Nearly 5 percent of the nation’s population over the age of 12 suffers from hypothyroidism, with older women more likely than any other age group to experience this condition.

Hypothyroidism occurs when the thyroid gland — located in the front lower part of the neck below the voice box— doesn’t produce enough thyroid hormones to keep up with the needs of the body. Simply put, the thyroid is underactive.

And that becomes a problem, because the thyroid is charged with overseeing the function of your metabolism, which determines how your body uses energy from food. For those suffering an underactive thyroid, body processes can slow down, which upsets the normal balance of chemical reactions to your body.

What are some of the signs? If you have any of the following symptoms, you may be suffering from hypothyroidism:

Aches and pains Anxiety
Constipation Depression
Dry skin Elevated cholesterol
Fatigue Hair loss or thinning
High or low blood sugar Memory loss
Morning headaches Restless sleep
Swelling of the face or body Weight gain or difficulty losing weight even with diet and exercise

These are just the short-term impacts. The long-term impacts are even more serious:

  • Impaired brain function
  • Atherosclerosis (hardening of the arteries), according to a recent Dutch study published in the American Heart Association’s journal Circulation
  • Osteoporosis (reduced bone density), which makes bones weak and brittle
  • Reduced exercise and other physical activity, which further erodes health
  • Poor performance at school or work, which contributes to depression and anxiety
  • Difficulty dealing with stress

The Conventional Medicine Mistake

If you seek help from a conventional medical doctor, he or she will probably order blood tests to check your levels of thyroid hormones — called T3 and T4 — and the thyroid stimulating hormone (TSH). If your T3 and T4 levels are low and your TSH level is normal or high, your doctor may order a thyroid uptake test or an ultrasound to check thyroid function or any abnormalities in the thyroid structure that may indicate the presence of tumors. If those tests show no abnormalities your doctor is likely to prescribe synthetic T4.

If your T3, T4, and TSH levels are all low, your doctor may perform additional tests to evaluate pituitary function. (The pituitary gland produces TSH, which stimulates the thyroid gland to produce T3 and T4.) If the pituitary gland is causing the hypothyroidism, the diagnosis is secondary hypothyroidism — which rarely occurs.

The problem with this conventional medicine approach to diagnosis is that it goes no further than the thyroid and (sometimes) the pituitary gland. It stops short of asking a very important question: Why is my thyroid or pituitary gland dysfunctional? The truth is, conventional doctors should be digging deeper. They should be treating hypothyroidism as a symptom of an underlying condition — not merely as the cause of the symptoms that a patient initially describes to the physician.

Digging Deeper to Find the Cause of Hypothyroidism

In the United States, 80 to 90 percent of all cases of hypothyroidism are caused by autoimmune disorders — the immune system attacking the thyroid. This immune system dysfunction is typically due to a genetic vulnerability with the addition of a stressor:

  • Genetics: If your mother has or has had hypothyroidism, you have a 50 percent chance of developing it. It’s especially prevalent in women in their 50s and older.
  • Triggers: Triggers include stress, infection, hormone fluctuations in pregnancy and menopause (and sometimes puberty), toxic environments, and chronic mold exposure. A variety of infections can contribute to hypothyroidism, including Epstein-Barr virus (EBV), Lyme disease, or small intestinal bacterial overgrowth (SIBO).

A hypothyroid condition should be viewed as an effect, not the cause of a problem. And while nothing can be done to address the genetic vulnerability, you can lessen the impact of the triggers and treat the underlying autoimmune disorder.

Treating the Root Causes of Hypothyroidism

As a functional medicine practitioner, I take a systematic and gradual approach to thyroid cases in order for me to more fully understand what is contributing to the problem and then build a treatment plan from there. Here’s my game plan prior to treatment:

  1. Order tests for underlying cause(s), such as SIBO, EBV, Lyme disease, chronic mold exposure, and hormonal changes. These tests will vary considerably based on the initial evaluation.
  2. Order baseline testing on all thyroid markers including antibodies. This testing is much more comprehensive than the testing patients typically receive.
  3. Test for nutrient deficiencies that may be contributing to low fatigue and energy.

Depending on the patient and on the patient’s test results, treatment may include the following:

  • Review and adjust the diet to reduce inflammation in the gut, heal infections, reduce mold or yeast load, and balance blood sugar, specific to the patient’s labs and clinical findings.
  • Restore healthy balance of gut microbes and repair leaky gut.
  • Measure and reduce inflammation (through labs, and then using targeted nutrition and supplements).
  • Provide nutrient supplements to support proper thyroid function.
  • Use immune modulation supplements to calm the attack on the thyroid, while monitoring thyroid antibodies and conducting sonogram studies.
  • Follow up with bi-weekly or monthly visits to ensure treatment is working and make any necessary adjustments as healthy thyroid function is restored.
  • Support with appropriate thyroid hormones. Some patients need T3 but are only taking T4. Many others need to adjust their dose of T4. Treating the underlying cause(s) usually results in a need for less (or no) medication, so T3 and T4 supplementation must be carefully monitored and adjusted accordingly.

The bottom line is this: In most of the cases I see, taking T4 supplements alone does little to resolve the problem. I strongly encourage anyone who has a hypothyroid diagnosis to consult with a functional medicine doctor for re-evaluation. Effective treatment requires an accurate diagnosis that looks past the thyroid to find out what is causing the thyroid dysfunction. Only then can treatment be targeted to address the root causes and restore healthy thyroid function.

Disclaimer: The information in this blog post is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from Dr. Matt Lewis, D.C., DACBN, CFMP®, nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.

About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Florida. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.