Functional Medicine Approach to Hypothyroidism: A Guide for Women

Hypothyroidism—a condition in which the thyroid gland produces insufficient thyroid hormones—commonly affects women and is often misdiagnosed or improperly managed in conventional healthcare settings. A functional medicine approach to hypothyroidism focuses on uncovering and addressing the root causes rather than merely alleviating symptoms, leading to a more sustainable, personalized, and holistic treatment.

Understanding Hypothyroidism in Women

According to the American Thyroid Association:

One in eight women will develop a thyroid disorder in her lifetime.
Hypothyroidism is the most common thyroid disorder.
Up to 60% of people with thyroid disease are unaware of their condition.
Untreated thyroid disease can lead to severe issues, including cardiovascular disease, osteoporosis, infertility, and pregnancy complications.

Symptoms and Misdiagnoses

Hypothyroidism symptoms frequently overlap with those of other conditions, leading to misdiagnosis. Women with hypothyroidism may experience:

Fatigue, brain fog, and depression
Weight gain and a slowed metabolism
Digestive issues such as constipation, bloating, or food intolerances
Heavy or irregular menstruation
Frequent infections and reduced immunity
Skin issues, joint pain, and muscle aches

These symptoms are sometimes misattributed to depression, anxiety, fibromyalgia, or chronic fatigue syndrome, resulting in delayed or inadequate treatment.

Types of Hypothyroidism and Their Causes

There are several types of hypothyroidism, each with unique underlying causes:

Primary Hypothyroidism: Often due to iodine deficiency or autoimmune thyroid disease (like Hashimoto’s thyroiditis). It can also result from radiation treatment, surgery, or certain medications.
Secondary and Tertiary Hypothyroidism: Involves dysfunction in the pituitary gland (secondary) or hypothalamus (tertiary) and requires specific diagnostic markers.
Subclinical Hypothyroidism: This type, common among post-menopausal women, features elevated TSH levels with normal T4 levels, causing mild symptoms that may gradually worsen.
T4 to T3 Conversion Deficit: This type involves difficulty converting T4 to T3, the active hormone that cells utilize. Testing for free T3 and reverse T3 is essential, as well as evaluating factors that may impair conversion.

Limitations of Conventional Treatment for Hypothyroidism

In conventional healthcare, only TSH levels are typically measured, often using outdated reference ranges. As a result, women with symptoms and functionally elevated TSH levels may not receive the care they need.

Hashimoto’s thyroiditis, an autoimmune condition, is the most common cause of hypothyroidism in the U.S. Conventional doctors often do not test Hashimoto’s antibodies, or if they do, they may not tell women when they are positive. Many women don’t realize they have an autoimmune condition and they think they just have hypothyroidism. (See our article Holistic Approach to Hashimoto’s: Addressing Root Causes.)

When patients need thyroid hormone replacement therapy, conventional doctors typically prescribe T4 hormone replacement (levothyroxine). However, this assumes efficient T4-to-T3 conversion, which doesn’t occur in all cases, leaving many women with unresolved symptoms.

Lastly, subclinical hypothyroidism and conversion issues often remain untreated in conventional approaches,

Comprehensive Functional Medicine Testing for Hypothyroidism

Functional medicine utilizes a comprehensive approach to thyroid testing that goes beyond TSH. Key tests include:

Free T4 and Free T3: These are the active thyroid hormones in the body.
Thyroid Antibodies (TPO and TgAB): Elevated antibodies may indicate Hashimoto’s.
Reverse T3: High levels suggest poor T4 to T3 conversion.
Related Hormones: Tests for insulin, leptin, and cortisol provide additional insights.

Functional medicine uses optimal reference ranges that are narrower than conventional ranges, as many women feel unwell even within conventional “normal” levels.

Addressing Root Causes with Lifestyle and Nutritional Interventions

After identifying the type of hypothyroidism, functional medicine targets the root causes. While thyroid hormone replacement may still be necessary, lifestyle and dietary changes play a crucial role in managing symptoms and improving overall well-being.

Common root causes that functional medicine addresses include:

Poor T4-to-T3 Conversion: Enzymes responsible for this conversion, known as deiodinase enzymes, can be affected by cortisol imbalance, inflammation, calorie restriction, insulin resistance, and environmental toxins.
Nutrient Deficiencies: Functional medicine practitioners test for and address nutrient levels necessary for thyroid health, such as iodine, selenium, iron, and omega-3 fatty acids.
Managing Insulin and Leptin Resistance: Hypothyroidism often correlates with metabolic issues like insulin and leptin resistance. A balanced diet with adequate protein, healthy fats, and balanced carbohydrates helps manage blood sugar and insulin levels.
Autoimmune Considerations: For Hashimoto’s, an autoimmune approach focuses on gut health and an anti-inflammatory diet, which are cornerstones of our program for autoimmune recovery.

Experience a Functional Medicine Approach to Hypothyroidism

Hypothyroidism requires more than a standard approach. By diving deep into root causes and underlying imbalances, we can create a treatment plan that genuinely aligns with each woman’s health needs. If you’re struggling with hypothyroidism or suspect low thyroid function, don’t settle for generic solutions. Discover the power of a functional medicine approach, personalized for lasting results.

Ready to take the next step? Book a discovery call today to explore how a functional approach can transform your thyroid health!