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Many faces of hypothyroidism

Updated: Feb 3


Low thyroid function

If you’re reading articles on health online, low thyroid function (and Candida) is a common culprit for many different health conditions. While this likely has to do with both the obesity epidemic and weight loss mania, proper thyroid function does control our metabolism, affecting how much energy is produced. Our metabolism controls how quickly we produce new cells or fix old ones, helps maintain proper body temperature, and strongly influences how much energy we have as well. So of course everyone, both patient and doctor, would like to have a magic bullet (i.e. thyroid replacement) to solve the many issues hypothyroidism can cause.

The reality is that while many people, particularly women, are affected by hypothyroidism, its prevalence in the US is relatively low. By most estimates this is approximately 0.3-4% of the American population. And of course this single condition cannot account for all the obesity, fatigue, dry skin, hair loss, and constipation so many people experience.

There are many factors pertaining to improper thyroid function: environmental toxicants, food reactions, nutrient status, pregnancy, and even physical or emotional stress. And of course very little occurs in the human body in isolation. Low production and/or function of thyroid hormone does not occur haphazardly and is typically a reaction to something else. Even in its most common presentation, the autoimmune condition called Hashimoto’s, thyroid trouble is often triggered by other factors. Our thyroid function can be affected anywhere from the pituitary gland in our brain to thyroid receptors on our cells with a multitude of possible factors influencing these. In fact, it seems that the more we learn about thyroid, the more things which discover impacts thyroid function.


Proper thyroid function is oftentimes not even clarified by lab testing. While most doctors and endocrinologists only check one hormone to assess thyroid function (TSH and thyroid antibodies) and functional medicine doctors often check the “free” levels of the thyroid hormone itself (free T3, free T4), even these precise measurements can incorrectly represent what is going on. When TSH values are normal, thyroid hormone levels can be low. And even though thyroid hormone levels can be normal, there may be reduced conversion of T4 (the storage and transport form of thyroid) to the active thyroid T3 at the cell, or the T3 available may be shunted to an inactive (reverse T3) form which has no effect on metabolism.


Our bodies do an amazing job at coordinating the many systems and processes with input from our own environment, state of nutrition, or states of health or illness. And there are many situations where the body needs to reduce overall metabolism to maintain health. The mechanisms for this can be complex are still being discovered by researchers, but giving thyroid hormones to counteract the changes the body is intentionally producing makes as much sense as a cat chasing its tail! Like so many chronic health conditions, abnormal thyroid function is sometimes simply a sign that something else is not right. Working with, instead of against the normal processes of the body is far more effective at producing lasting change, and to do this we must address the underlying causes first.


As with most chronic health conditions, the first step is to find what is out of balance and work to restore proper function. Optimizing digestion, treating infections or imbalanced gut bacteria, identifying nutrient deficiencies or food sensitivities, balancing immune function, and addressing physical and/or emotional stress can oftentimes reduce the triggers for low thyroid function.




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