Six hypothyroid patterns often overlooked

Hypothyroidism is Often Over-Looked

Are you, or is someone you love, suffering from weight gain, hair loss, exhaustion, constipation, depression, or mental fog? Do you feel cold all the time, feel tired and require excessive amounts of sleep to function properly?

Many people don’t realize that these symptoms are frequently caused by a thyroid disorder or imbalance. Did you know that an estimated 20 million Americans have some form of thyroid disease? One in eight women will develop a thyroid disorder during her lifetime. And, the number of people suffering from thyroid disorders continues to rise each year.

Unfortunately misdiagnosis is common in the management of hypothyroidism. If you go to a doctor with hypothyroid symptoms, you’ll simply be given replacement thyroid hormones without any further inquiry into the cause of your condition. Even worse, if you have hypothyroid symptoms but your lab tests are normal, you’ll be told you’re “fine”. If you insist you’re not, you might be sent home with an antidepressant, but no further clue about the cause of your symptoms.

A Functional Medicine Approach to Thyroid Health

Datis Kharrazian ( highlights six patterns of thyroid dysfunction that won’t show up on standard lab tests. If you have one of these patterns, your thyroid isn’t functioning properly and you will have symptoms.


Pattern #1: Hypothyroidism secondary to Pituitary Hypofunction

Typical Cause: Stress from an active infection, blood sugar disorders, unrelenting stress
Cortisol (stress) suppresses pituitary function
An adrenal salivary index demonstrates adrenal dysfunction
Blood Test: TSH will be below functional range (1.8-3.0), T4 – below 6, T3 – Normal
Important: Balance blood sugar, check for infections

Pattern #2: Thyroid Underconversion leading Hypothyroidism

T4 is inactive, must go through conversion process to become T3 – the active form of thyroid hormone
Conversion takes place in the Liver and Gastro-Intestinal Track – requires healthy liver and good gut bacteria
Typical Cause: Poor diet and gut function can lead to a deficiency of nutrients responsible for adequate function of the enzymes needed for conversion
Blood Test: Total T3 & Free T3 will be low
Important: Clean Gut, Clear Liver (Detox)

Pattern #3: Elevated Thyroid Binding Globulin leading to Hypothyroidism

Thyroid biding globulin (TBG) is the protein that transports thyroid hormone through the blood. When thyroid hormone is bound to TBG, it is inactive and unavailable to the tissues.
When TBG levels are high, levels of unbound (free) thyroid hormone will be low, leading to hypothyroid symptoms
TSH and T4 will be normal, T3 will be low, and TBG will be high
Typical Cause: Excess estrogens from oral contraceptives and Premarin (estrogen replacement)
Blood Test: TBG will be high, T3 will low
Important: Clear excess estrogen from the body

Pattern #4: Depressed Thyroid Binding Globulin leading to Hypothyroidism

Opposite from pattern #3
When TBG drops, levels of free thyroid hormone will be high.
Too much T3 causes thyroid receptor site to become resistant
Typical Cause: Excess Testosterone– typically caused by metabolic syndrome (insulin resistance) or testosterone hormone replacement
Blood Test: TBG is low, T3 is high
Important: Reversing insulin resistance, restoring blood sugar & hormone imbalances

Pattern #5 Thyroid Hormone Resistance leading to Hypothyroidism

Typical Cause: Stress & Inflammation
Depresses thyroid receptor site responsiveness
The hormones aren’t getting into the cells where they are needed
Blood Test: TSH, T4, T3 will be normal, but individuals still present with thyroid symptoms
Important: Careful examination of immune related disorders and managing stress

Pattern #6 Autoimmunity leading to Hypothyroidism

Blood Test: Positive Antibodies to TPO (Thyroid Perixodase) or TBG (Thyroid Binding Globulins)
Immune Disorder – Immune system recognizes & flags the thyroid as a threat – develops memory cells to destroy thyroid tissue
AKA – Hashimotos Hypothyroidism
Typical Cause: Immune Dysregulation – not a thyroid disorder
Important: Manage immune system/barrier system – manage triggers, heal/seal the gut, restore immune integrity

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