Thyroid disease affects about 27 million adults in the United States. One of the most common forms of thyroid disease is a condition known as hypothyroidism. Unfortunately, many are not only unfamiliar with the condition but also unaware that they are suffering from it!

Some studies estimate that up to one-third of those with hypothyroidism are undiagnosed, making it virtually impossible that they will be able to manage their condition. Resolving the problem of hypothyroidism requires that everyone have greater awareness and understanding of the thyroid and hypothyroidism.

Understanding the Thyroid Gland

To best understand hypothyroidism, it is important to first have a good understanding of the thyroid gland. The thyroid is a small butterfly-shaped gland in the neck. Despite its size, it has a very large impact on virtually every bodily system and function. Some areas most affected by the thyroid are metabolism, mood, and weight. However, the influence of the thyroid can be seen in a myriad of other areas throughout the body reaching from the heart, brain, gut, and beyond.

The thyroid exerts its impressive influence through the production of various hormones. Hormones act as one of the body’s primary methods of communication. Depending on the hormone, different types of information are relayed to control activity throughout the body. Thyroid hormones specifically regulate the speed in which bodily processes are carried out. For this reason, some liken the thyroid to a gas pedal that dictates how fast or slow the many systems throughout the body act.

The Thyroid Hormones

When discussing the thyroid, there are four hormones that must be discussed: Thyroxine (T4), Triiodothyronine (T3), Reverse Triiodothyronine (RT3), and Thyroid-Stimulating Hormone (TSH). To sustain healthy bodily function, each of these hormones must be regulated and maintained at the appropriate balance. In part, this is because each influences the behavior and efficacy of the others.

  • T4 is the storage form of thyroid hormone that remains inactive until it is converted into either T3 or RT3. Without adequate levels of T4, the body may become deficient in other more influential thyroid hormones resulting in dysfunction.
  • T3 is the active form of thyroid hormones that upregulates activity. Too much T3 can cause a dangerous acceleration of bodily processes, while too little can lead to sluggishness.
  • RT3 is the mirrored form of T3 and inhibits the efficacy of T3. This quality allows RT3 to act as a regulatory agent and protect against an overabundance of T3. However, excess RT3 can overly impede T3, resulting in an undesirable decline in bodily function.
  • Although TSH is not technically a thyroid hormone, it plays an important role in thyroid function. The pituitary gland produces TSH and informs the thyroid it needs to produce more T3 and T4. Disruption of TSH delivery, reception, or production can cause thyroidal disruption and contribute to hormone imbalances.

The Basics of Hypothyroidism

When the thyroid is not working properly serious dysfunction may occur. One of the most common forms of thyroid malfunction is a condition called hypothyroidism. Hypothyroidism is defined as abnormally low or slowed thyroid activity. This typically results in a deficiency of thyroid hormones that prompt the development of many symptoms.

Common symptoms of hypothyroidism include:

  • Changes in skin and nail quality
  • Constipation
  • Depression
  • Difficulty thinking clearly or “brain fog”
  • Fatigue
  • Hair loss
  • Headaches
  • Insomnia or a reduction in sleep quality
  • Loss of libido
  • Menstrual irregularities
  • Pain and weakness
  • Sensitivity to cold
  • Weight gain or difficulty losing weight

Because the symptoms of hypothyroidism are so disparate and often shared among multiple conditions, it’s difficult to identify thyroid disease through symptoms alone. This means that effective and accurate testing is essential.

Learn more about hypothyroidism in this interview with Dr. Kent Holtorf.

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Testing Practices for Hypothyroidism

One of the major contributors to the woefully under-diagnosed nature of hypothyroidism is a reliance on ineffective testing practices. The standard approach to assessing thyroid function is by measuring TSH values. However, TSH is only a metric for how well the pituitary is communicating with the thyroid and not the actual functionality of the thyroid or the prevalence of thyroid hormones. The ineffectiveness of this testing practice is exemplified by the fact that many thyroid patients who present TSH values within the “normal” range still experience significant thyroid-related dysfunction.

TSH has value when assessing thyroid function. However, it should not be the sole metric used in diagnosis. At a minimum, a thyroid test should include TSH, T4, T3, and RT3. However, a more complete thyroid panel should also include:

  • Assessment of symptoms
  • Basal body temperature
  • Basal metabolic rate
  • Reflex relaxation phase
  • Sex Hormone Binding Globulin (SHBG)
  • The ratio between T3 and RT3
  • Thyroid antibodies

Dr. Holtorf explains more about the importance of proper testing.

Identifying the Cause of Hypothyroidism

Hypothyroidism may develop from a singular trigger, but it is far more likely that there are multiple contributing factors. Some of the most common causes of hypothyroidism include nutritional imbalances (specifically iodine deficiency), exposure to environmental toxins, pituitary malfunction, congenital predisposition, inhibited hormone signaling or transport, and various medications such as antidepressants.

Perhaps the greatest contributor to thyroid disease, including hypothyroidism, is a chronic illness. Conditions such as diabetes, insulin resistance, depression, and fibromyalgia can disrupt many factors relating to thyroid activity. One of the most common causes of hypothyroidism is a chronic autoimmune condition known as Hashimoto’s thyroiditis. The disorder encourages the body’s own immune system to attack the thyroid gland, resulting in an irreparable decline in thyroid function. Hypothyroidism caused by Hashimoto’s or other chronic illnesses cannot improve until the underlying contributors are treated.

Treatment Options for Hypothyroidism

When treating hypothyroidism, the primary goal is to normalize thyroid hormone values so bodily function can return to normal. Typically, this is done through hormone replacement therapy wherein synthetic or natural thyroid hormones are introduced into the body. The most common approach is a daily oral dose with a synthetic form of T4 called Levothyroxine. However, many hypothyroid patients do not see a significant improvement in their condition with this specific form of thyroid hormone therapy.

Studies suggest that patients often do better when their treatment is optimized to suit their specific needs. Therefore, effective treatment requires investigation of all thyroid hormone therapy options including combination T4 and T3 formulations, time-released T3, natural desiccated thyroid hormone, or highly customizable Bioidentical Hormone Replacement Therapy (BHRT). Each approach has its pros and cons, meaning that patients should work with their doctor to find out which methods work best for them.

How You Can Help Combat Thyroid Disease

Thyroid disease, specifically hypothyroidism, is a common condition affecting many. To better identify, treat, and live with hypothyroidism, it is essential that individual awareness and understanding of the condition being raised. You have taken an important step towards greater thyroid wellness by actively seeking information on hypothyroidism. Now, take action by partnering with a qualified, thyroid-literate physician.

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your thyroid condition, optimize your health, and improve your quality of life. If you have been diagnosed with hypothyroidism, but aren’t getting the treatment you need or if you have symptoms associated with thyroid dysfunction, contact us today to see how we can help you!

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