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

It wasn’t the usual type of sore throat, on the inside by my tonsils and tongue. Instead, it felt like a big sore lump at the front of my neck. It was tender to the touch (especially when his little meandering hand would accidentally bump it when we were nursing.) The sides of my neck were painful too, and when I’d tuck my chin at night, there was a sense of uncomfortable pressure. 

Looking in the mirror, the change was subtle. I don’t think I’d have noticed it otherwise because having a baby made it difficult to spend much time examining my reflection. I honestly thought it was just residual soreness in my neck from being hunched over while rocking my son to sleep. But one night, I was so frustrated by the discomfort that I flipped on the light in the bathroom and took a closer look. The bottom of my neck, under my cricoid cartilage (or as I jokingly call it, my “Eve’s apple”), there was some swelling. Where I normally could see my neck tendons extend all the way from my chin to my chest, their outline was obscured partly at the base of my throat from my inflamed thyroid. 

I knew right away what was going on. I had thyroiditis, an increasingly common postpartum health issue. 

The thing is, none of my healthcare providers had ever warned me about it. Instead, I knew what was going on because I’d learned about it in school and had actually treated a number of my own patients for it. In fact, it affects up to 8 out of every 100 pregnancies. 

Identifying Thyroid Disorders

Conventional medicine likes to break up our health into different systems. We see cardiologists for heart problems and GI doctors for poor digestion. We have endocrinologists and gynecologists and urologists. In some ways this is a good thing, because we end up with providers who really know their respective systems well. But on the downside, we lose sight of the fact that the systems of our bodies are all closely connected to each other. This is especially true with hormones, including reproductive hormones, thyroid hormones, and stress hormones. We even have a special name for this connection called the hypothalamic-pituitary-adrenal-thyroid-gonadal axis, or HPATG axis for short. The main takeaway of all this (for the purpose of our current conversation) is the fact that when one category of hormones changes, it affects all the other hormones too.

I often liken pregnancy to going through puberty in 10 months, and childbirth to going through puberty overnight. The hormonal shifts are enormous and extremely fast. For some reason, the body sometimes has a hard time leveling off after the rapid changes along one axis of the HPATG web (reproductive hormones), and the thyroid or adrenal glands end up suffering as a result. Some women even end up developing autoimmune problems because of this, if they have a genetic predisposition. 

Fortunately, I already had the anti-inflammatory herbs and supplements I knew I needed on hand and started taking them right away. Then, I hurried off to get my labs drawn as soon as the order was placed. I was extremely relieved that there were no signs of Hashimoto’s, an autoimmune condition which happens to be the #1 cause of hypothyroidism in women. I’m grateful that my thyroiditis quickly resolved and didn’t become a chronic issue, as is the case with autoimmunity, and that it responded well to postpartum thyroiditis natural treatment.

How I Treated My Postpartum Thyroiditis

Thyroiditis in pregnant and breastfeeding women should be treated differently than thyroiditis in the general population for two key reasons:

• The root cause is different (in most cases, hormonal and immunological shifts drive thyroiditis in the perinatal period, which isn’t always the case in other populations)
• The herbs and supplements that may be used to ordinarily treat thyroiditis aren’t all safe in pregnant or breastfeeding women. (I tend to observe pregnancy-safe guidelines for breastfeeding women)

Here’s the Postpartum Thyroiditis Natural Treatment Strategy that I used:

1. Fish Oil

I was already taking 2,000 mg of cod liver oil daily and for 1 week, I increased the amount I was taking to 4,000 mg. The omega-3 fatty acids in cod liver oil are very anti-inflammatory, which is a key factor in moderating the inflammation that drives thyroiditis.

It’s important to note that not all fish oils are safe during pregnancy due to vitamin A content and risk for contamination with heavy metals. Fish oil can also increase risk of bleeding disorders and can interact with some medications, so check with your doctor before changing your fish oil routine or starting any of the other supplements I describe.

2. Probiotics

The liver and GI system are responsible for detoxifying hormones, and there’s a lot of detox that goes on in the postpartum period. In the third trimester, estrogen levels are six times higher than pre-pregnancy levels, and they dip even lower for breastfeeding women. That’s a lot of transition in a short time, which means a lot of work for the GI system.

The ability of the body to detoxify these old, ‘used’ hormones depends largely on the microbiome. This subset of bacteria is appropriately termed the ‘estrobolome’ for its function in clearing out old estrogen compounds. A buildup of estrogen byproducts can contribute the the hormonal storm that drives thyroiditis, so I started taking a probiotics with a wide variety of strains in addition to my prenatal probiotic to help support the diversity of my gut and its ability to detoxify estrogen.

