Hypothyroidism is now the most common thyroid disorder in Australia, affecting at least one in 33 Australians.
The condition is characterised by underactive thyroid function, resulting in uncomfortable and frustrating symptoms, and it carries some potentially serious health risks too.
Unfortunately, people living with hypothyroidism will often suffer with symptoms for a long time before gaining a diagnosis, and treatments are delayed by months or sometimes even years of ‘normal’ test results.
In this article, we take a look at why conventional medicine often overlooks hypothyroidism, and how a functional medicine approach could help you on the road to recovery sooner.
What is hypothyroidism?
Hypothyroidism is a term given to underactive thyroid function, which involves a deficiency of thyroid hormone.
It causes the body’s metabolic processes to slow, leading to symptoms of sluggishness, weight gain, cold intolerance, hair loss, and impacts on digestive and reproductive health.
Hypothyroidism is up to ten times more common in women than among men.
It is a progressive condition, and its presentation varies between individuals, with some people experiencing severe symptoms, and others noticing little changes at all.
Depending on the progression of the condition, hypothyroidism can be categorised into three types - subclinical, primary and secondary hypothyroidism.
Subclinical hypothyroidism: Many people experiencing hypothyroid symptoms are told their test results are ‘normal’. This is commonly referred to as subclinical hypothyroidism. In conventional medicine settings, however, the term subclinical hypothyroidism refers to someone who presents with confirmed hypothyroid pathology results with no clinical symptoms of the condition. Subclinical hypothyroidism will often progress to primary hypothyroidism if left untreated.
Primary hypothyroidism: This describes the type of hypothyroidism caused by a disorder or disease within the thyroid gland itself. The most common cause is autoimmune interference with thyroid hormone production from Hashimoto’s thyroiditis, as well as insufficient nutrient supplies to produce hormones, defective receptors, and faulty hormone synthesis.
Secondary hypothyroidism: Resulting from insufficient stimulation of the thyroid and lack of thyroid-stimulating hormone production from the pituitary gland. In rare cases, secondary hypothyroidism may involve insufficient thyrotropin-releasing hormone from the hypothalamus.
Signs and symptoms of hypothyroidism
It’s important to remember the symptoms of hypothyroidism are common, and may have other causes. However, if you’re experiencing a combination of these symptoms, it may be a sign of hypothyroidism or low thyroid function.
- Dry coarse hair and hair loss
- Hoarse voice
- Loss of eyebrow hair
- Puffy face
- Enlarged thyroid (goitre)
- Slow heartbeat
- Rapid weight gain (particularly around the abdomen)
- Fluid retention
- Difficulty losing weight
- Brittle nails
- Body aches
- Cold sensitivity and intolerance
- Dry skin
- Difficulty concentrating
- Heavy periods
Root causes and contributing factors of hypothyroidism
As mentioned earlier, the most common cause of hypothyroidism in Australia is Hashimoto’s disease, an autoimmune disorder that causes the immune system to attack the thyroid gland, known as thyroiditis. This results in swelling and inflammation of the thyroid gland and the destruction of thyroid cells, creating a lack of thyroid hormones. Hashimoto’s may cause extensive damage to the thyroid before symptoms are experienced, or a diagnosis is made.
Other causes of hypothyroidism include:
- Genetic disorders
- Other autoimmune conditions
- Iodine deficiency
- Congenital hyperthyroidism
- Radiation exposure from x-rays or radiotherapy
- Surgery and medication for the treatment of hyperthyroidism
- Postpartum thyroid disorder
- Compromised gut health and leaky gut (intestinal hyperpermeability)
- Adrenal dysfunction
While stress is not medically recognised as a direct cause of hyperthyroidism, ongoing, chronic stress can contribute to high cortisol levels and disruptions to thyroid hormone production. People experiencing high or unrelenting stress and lack of sleep are also more likely to experience inflammation and digestive health issues, all of which are commonly associated with hypothyroidism.
Common and conventional treatments for hypothyroidism
The conventional approach of thyroid testing focusing on just TSH (thyroid stimulating hormones) often results in false ‘normal’ results. Unfortunately, these classifications of normal are based on outdated reference ranges and basic testing methods that fail to take into consideration other markers.
Our practitioners see a lot of patients who are battling with the classical symptoms of hypothyroidism, and their GP has assured them their thyroid test results are normal. If they’re trying to lose weight, they’ll often be told to exercise more, or eat less, and sent on their way.
Of course, losing weight with hypothyroidism isn’t that easy, and requires help to first restore thyroid function.
When people do receive a diagnosis of hypothyroidism, the conventional medicine approach to treating the condition is medication.
Hormones Australia recommends people diagnosed with primary hypothyroidism receive life-long treatment with synthetic thyroid hormone, levothyroxine, or thyroxine. The tablets are taken daily, and thyroid levels monitored over time to adjust the dose accordingly. If hormone levels are allowed to rise too high, people may experience symptoms of hyperthyroidism, such as rapid heart rate, weight loss, and anxiety. It’s important to note this medication doesn’t heal the damaged thyroid gland, it simply replaces deficient hormone production with synthetic hormones.
