Thyroid Health: Could you Unknowingly have an Underactive Thyroid?

The thyroid gland, a small butterfly-shaped organ located at the base of your neck, plays a crucial role in regulating numerous bodily functions. From influencing metabolism to controlling energy levels and body temperature, its proper function is essential for your overall well-being. Despite its significance, many people are unaware of the symptoms that might indicate an underactive thyroid, also known as hypothyroidism.

Hypothyroidism, an underactive thyroid, occurs when the thyroid gland doesn't produce enough thyroid hormones to meet the body's needs (1). This can lead to a slowing down of various metabolic processes. It's more common than you might think, especially among women and older adults.

Unexplained Weight Gain or Difficulty Losing Weight: Struggling with weight despite eating a healthy diet daily and exercising regularly? An underactive thyroid could be affecting your metabolism.

Fatigue: Feeling constantly tired, even after a full night's sleep, can be a sign that your thyroid isn't functioning optimally.

Dry, Coarse Skin and Hair: Low thyroid hormone can reduce oil production, leading to dry, flaky skin and brittle hair.

Frequent Muscle Aches and Weakness: Persistent muscle and joint pain may indicate hormonal imbalances.

Depression or Mood Swings: Thyroid hormones have a significant impact on mood regulation.

Difficulty Concentrating or Memory Problems: Known as 'brain fog', this can be a frustrating symptom of hypothyroidism.

Intolerance to Cold Temperatures: If you're always cold, it might be due to a slowed metabolism.

Irregular Menstrual Periods or Heavy Flow in Women: Thyroid hormones interact with reproductive hormones, potentially affecting menstrual cycles.

Constipation: A common yet often overlooked symptom of an underactive thyroid.

In the UK, a significant number of individuals with hypothyroidism remain undiagnosed (3), leading to untreated symptoms that can affect their quality of life. Traditional testing methods primarily focus on measuring Thyroid Stimulating Hormone (TSH) levels, which can overlook subtle cases of thyroid dysfunction that do not present with elevated TSH. This narrow focus can result in a misdiagnosis or delayed treatment for many patients who are struggling with fatigue, weight gain, and other related symptoms.

Functional medicine approaches, on the other hand, offer a more comprehensive assessment by examining a broader spectrum of thyroid-related markers. In addition to TSH, these methods analyse Free T3, Free T4, Reverse T3, and various thyroid antibodies (4). By evaluating this wider array of indicators, healthcare providers can gain a deeper understanding of an individual’s thyroid health, potentially leading to more accurate diagnoses and tailored treatment plans that address the root causes of thyroid dysfunction. This holistic approach is essential for improving patient outcomes and ensuring that those affected receive the care they need.

In conventional medicine, the diagnosis of hypothyroidism is primarily determined through elevated TSH (Thyroid-Stimulating Hormone) levels and, in some cases, low Free T4 (the active form of thyroxine) (6). This traditional approach is effective for identifying overt hypothyroidism, where patients have clear symptoms of thyroid deficiency. However, it can often overlook subclinical cases—situations where individuals exhibit symptoms indicative of hypothyroidism, yet their hormone levels fall within the 'normal' range according to standard lab tests.

Conventional Medicine Approach:

Diagnosis: The diagnosis is mainly based on measuring TSH and Free T4 levels. A significantly elevated TSH level typically indicates that the thyroid gland is not producing enough hormones, prompting further evaluation of Free T4 levels to confirm insufficient hormone production.

Treatment: The standard treatment protocol typically involves the administration of synthetic levothyroxine, a medication designed to supplement low hormone levels and restore balance. Patients usually require regular monitoring of their TSH and Free T4 levels to adjust medication dosages appropriately.

Limitations: One of the main limitations of this approach is its inability to address the underlying causes of hypothyroidism. Additionally, it may fail to recognise subclinical hypothyroidism, where patients may experience symptoms like fatigue, weight gain, or depression despite having ‘normal’ lab results.

Functional Medicine Approach:

Diagnosis: In contrast, the functional medicine approach embraces a more comprehensive testing methodology. It includes not just TSH and Free T4, but also Free T3 (the most active thyroid hormone), Reverse T3 (which can block the effects of Free T3), and thyroid antibodies to check for autoimmune conditions like Hashimoto's thyroiditis. This extensive evaluation allows for a more accurate diagnosis of thyroid function.

Treatment: Treatment in functional medicine focuses on identifying and addressing the root causes of thyroid dysfunction. This may involve lifestyle modifications such as stress reduction techniques, regular exercise, and sleep optimisation, alongside dietary changes that could include the elimination of inflammatory foods and the incorporation of nutrient-dense options. Supplementation may also be recommended to correct any identified deficiencies, such as iodine, selenium, or vitamin D. In extreme cases where the thyroid does not become within normal limits when diet, supplementation and exercise protocols are adhered to, supplementation of the thyroid gland may be suggested or synthetic thyroid hormones may be prescribed.

Advantages: The functional medicine approach provides a holistic view of health, addressing not only thyroid function but also potential nutrient deficiencies, overall metabolic health, and stress management. This comprehensive perspective can lead to improved overall well-being and a reduction in symptoms related to hypothyroidism, thereby enhancing the quality of life for individuals affected by thyroid imbalances. Opting for this route in all instances ensures that the root cause is found and medication is reserved for worst-case scenarios.

1. Schedule a Thyroid Function Test: If you experience two or more of the aforementioned symptoms, consult your GP or a functional medicine practitioner to discuss comprehensive thyroid testing.
2. Share Information: Raising awareness is crucial. Share this information with friends and family who may also be experiencing similar symptoms.
3. Diet and Lifestyle Changes: A balanced diet rich in iodine, selenium, and zinc can support thyroid function. Regular physical activity helps maintain a healthy weight and improves overall well-being.
4. Stay Informed: Engage with reliable healthcare resources and professionals to stay updated on thyroid health.
5. Consider Functional Medicine: If traditional approaches haven't provided relief, exploring functional medicine might offer new insights and treatment options.

British Thyroid Foundation: The BTF provides comprehensive information on thyroid disorders, supporting both patients and healthcare providers.

NHS UK: For a conventional overview of symptoms, diagnosis, and treatment options.

Endocrine Society: Offers scientific research articles and guidelines on the endocrine system, including thyroid health.

Restoring Thyroid Hormone Balanced: A comprehensive article from the Institute for Functional Medicine covering the functional medicine viewpoint on thyroid health.

An Integrative Approach to Hypothyroidism: Another comprehensive article covering the root causes of an underactive thyroid.

Thyroid health is integral to your overall well-being. Recognising the symptoms of an underactive thyroid early can lead to more effective management and improved quality of life. If you suspect your thyroid might be underactive, take proactive steps by consulting with your healthcare provider and considering a comprehensive assessment through functional medicine. Empower yourself with knowledge and take charge of your health today.

For further guidance, reach out to health professionals who specialise in thyroid issues and explore resources that align with your health needs. Your thyroid health matters—ensure it's not unknowingly holding you back.

Written by Amy Morris, BSc (Hons) Nutritional Therapy. Amy has been a nutritional therapist for 12 years, specialising in recent years as a functional medicine nutritional therapist. Women’s health, and pre-diabetes and type 2 diabetes prevention are Amy’s specialist areas. Diagnosed with a chronic condition called endometriosis at age 20, this is what motivated Amy to study nutrition. Amy has been in remission for 6 years now, attributing powerful nutrition, lifestyle and bio-identical hormone strategies she now shares with her clients.

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