The number one cause of thyroid disorders in the US is an autoimmune condition known as Hashimoto’s Thyroiditis. In our office, we see less than 10% of our thyroid patients having been tested for this! The only reason we can surmise is that there isn’t a drug for Hashimoto’s, and so for most physicians the diagnosis doesn’t matter because they are still going to put you on Synthroid or Levothyroxine. These are T4 replacement hormone drugs.
If you have a primary Thyroid disorder, meaning that your thyroid gland is in fact malfunctioning, then these medications will likely make you feel much better. However, what we hear from many patients is that they continue to feel lousy even after taking the drugs. Patients often tell us that their doctor has tested their hormones and tell them that they are “fine”, or it’s all in your head, which is confusing especially if you don’t feel “fine.”
The pituitary gland that sits in your brain secretes a hormone called TSH, or Thyroid Stimulating Hormone. This hormone stimulates the thyroid to produce its hormones T4 and T3. The problem here is that most of the hormone produced by the thyroid, approximately 93% is T4 and a very small amount of T3 which is the hormone that every cell in your body needs to get it running. T4 is what tells the pituitary gland if the thyroid is doing its job, so if you test the TSH level and it’s high, then that tells us the thyroid needs help getting stimulated.
However, there is small hiccup with this; there isn’t great agreement on the “normal levels” of TSH. Some labs like Labcorp in California say anything from 0.45 - 4.5, and many endocrinologists don’t think TSH is an issue even at 5.0 something. In 2005, the Society for Endocrinology proposed a new reference range of 0.5 - 2.0 as a more accurate determination for thyroid function, but they also found a stronger correlation between T3 activity and levels and health.
T4 gets converted into T3 in your peripheral tissues as well as your liver and gastrointestinal tract. If you have Hashimoto’s, you have an autoimmune condition. This means that your immune system is attacking your thyroid and destroying it over time. So we don’t want to simply replace the hormone T4. You have to get your immune system to calm down and stop attacking your body, as well as increase the conversion of T4 - T3.
This likely involves not only addressing your thyroid but your gut health, your adrenal health, your blood sugars, etc. The reason for this is because so many things can interfere with thyroid function, especially as it speaks to Hashimoto’s.
If you are suffering with a thyroid condition and want to feel better, then we need to be looking at all the things that can be affecting normal thyroid function, and not just replacing Thyroid hormones.