People with subclinical hypothyroidism may be denied medication if their GP determines their thyroid levels don’t warrant intervention. The problem with this wait and see approach, is that unmedicated subclinical hypothyroidism will often develop into clinical hypothyroidism if no other measures such as lifestyle or dietary changes are introduced to support thyroid function.
The Melbourne Functional Medicine Approach to hypothyroidism
Our practitioners understand the frustration and confusion surrounding the diagnosis of hypothyroidism. Which is why we prioritise supporting our patients to first find the answers they are looking for. With a diagnosis, and a clearer picture of each individual’s health profile, our practitioners can then provide individualised support for hypothyroid symptoms. This might include:
Full thyroid panel: Detailed thyroid pathology testing can be requested by our practitioners including TSH, total T4, T3 uptake, free T3, free T4, reverse T3, and thyroid antibody levels.
Optimal levels: Our practitioners base thyroid function on optimal reference ranges, rather than outdated conventional ‘normal’ levels which have proven inaccurate in the diagnosis of early stage thyroid dysfunction. We will also often check additional pathology markers such as CRP (inflammation), sex hormones and nutrient stores.
Education: We believe everyone should feel empowered and in control when it comes to their health, so our practitioners prioritise patient information and education to help you make informed decisions about your health. We also partner each patient with a health coach, whose role is ongoing education, and helping patients implement their protocol with greater ease.
Food sensitivities: Undiagnosed food sensitivities can cause inflammation that can contribute to thyroid disorders. Our practitioners complete thorough investigations to detect or rule out these underlying issues.
Balance hormones: People with hypothyroidism often experience elevated liver enzymes and compromised liver function, which is often associated with hormonal imbalance and impaired hormone detoxification pathways. Our practitioners can test these levels and help you restore balance with a combination of nutrition, herbal medicine and lifestyle change.
Optimise nutrition: The fatigue associated with hypothyroidism can make it very hard to prioritise healthy eating and preparing meals. For this reason, many people with underactive thyroid may find they opt for easy, pre-packed and processed foods high in carbohydrates, sugars and other inflammatory ingredients that further exacerbate their symptoms. Our health coaches can help you with simple, healthy recipes that increase nutrient-rich foods, while reducing potentially inflammatory ingredients like gluten, dairy and sugar.
Supplement vitamin and mineral deficiencies: People with hypothyroidism tend to have lower levels of key vitamins and minerals that support thyroid function. These include:
Iodine: Found in sea vegetables including nori, dulse, kombu, arame, and kelp. Iodine is essential for thyroid hormone production.
Selenium: Required to convert T4 to T3, selenium can be found in brazil nuts, liver, onion, garlic, broccoli, eggs, and herrings. Brazil nuts tend to be the most nutrient-dense sources, with just 2-4 brazil nuts a day being sufficient to meet minimum daily requirements, however, supplementation may be necessary to reach therapeutic levels.
Zinc: Zinc deficiency can result in hypothyroidism, and sufficient thyroid hormones are essential for the absorption of zinc. Hence, zinc is a critical nutrient for thyroid health.
Vitamin A: Low levels of Vitamin A can block activation of T3. Vitamin A can be found in grass-fed liver and tuna, while its precursor, beta-carotene, can be found in sweet potatoes and carrots.
Vitamin C: Together with Vitamin B2, Vitamin C helps the absorption of iodine which supports T4 production.
Vitamin D: Regular sunlight exposure increases Vitamin D levels, to support genetic pathways and hormone receptors. Supplements may be required to boost levels.
Address other underlying triggers: Rarely is the thyroid gland the only affected organ in people with hypothyroidism. Usually there are underlying imbalances or illness that contribute to underactive thyroid, and then the under-performing thyroid function exacerbates or leads to further regulatory dysfunction elsewhere in the body. Our practitioners will work with you to assess and optimise the health of your:
Liver: The liver, along with the gallbladder and kidneys, is responsible for removal of toxins and hormones. Poor thyroid function can impair their performance, which can lead to toxin overload or conditions like non-alcoholic fatty liver disease.
Adrenals: People with hypothyroid disorder often have high levels of cortisol, produced in response to stress and the body’s attempt to deliver more energy to the cells. This can lead to hypothalamic-pituitary-adrenal axis dysfunction and adrenal fatigue.
Gut health: Thyroid hormones are involved in digestion, and low levels of these hormones can impair intestinal function, leading to nutrient malabsorption, inflammation, and increased intestinal permeability.
Pain: Chronic pain can suppress an essential liver enzyme that converts 80 percent of our T4 stores into T3. Our practitioners can provide a range of functional medicine therapy options to reduce inflammation and pain if this is a problem for you.
These are just some of the ways our practitioners can support people with hypothyroidism and underactive thyroid at Melbourne Functional Medicine. The approach for you may be different depending on your individual findings. Self-diagnosis and treatment of hypothyroidism are not recommended due to the serious nature of long-term thyroid damage.
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