Hypothyroidism: The Hidden Condition That’s Often Overlooked
Are you or someone you love struggling with weight gain, hair loss, chronic fatigue, constipation, depression, or brain fog? Do you feel cold all the time, or find that no matter how much you sleep, you’re still exhausted?
These are classic symptoms of a thyroid disorder—and yet, many people are unaware that their thyroid could be to blame. An estimated 20 million Americans suffer from some form of thyroid disease, with 1 in 8 women developing a thyroid condition during their lifetime. Unfortunately, the number of people affected by thyroid disorders continues to rise.
But what’s even more concerning is how often hypothyroidism goes undiagnosed or misdiagnosed. Many doctors rely on standard blood tests, and if your results come back “normal,” they may dismiss your symptoms altogether. You might be sent home with antidepressants or told to “wait it out,” without ever addressing the root cause of your discomfort.
A Functional Medicine Approach to Thyroid Health
In functional medicine, we dig deeper. Thyroid health isn’t just about replacing thyroid hormones; it’s about understanding the underlying causes of dysfunction. While conventional medicine often looks at a narrow set of markers like TSH (Thyroid Stimulating Hormone), this approach can miss key indicators of thyroid imbalances.
Leading thyroid expert Dr. Datis Kharrazian identifies six patterns of thyroid dysfunction that are frequently overlooked in standard lab testing. These hidden patterns can leave you suffering from thyroid symptoms even when your lab results appear “normal.” Let’s unpack them.
1. Hypothyroidism Secondary to Pituitary Hypofunction
What’s Happening: The pituitary gland, which regulates your thyroid, may be underperforming due to chronic stress or blood sugar imbalances. Elevated cortisol from stress suppresses pituitary function, which impacts thyroid hormone production.
Typical Causes:
- Chronic stress
- Ongoing infections
- Blood sugar disorders
Blood Test Clues:
- TSH below functional range (1.8–3.0)
- T4 low
- T3 normal
What’s Needed: Balancing blood sugar and checking for underlying infections are crucial steps in restoring proper thyroid function.
2. Thyroid Underconversion: Inactive T4 Not Converting to Active T3
What’s Happening: Your thyroid produces T4, an inactive form of thyroid hormone that must be converted to T3 (the active form) in the liver and gut. Poor liver health or gut imbalances can impair this conversion, leading to low T3 and hypothyroid symptoms.
Typical Causes:
- Poor gut health
- Liver dysfunction
- Nutrient deficiencies
Blood Test Clues:
- Low Total T3 and Free T3
What’s Needed: Focus on gut healing and liver detoxification to support the conversion of T4 to T3.
3. Elevated Thyroid Binding Globulin (TBG): Trapped Thyroid Hormone
What’s Happening: Thyroid Binding Globulin (TBG) is a protein that transports thyroid hormone in the blood. When too much hormone is bound to TBG, it becomes inactive and unavailable to your tissues.
Typical Causes:
- Excess estrogen from hormone replacement therapy, birth control, or pregnancy
Blood Test Clues:
- Normal TSH and T4
- Low T3
- High TBG
What’s Needed: Clearing excess estrogen from the body is key to improving thyroid hormone availability.
4. Depressed TBG: Excess Free Thyroid Hormone
What’s Happening: The opposite of Pattern #3, low levels of TBG lead to an excess of free thyroid hormone. Too much free T3 can cause thyroid receptor sites to become resistant, meaning your cells can’t use the hormone properly.
Typical Causes:
- Excess testosterone (from conditions like insulin resistance or testosterone therapy)
Blood Test Clues:
- Low TBG
- High T3
What’s Needed: Addressing insulin resistance and balancing hormones are critical for restoring thyroid health.
5. Thyroid Hormone Resistance
What’s Happening: In this pattern, your thyroid hormones may be produced in normal amounts, but inflammation and stress prevent them from entering your cells, leaving you with persistent symptoms.
Typical Causes:
- Chronic inflammation
- Ongoing stress
Blood Test Clues:
- Normal TSH, T4, and T3, but thyroid symptoms persist
What’s Needed: Reducing inflammation and managing stress are key to improving thyroid receptor sensitivity.
6. Autoimmune Thyroid Disease (Hashimoto’s)
What’s Happening: In Hashimoto’s disease, the immune system mistakenly attacks the thyroid gland, leading to gradual thyroid destruction. This is not just a thyroid issue; it’s an immune system imbalance.
Typical Causes:
- Autoimmune dysfunction
- Gut health issues
- Environmental triggers
Blood Test Clues:
- Positive antibodies to TPO (Thyroid Peroxidase) or TBG
What’s Needed: Managing autoimmunity by addressing gut health, reducing triggers, and balancing the immune system is critical for long-term thyroid health.
Restoring Thyroid Health from the Inside Out
If you’re struggling with thyroid symptoms and have been told your labs are “normal,” it may be time for a more comprehensive approach. Functional medicine offers an in-depth look at thyroid function, focusing on the root causes of imbalance rather than masking symptoms with medication.
Whether it’s improving gut health, detoxifying the liver, balancing hormones, or managing stress, a functional medicine approach to thyroid health can help you regain energy, vitality, and well-being.
If you’re ready to dig deeper into your thyroid health and uncover hidden imbalances, let’s start the journey together. You are here to feel your best—and we’re here to help make that happen.