3. N-Acetyl Cysteine

A chemical called glutathione is one of the body’s main weapons against oxidative stress and inflammation, and supplementing with it is very effective in treating conditions related to oxidative stress such as thyroiditis. However, there isn’t a lot of data regarding its use in pregnancy or during breastfeeding.

N-Acetyl Cysteine, on the other hand, has the effect of bolstering up the body’s own stores of glutathione, creating the same antioxidant effect without the potential risks of taking oral glutathione. NAC has been shown to be both safe and effective during pregnancy/breastfeeding. I took a dose of 1,200 mg for 14 days, then reduced the dosage to 600 mg.

4. Vitamin C

Vitamin C plays an important role in helping the body recycle its glutathione stores. I took 2,000 mg of Vitamin C daily in the form of chewable tablets for 1 month.

5. Rest, water, calories, nutrients…

Possibly the most important of all was getting back to the basics of self-care. During this time, I cut back on my daily walking and spent more time resting in bed with my baby, focusing on conserving energy and allowing my body to heal. I also paid extra attention to my water intake, focused on getting plenty of meals and snacks to keep my calories up (and avoid putting my body under even more stress) and made sure to eat plenty of nutrient-dense foods like organic butter, grass fed red meat, berries and leafy greens.

I count myself very lucky not only because I recovered quickly, but because I had access to the information I needed to start taking steps right away. So many providers never talk to their patients about the risk of thyroid problems after childbirth, so they end up going undiagnosed for a long time. That’s because not every case of thyroiditis presents with neck pain like mine did. Other symptoms can include weight gain (which gets blamed on pregnancy or “baby weight”), hair loss (again, blamed on “postpartum hormones”), extreme fatigue (“it’s just because you aren’t getting as much sleep”), constipation (“here, take a stool softener…”), depression (postpartum depression is a thing, but so is hypothyroidism), dry skin, feeling cold, a puffy face, muscle weakness, joint pain, brain fog and more. 

Other Strategies for Postpartum Thyroiditis Natural Treatment

There are more strategies available for treating postpartum thyroiditis than just what I used. Here are some other, breastfeeding-safe postpartum thyroiditis natural treatment strategies that I often use in my practice when treating postpartum mamas.

Selenium

Selenium supplementation (200 μg daily) during pregnancy and postpartum in thyroid peroxidase antibody-positive women significantly reduces the incidence of postpartum thyroid dysfunction. My go-to prescription for patients is in the form of selenomethionine.

Vitamin D

In women with established postpartum thyroiditis receiving levothyroxine, vitamin D supplementation (2000-4000 IU daily based on baseline levels) reduces thyroid peroxidase antibody titers over 3 months, with stronger effects in those with vitamin D deficiency

Gluten-Free Diet

If a patient tests positive for thyroid antibodies, the research shows strong support for following a gluten-free diet as as a treatment strategy. Many, if not most, cases of postpartum thyroiditis include an autoimmune component, demonstrated by positive results for anti-thyroglobulin and/or anti-thyroperoxidase antibodies. In these cases, the recommendation would be to follow a gluten-free diet strictly, and for the rest of the patient’s life.

What to Do if You Think You Have Postpartum Thyroiditis

If you suspect that something is running amok with your thyroid, get tested! The sooner a diagnosis is made, the sooner you can start doing something to improve your health. However, keep in mind that it’s not a good idea to just assume you have a problem with your thyroid and treat it on your own. Even if you are 100% correct that your thyroid isn’t functioning well, it’s important to discern whether or not there’s an underlying autoimmune problem because the problem should be addressed differently if there is. Failing to acknowledge autoimmunity can make the problem even worse. (Autoimmune thyroiditis is the most common type of thyroid problem. Click here to learn more about the different types of hypothyroidism.)

• Ask your doctor for a comprehensive blood test including the following: TSH, free and total T3, free and total T4, reverse T3, throxine-binding globulin, anti-Tg antibodies, and anti-TPO antibodies. Ask for nutrient panels too, including vitamin D, zinc, selenium, iodine, and omega-3’s
• Support your microbiome by consuming 30 different types of plants weekly (remember that nuts, whole grains, seeds, legumes, fruits and vegetables all ‘count’ as plants)
• Regularly consume wild-caught fatty fish like salmon to maintain healthy omega-3 levels
• Make sure you get enough sleep, ideally 8-10 hours per night in the winter
• For personalized care, make an appointment with a functional medicine physician who can help you in identifying the root cause of your health concerns and support the optimal function of all your body’s systems. If it’s not your thyroid, it’s something else, and you deserve to have it addressed so you can feel your best!

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 Postpartum Thyroiditis Natural Treatment 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.