the other types of hypothyroidism we’ve already discussed, supplementing with thyroid hormone won’t correct the problem. The body already has plenty of T3 floating around, and adding more hormone isn’t going to have much effect. Sure, it might crowd out the toxins, out competing them for the receptor site, but typically the therapeutic dose used for patients isn’t sufficient to have an effect. The only solution is to remove the source of the exposure and support the body’s detoxification efforts, especially gut health.

6. Binding Globulin Availability (Sex Hormone Imbalances)

The sixth root cause of hypothyroidism is Binding Globulin Availability problems. Remember all those details about TRH, TSH, T3, and T4 Well, there are three more hormones to add to the list to make things just a little more confusing: rT3 (reverse T3), free T3, and free T4.

When thyroid hormones travel through the blood stream, they aren’t just floating around willy-nilly, waiting to find their receptor. Instead, they’re bound to carrier proteins, called globulins, which help protect them from damage and shuttle them to where they need to go. While on the bus (attached to the hormone binding globulin), the thyroid hormone is inactive. Only when it detaches from the globulin, metaphorically getting off the bus, can it do its job of binding to the receptor. Sometimes, the ratio of globulin to thyroid hormone becomes distorted, with too much globulin. The result of this is that the thyroid hormone gets all bound up, making it inactive by preventing it from accessing the receptor site. In order to truly be “active,” thyroid hormone needs to be unattached from globulin. In this situation, we call the thyroid hormone “free T3” and “free T4.” As you might guess, a person might have normal and healthy levels of total T3 and T4, but the amount of free T3 and free T4 are too low because the amounts of hormone binding globulin are too high.

What causes elevated levels of hormone binding globulins Lots of things, but most often excess amounts of estrogen (from birth control pills, pregnancy, or other reasons) and estrogen “look alike” molecules, such as plastics, soy products, and other toxins. The best way to treat a patient in this situation is to uncover the cause of the excess globulins, remove the source, and support the body’s detoxification as it returns to a functional baseline.

7. Nutrient Deficiencies

If we circle back to point #1, we remember that thyroid hormones (T4 and T3) are named as such because of the number of iodine molecules they contain. So, what happens when a person needs to synthesize more thyroid hormone but they don’t have enough iodine in order to do so?

The seventh root cause of hypothyroidism is—you guessed it—thyroid hormone deficiency. However, iodine isn’t the only nutrient which, when depleted, can induce a state of hypothyroidism. Zinc, selenium, vitamin D and magnesium are all necessary for thyroid hormone production, and low levels mean bad news for thyroid health. (Additionally, hypothyroid patients also tend to be low on vitamin B12, though that isn’t necessarily something that causes hypothyroidism.)

If that sounds complicated, it’s because it is! What makes it even more complicated is the fact that you can’t possible know whether or not you have vitamin deficiencies that predispose you to hypothyroidism, or what type of hypothyroidism you actually have (if you have it at all) unless you have a thorough lab workup done by your doctor.

In conclusion…

The root causes of hypothyroidism are complicated and multi-faceted, even more so than I’ve been able to cover in this blog post! But the main takeaway is that you shouldn’t settle for a simple diagnosis if your doctor simply tells you you have hypothyroidism. There’s always more to the picture, and there are likewise a lot more options for education and management. Many people don’t need a lifelong prescription for Synthroid. In some cases, it’s possible to completely reverse the hypothyroidism, prevent it from worsening, and even heal related conditions (like sex hormone imbalances, toxin exposure, or autoimmune disease.) If you’re concerned that you may have a thyroid imbalance, check out The Hormone Hacker, my expert guide for decoding lab results so you can get to the root cause of your symptoms once and for all.

If you’re suffering with thyroid disease, first of all, I’m so sorry. But more importantly, there’s hope for you! Ask your doctor to dig a little deeper, or find a new healthcare provider who will help get to the bottom of your symptoms and empower you to manage your health according to your values.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post The Root Cause of Hypothyroidism appeared first on Dr. Alexandra MacKillop.