Hypothyroidism

What is hypothyroidism?

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The thyroid gland is a small endocrine gland that sits directly under the atom's apple. Structurally, it looks like a butterfly and plays a highly critical role in your body. It controls body temperature, metabolism, energy, and weight.

People can develop thyroid disease for several reasons, such as genetic predisposition, autoimmunity, toxin exposure, nutrient deficiencies, and infections. It is most commonly seen in women, and often it is diagnosed between the ages of 20-40.

Symptoms of thyroid disease include weight gain, fatigue, hair loss, depressed mood, loss of eyebrows, hoarseness of voice, and dry skin. Routine blood work can help identify a thyroid problem, and more comprehensive testing can help you learn if your thyroid gland is working optimally.

A thyroid ultrasound can help you learn about the size of the gland if it contains any nodules (growths on the thyroid gland; can have one or many) and if there are signs of autoimmunity (your immune system attacking the gland).

Generally, a normal thyroid gland should not be felt in your neck. If your neck is swollen or enlarged, it is a good idea to get it checked out!

Learn how to optimize your hormones by understanding what they do in your body. An optimal thyroid gland can help ensure that your body temperature is well regulated has a thriving metabolism where you can quickly lose weight and feel energetic and happy.

How NES can optimize your hormones to treat your hypothyroidism

At NES, we help you learn about these endocrine glands and educate you on how these hormones work in your body. We also help you understand how hormones work together and create a treatment plan that is completely individualized to your needs.

We test for markers that contribute to the underlying cause of thyroid diseases such as nutrient deficiencies (ex. Selenium, Zinc, Vitamin B12/Folate, Vitamin C, Vitamin D), detailed thyroid markers such as antibodies (ex. TPO antibody, TGB antibody, TSI) and thyroid hormones (ex. T4, T3, fT4, fT3, RT3). 

What our process typically looks like

At your doctor's appointment, your doctor will order a comprehensive thyroid panel. Examples of markers that may be run include TSH, FT3, FT4, Anti-TPO, thyroglobulin, ferritin, zinc, iodine. 

By assessing these markers, your doctor will be better able to determine whether you're a candidate for thyroid medication and evaluate for nutrient deficiencies or excesses that could exacerbate your condition.

This information is helpful in generating treatment recommendations for you.

The treatments will also usually consist of diet and lifestyle recommendations, supplement recommendations, stress management recommendations, medications, possible imaging, referrals to specialists, future lab recommendations, and next steps for follow-up.

Case Study

A 60 year old female presented to the clinic with a history of Hashimotos. She said her thyroid has been off for almost 10 years. She said she’s tried everything for her thyroid and nothing has been helping. She presented with a very high TSH of 68.900 (should be less than 4.5). She said her husband is a physician and no one has been able to regulate her thyroid.

After a detailed discussion with the patient, she admitted that she was also taking many supplements in the morning very close to her thyroid medicine. Amongst those supplements, she was taking iron and calcium and was never told she needed to take those nutrients at least 4 hours away from her thyroid medicine as they inhibit absorption of thyroid hormones. The patient was on a compounded thyroid medicine that included both T4 and T3 hormones.

Even though her TSH was so high, we changed her medicine to a lower dose and instructed her to take her medicine at least 4 hours away from her other supplements. We also ordered more lab tests assessing for other absorption issues that could be impeding her ability to absorb thyroid medicine.

The patient returned two months later, and her TSH went down from 68.900 to 9.8. At that visit, we also diagnosed the patient with Celiac Disease and changed her thyroid medicine to a liquid form, helping optimize her ability to absorb. At that visit, we told her to avoid all gluten, and increased her thyroid medicine slightly. The patient was also had low iron, which is necessary for optimal thyroid function, so we had the patient do some iron IVs. After several visits, we were able to reduce how much T3 thyroid hormone the patient was on, and got to her TSH to a normal value of 2.160. 

Want to know more about hypothyroidism? Read this article!