May is Women's Health month, so let's dive into a topic that is becoming more prevalent in today's society, but is lesser understood. It is said that 1 in 8 women will endure thyroid dysfunction at some time in their life. Hypothyroidism is often underdiagnosed and mismanaged, so I consider thyroid health to be a critical topic in women’s health. The thyroid regulates and deals with stress. The countless stressors women encounter (from professional pursuits to familial responsibilities and finding life balance) threaten to target the thyroid and make it a fertile ground for thyroid dysfunction.

Such dysfunction includes hyperthyroidism, commonly caused by Graves disease, but for this conversation, I want to focus on hypothyroidism. Hypothyroidism could be a result of Hashimoto’s disease, or other things that we will soon discuss. Hashimoto’s is an autoimmune condition that causes both hyper and hypothyroid symptoms. Currently, the conventional medicine model addresses hypothyroidism the same, whether it results from an autoimmune condition or other causes.

In functional medicine, when a patient presents with hypothyroidism symptoms and high thyroid stimulating hormone (TSH), we always want to answer the question of why? Why is this patient having hypothyroidism?  What is the cause?  We prioritize the answers to these questions because they will guide the way in which we address the problem.

For patients suffering from Hashimoto’s, we want to know what is triggering the immune system to attack the thyroid. A triggering event for Hashimoto’s could be severe stress, infection, food reaction, etc. For patients not experiencing Hashimoto’s, hypothyroidism could be a result of compromised or poor gut health, liver health, nutritional deficiency, severe stress, etc.

We have seen patients on thyroid medication who have experienced some relief but still have persistent symptoms, such as fatigue, headaches, hair thinning, cold hands and feet, or persistent weight gain.  As I have mentioned earlier, there are many causes for hypothyroidism. While there is good intention when giving thyroid medications, the underlying cause(s) must be analyzed first. For example, if a patient has an allergy that affects thyroid function, we will remove the allergen and assess the patient’s response. Although the patient may need and benefit from medication, symptoms will persist until the causes and various consequences of hypothyroidism are resolved.

The thyroid is a metabolism and stress regulator. It innately knows to slow down when the body senses unmanageable stress, whether chemical, physical, or emotional.  It is up to the well-trained clinician and patient to work together and determine the cause of the patient’s thyroid problems, develop a plan to mitigate the effects, and address the causes.

Some symptoms of hypothyroidism include:

-       Tired/ sluggish

-       Cold hands/feet

-       Hypersomnia (require an excessive amount of sleep to function)

-       Readily gaining weight

-       Constipation, depression/ lack of motivation

-       Morning headaches that wear off as the day progresses

-       Thinning of hair and hair loss

-       Dry skin or scalp

-       Mental sluggishness. 

If you or someone you know has been struggling with these symptoms, it might be time to pay some much needed attention to that often misunderstood (but vital!) gland.

When patients present to our office with hypothyroid symptoms, we prefer to run a complete blood panel: TSH, Total T4, Free T4, Total T3, Free T3, Reverse T3, T3 Uptake, thyroglobulin and thyroid peroxidase antibodies. This panel and a thorough history are used to determine the root cause of the presenting problems. Some strategies we use to support thyroid dysfunction include removing indicated allergens, addressing stress, gut health, finding enzyme needs, adopting whole food nutrition, and restoring sleep hygiene.