Six Hypothyroid Patterns Often Overlooked
There is an explosion of hypothyroidism in the country. It is estimated that more than 20 million Americans suffer from low thyroid problems or hypothyroidism, and up to 60 percent of these people are unaware of any condition. One in eight women will develop a thyroid disorder during her lifetime. Weight loss resistance, fatigue, brain fog, irritability, depression, hair loss, cold intolerance, constipation, and infertility have all been linked to low thyroid function.
Unfortunately misdiagnosis is common in the management of hypothyroidism. If you go to a doctor with hypothyroid symptoms, you’ll simply be given replacement thyroid hormones without any further inquiry into the cause of your condition. Even worse, if you have hypothyroid symptoms but your lab tests are normal, you’ll be told you’re “fine”. If you insist you’re not, you might be sent home with an antidepressant, but no further clue about the cause of your symptoms.
A Functional Medicine Approach to Thyroid Health
A standard thyroid panel usually includes TSH and T4 only. The ranges for these markers varyfrom lab to lab, which is one of two main problems with standard lab ranges. The ranges arealso wide and large…assuming health if you fall within them. Unfortunately misdiagnosis iscommon in the management of hypothyroidism.
Even worse, if you have hypothyroid symptoms but your lab tests are normal, you’ll be toldyou’re “fine”. A full thyroid panel includes: TSH, T4, T3, fT4, fT3, T3 Uptake, rT3, Thyroid Antibodies (TPO/TBG)
Datis Kharrazian (www.thyroidbook.com) highlights six patterns of thyroid dysfunction that won’t show up on standard lab tests. If you have one of these patterns, your thyroid isn’t functioning properly and you will have symptoms.
Pattern #1 Hypothyroidism secondary to Pituitary Hypofunction
The pituitary isn’t sending a clear signal to the thyroid to produce more thyroid hormones.
- Typical Cause: Stress from an active infection, blood sugar disorders, unrelenting stress
Cortisol (stress) suppresses pituitary function - An adrenal salivary index demonstrates adrenal dysfunction
Blood Test: TSH will be below functional range (1.8-3.0), T4 – below 6, T3 – Normal - Important: Balance blood sugar, check for infections
Pattern #2 Hypothyroidism secondary to Pituitary Hypofunction2
T4 is inactive and must go through a conversion process to become T3 – the active form of thyroid hormone.
This conversion takes place in the liver and gastro-intestinal track and requires a healthy liver and good gut bacteria.
- Typical Cause: Poor diet and gut function can lead to a deficiency of nutrients responsible for adequate function of the enzymes needed for conversion
- Blood Test: Total T3 & Free T3 will be low
- Important: Clean Gut, Clear Liver (Detox)
Pattern #3 Elevated Thyroid Binding Globulin leading to Hypothyroidism
Thyroid biding globulin (TBG) is the protein that transports thyroid hormone through the blood. When thyroid hormone is bound to TBG, it is inactive and unavailable to the tissues.
When TBG levels are high, levels of unbound (free) thyroid hormone will be low, leading to hypothyroid symptoms
- Typical Cause: Excess estrogens from oral contraceptives and Premarin (estrogen replacement)
- Blood Test: TSH and T4 will be normal, T3 will be low, and TBG will be high
- Important: Clear excess estrogen from the body
Pattern #4 Depressed Thyroid Binding Globulin leading to Hypothyroidism
Opposite of pattern #3: When Thyroid Binding Globulin drops, levels of free thyroid hormones will be high. Too much T3 causes thyroid receptor sites to become resistant.
- Typical Cause: Poor diet and gut function can lead to a deficiency of nutrients responsible for adequate function of the enzymes needed for conversion
- Blood Test: Total T3 & Free T3 will be low
- Important: Clean Gut, Clear Liver (Detox)
Pattern #5 Thyroid Hormone Resistance leading to Hypothyroidism
Inflammation, cortisol and oxidation will depress thyroid site responsiveness. The hormones aren’t getting into the cells where they are needed.
- Typical Cause: Stress & Inflammation
- Blood Test: TSH, T4, T3 will be normal but individuals still present with thyroid symptoms
- Important: Careful examination of immune related disorders and stress management
Pattern #6 Autoimmunity leading to Hypothyroidism
The immune system recognizes and flags the thyroid as a threat – develops memory cells to destroy thyroid tissue.
- Typical Cause: Immune Dysregulation – not a thyroid disorder
- Blood Test: Positive TPO or TBG Antibodies
- Important: Manage immune system/barrier system – manage triggers, heal/seal the gut, restore immune integrity
