I Feel like My Thyroid is off, but My Doctor Says…
One of the very most common reasons that patients contact my office to seek the alternative answers provided by functional medicine is to discuss concerns that they believe to be associated with their thyroid. They will tell me that, for some period of time, they have been experiencing at least several clinical symptoms widely known to be related to these glands, including, but not limited to:
- Weight gain
- Fatigue
- Loss/shedding/thinning of hair
- Change in the texture of nails or hair
- Poor sleep
- Diminished concentration or memory/brain fog
- Irregular or slowed heartbeat
- Menstrual irregularity
- Increased sensitivity to cold
- Constipation
- Dry skin
- Puffy face
- Hoarseness
- Swelling/ pressure in the lower neck
- Depression
Typically, they have already asked their primary care docs to check their thyroid, and, lo and behold, they are told that their “tests came back normal”. But they don’t feel “normal”. And that is often when these folks come in for a consultation.
In fact, there are many aspects to thyroid function and efficacy that need to be investigated and addressed when someone is experiencing “hypothyroid symptoms”. For whatever reason, this in-depth investigation of the thyroid often falls into province of functional physicians such as me.
For many medical doctors, thyroid testing consists only of testing a patient’s TSH (thyroid stimulation hormone that emanates from the pituitary gland and leads the thyroid gland to produce active thyroid hormone). If this number is elevated, it will trigger a response with medication. The functional physician’s “cutoff” for a “good” TSH vs. a not-so-good TSH is quite different from the traditional/lab cutoff. And this is one of many distinctions in the traditional as opposed to the holistic approach to establishing thyroid status.
Some physicians will also check the total amount of “T4”, the precursor to the active thyroid hormone in the body, known as “T3”. A decent T4 level does not insure adequate ACTIVE T3 levels, as sufficient and accurate conversion is by no means guaranteed. Always, at least some portion of all active thyroid hormone in produced inaccurately by the glands, but this portion varies widely. Therefore, it is critical to check not only for the actual total and active T3 levels, but also for levels of poorly-manufactured, and hence ineffectual, T3 (so-called “reverse T3”).
Other considerations in a thorough evaluation would include:
1 – Is there adequate iodine in the body to support thyroid function?
2 – Are other nutrient levels that support thyroid function optimal?
3 – Is thyroid hormone being will-received in the body’s tissues?
4 – Is auto-immune disease interfering with thyroid function?
5 – (This is a big one!) Are the adrenals that partner with the thyroid glands in good shape, doing their part in
working with the thyroid to produce “good thyroid” results – or not?
In finding the answers to these questions, we are in a much better position to understand why someone may indeed be experiencing thyroid-like symptoms, even though their most basic tests are coming out seemingly “normal”. Once we discover exactly where the issues lie (the underlying “root causes”), it is possible to treat and correct the problem or problems at hand, and alleviate symptoms, permanently restoring a patient back to a more robust level of health. As they say on TV: “The more you know….”.
Robin Ellen Leder, M.D. has been treating the thyroid/adrenal axis using a functional approach since her mentorship with Dr. Robert Atkins (of “The Atkins Diet” fame) at the onset of her career. She has participated in courses with the orginal Broda Barnes thyroid group, with David Brownstein when he first published his work on iodine, with Denis Wilson when he put forth his concept of “Wilson’s Syndrome.” She has applied this same detailed approach, seeking the root cause of issues, to successfully treat thousands of patients at her Hackensack office for a wide variety of conditions, including difficult gut issues, psychological conditions, weight loss, diabetes, auto-immune disease, ongoing fatigue, and many others, always prioritizing the use of diet, supplements, behavioral change, and exercise as first-line therapies.
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