Functional Approach to Thyroid Health: Part 1

Understanding Thyroid Dysfunction and Functional Medicine Approach (Part 1)

By Dr. Kolin Durrant, DACM, L.Ac.

Thyroid issues are highly prevalent and can significantly impede overall health. Approximately 20 million Americans grapple with some form of thyroid disease, and an astonishing 60% of those affected may be unaware of it. Notably, 1 in 8 women experiences a thyroid ailment in her lifetime. While thyroid dysfunction is often associated with women, 20% of cases are found in men. (1)

It is crucial to conduct blood work if there is a suspicion or a family history of thyroid issues. Untreated hypothyroidism (underactive thyroid) can lead to various health problems, including heart issues, fatigue, joint pain, obesity, and infertility. (2) Adopting a Functional Medicine Approach to Thyroid Health offers the chance to address both the root cause and the associated symptoms. Here is a comprehensive analysis of the factors causing thyroid dysfunction and how functional medicine can contribute to optimal thyroid health.

How Your Thyroid Gland Works

The thyroid gland is a crucial hormone-producing gland that plays a significant role in the development, growth, and metabolism of the human body. Weighing between 20 and 60 grams on average, the gland produces three hormones: T4, T3, and Calcitonin. (10)

The gland is a vital part of the endocrine system, responsible for producing, storing, and releasing these hormones. Its primary function is to take iodine and convert it into T3 and T4 hormones. A normally functioning thyroid gland produces approximately 20% T3 and 80% T4. The body further converts the 80% T4 into T3, which is utilized by every cell in the body, or Reverse T3, which the body does not use. (11)

To maintain optimal function, T4 and T3 levels should not be too low or too high. When these levels drop, the pituitary gland releases more TSH, stimulating the thyroid to produce more hormones. Conversely, elevated T4 and T3 levels cause the thyroid gland to reduce hormone production. This is where thyroid medications come into play. Medication can suppress the symptoms of hormonal imbalance and alleviate discomfort. (12)

Underlying Causes of Thyroid Dysfunction

Numerous factors can influence thyroid health, with their impact varying among individuals. Thyroid issues can arise due to: (3)

 

  • Genetic disorders

  • Specific medications

  • Thyroid surgery

  • Radiation therapy

  • Cancerous tumors

  • Bacterial or virus-induced inflammation

  • Autoimmune conditions (e.g., Graves’ disease or Hashimoto’s disease)

  • Non-cancerous lumps (nodules)

  • Lack of/excessive iodine

  • Environmental toxins

  • Diet

  • Pregnancy

 

Research suggests that Hashimoto thyroiditis is the primary cause of underactive thyroid in the United States. However, globally, iodine deficiency appears to be the most prevalent factor. Left untreated, hypothyroidism can escalate mortality and morbidity. (4)

Signs of Thyroid Dysfunction

Decreasing thyroid health can affect various body systems and the body as a whole. The symptoms can vary based on whether it is an underactive or overactive thyroid, and may include:

  • Changes in weight: Weight gain or difficulty shedding extra pounds with an underactive thyroid, and weight loss or inability to gain weight despite eating more with an overactive thyroid.

  • Sensitivity to temperature: Feeling cold with an underactive thyroid, and sweating and feeling hot with an overactive thyroid.

  • Exhaustion and sleeping problems: Long naps and waking up drained with an underactive thyroid, and difficulty falling asleep due to a racing heart with an overactive thyroid.

  • Throat or neck complications: Nodules, enlarged thyroid, or neck swelling causing discomfort and difficulty breathing or swallowing.

  • Mood disorders and mental instability: Depression, panic attacks, and anxiety linked to an overactive or underactive thyroid.

  • Changes in bowel movements: Continuous constipation with an underactive thyroid and loose stools or diarrhea with an overactive thyroid.

  • Menstrual issues: Heavier flows and apparent aches with hypothyroidism, while lighter flow, shorter periods, and fewer periods are associated with hyperthyroidism. (5)

A Functional Medicine Guide to Thyroid Labs: What Tests Do You Need to Determine Your Thyroid Health?

 

Thyroid function tests are designed to differentiate between an overactive and underactive thyroid from normal thyroid gland function, as well as identify underlying autoimmunity. Traditionally, medical experts have relied on TSH (thyroid-stimulating hormone) as the primary test for assessing thyroid health. (6)

TSH tests are recommended as initial screening tests for thyroid dysfunction, detecting TSH levels below 0.01 mIU/L. However, focusing solely on TSH may miss approximately 7% of patients with overt thyroid dysfunction. (7)

In the past, most tests for thyroid issues assessed total thyroid hormone levels. However, since these hormones bind to carrier proteins, particularly thyroid-binding globulin (TBG), conditions affecting TBG levels can cause abnormal total thyroid hormone levels, even without actual thyroid dysfunction, as seen in acute diseases or pregnancy. (8)

Functional medicine practitioners often utilize a full thyroid panel including TSH, Reverse T3 (RT3), Free T3 (FT3), Free T4 (FT4), T3 Uptake, Total T3 (TT3), Total T4 (TT4), as well as examining antibodies (TPO and TG) that indicate autoimmunity (Hashimoto’s or Graves’). These tests can assess the state of your thyroid and are performed via blood spot analysis (blood draw).

 

How “Normal” Are Your Test Results?

 

Tests evaluating the hormone status of the thyroid gland, such as FT4 and TSH, can exhibit different normal values. Normal values are determined during laboratory testing by assessing hormones in a significant portion of the population in healthy patients and establishing a reference range.

Therefore, normal ranges may vary between laboratories. The typical normal value for the TSH test is from 0.5 – 5.0 mIU/L. There are instances where TSH is optimally maintained, such as in cases of family history of pituitary problems, thyroid carcinoma, pregnancy, and old age. The typical normal value for FT4 ranges from 0.7 – 1.9ng/dL.

Total T3 and T4 values can be influenced by various factors impacting protein levels in the system, including liver disease, sex hormones, and certain medications. A normal TT3 level in adults ranges from 80 to 220 ng/dL, while a normal TT4 level ranges from 5.0 to 12.0μg/dL. (9)

Functional medicine utilizes a functional range for lab results, enabling personalized lifestyle, dietary, and nutraceutical protocols.

 

Explore PART 2 to delve deeper into Functional Medicine versus Conventional Medicine, the nuances of thyroid medications, the impact of excipients, and the powerful role of nutrients in managing thyroid health.

Ready to take charge of your thyroid health? Don't let underlying thyroid issues go unnoticed. Discover how to address the root cause of thyroid dysfunction and optimize your well-being. Text/call 619.933.2340 to schedule your consultation.

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