Hypothyroidism affects millions of people worldwide. From kids to adults, this condition can have a major impact on your quality of life, with symptoms ranging from weight gain and fatigue to depression and more. But what exactly is this condition, why does it happen, and what can you do about it? Let's find out!
The thyroid is a small butterfly-shaped gland at the front of your neck, just below your Adam's apple. The thyroid gland acts like the body's barometer. Its main function is to help cells convert oxygen and calories into energy. It is also a part of your endocrine system and plays an important role in producing and releasing hormones that regulate:
The thyroid gland produces two primary hormones that are essential for regulating numerous functions throughout the body:
Together, these hormones play a crucial role in maintaining the body's metabolic rate, supporting energy production, and ensuring the proper development and function of all cells. They also influence key physiological processes such as heart rate, body temperature, and growth.
However, the thyroid gland doesn’t act alone. Its activity is tightly regulated by a feedback loop involving two key hormones from the brain:
These hormones are part of a feedback loop that ensures thyroid hormone levels remain balanced, adapting to the body's needs. When T4 and T3 levels drop, the hypothalamus and pituitary increase TRH and TSH production to stimulate the thyroid, restoring proper hormone levels.
Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones to support the body's normal functions. Since thyroid hormones are critical for regulating metabolism, insufficient levels can slow down various bodily processes, affecting overall energy and well-being.
When the thyroid hormone levels are too low, it impacts metabolism, leading to effects on weight, energy levels, body temperature, and even the health of the skin and hair. Managing hypothyroidism usually involves hormone replacement therapy to restore and maintain normal hormone balance, which helps keep metabolism and body functions steady.
Hypothyroidism can be categorized into different types based on its underlying cause and severity:
Each type requires a tailored approach to identification and management, depending on its root cause and the individual's overall health.
Hypothyroidism can cause a wide range of symptoms, which often develop slowly over time. Common symptoms include:
There are a variety of factors that can cause hypothyroidism. These include:
You have a higher risk of developing thyroid disease if you have one or more of the following risk factors:
Family history of thyroid problems
Your doctor may suggest several tests to help identify thyroid issues.
The most critical tests for evaluating thyroid function are TSH, Free T3, Free T4, and Reverse T3. The interaction between these hormones is central to understanding thyroid health:
In traditional lab testing, a TSH level above 4.5 is considered indicative of hypothyroidism. However, for optimal thyroid function, the ideal TSH range is closer to 1-2, as the standard reference range is often too broad and reflects a growing prevalence of hypothyroidism, potentially missing early or subclinical cases. Optimal lab ranges for thyroid hormones include 3-4.5 free T3, 1-2 free T4, and <15 reverse T3. This table compares the broader, traditional “normal” ranges with optimal ranges of these hormones:
| Thyroid Test | Traditional Reference Range | Optimal Range |
|---|---|---|
| TSH | 0.5–4.5 μIU/mL | 1–2 μIU/mL |
| Free T3 | 2.3–4.2 pg/mL | 3.0–4.5 pg/mL |
| Free T4 | 0.8–1.8 ng/dL | 1.0–2.0 ng/dL |
| Reverse T3 | <25 ng/dL | <15 ng/dL |
| Anti-TPO Antibodies | <35 IU/mL | 0 IU/mL |
| Anti-TG Antibodies | <40 IU/mL | 0 IU/mL |
Elevated TPO antibodies or thyroglobulin antibodies can signal autoimmune thyroiditis, also known as Hashimoto’s disease, where the immune system attacks the thyroid gland.
While blood tests provide valuable insights, they can sometimes be challenging to interpret and may not capture the full picture, particularly in early-stage hypothyroidism. A comprehensive evaluation of symptoms, not just lab results, is essential to ensure your condition is accurately identified and an effective care plan can be developed.
Adrenal Fatigue is a condition where the body is unable to keep up with long-term stress, resulting in various nonspecific symptoms. Initially, the adrenal glands produce large amounts of stress hormones like cortisol to help the body respond to stress.
However, when stress continues long-term, the adrenal glands may become depleted, leading to low cortisol levels and imbalances in the NeuroEndoMetabolic (NEM) Stress Response system. The NEM system encompasses six circuits of related organs that work together to manage stress. This can result in a range of symptoms depending on where in the NEM system the imbalances occur.
When the adrenal glands become exhausted, they can no longer effectively manage the energy demands of daily life. In response, the body slows metabolism as a survival mechanism. This "down-regulation" affects the thyroid, leading to reduced production of the thyroid hormones T3 and T4.
Here’s how:
Additionally, T3 plays a critical role in progesterone production. Low T3 can decrease progesterone levels, further disrupting reproductive hormone balance. This interplay between the adrenal glands, thyroid, and reproductive organs is known as the Ovarian-Adrenal-Thyroid (OAT) Axis.
Traditional thyroid medications are designed to boost metabolism by increasing T3 and T4 levels. However, for individuals with Adrenal Fatigue, this approach can conflict with the body’s attempt to conserve energy through down-regulation.
While these medications may provide short-term symptom relief, they can worsen Adrenal Fatigue over time, leading to increased exhaustion and a need for higher medication doses. In severe cases, this cycle can culminate in an adrenal crisis. If you have been taking thyroid medications, but not seeing your symptoms improve, you should take a closer look at your adrenal health. Ask your provider to run a reverse T3 test, as high levels could be a sign of Adrenal Fatigue.
For hypothyroidism related to Adrenal Fatigue, the primary focus should be on healing the adrenal glands. As adrenal health improves, thyroid function often normalizes spontaneously. Supporting the adrenals reduces the body’s need for down-regulation, lifting the suppression of thyroid activity.
Key points to consider:
For those pursuing thyroid recovery through adrenal fortification first, the body regains energy without increasing thyroid medication, even after years of relying on such replacement. Eventually, thyroid replacement may not be necessary and can be tapered off totally over time as adrenal function normalizes. However, this should only be done with the support of your doctor. There are also more natural types of glandulars and medications like NP thyroid or Armour Thyroid that can be utilized before jumping into levothyroxine or liothyronine.
Remember, it is important not to abruptly discontinue any thyroid medications and other natural compounds that may have stimulatory effects, such as herbs and glandulars, without professional guidance. Abrupt termination may result in serious withdrawal symptoms. In rare cases, an adrenal crisis may occur. Regular monitoring of thyroid and adrenal levels is recommended to make sure levels are in balance.
While synthetic T4 is a standard treatment for hypothyroidism, natural supplements can also play a role in promoting thyroid health and supporting the adrenals.
One example is Thyro-Blast by Dr. Lam. This supplement combines essential vitamins, minerals, and adaptogenic herbs, including:
Vitamins B6, B9, and B12: Critical for thyroid hormone synthesis and adrenal support.Hypothyroidism is often overlooked due to outdated and insensitive laboratory tests, making accurate identification a challenge. A comprehensive approach that includes a detailed history, physical examination, and advanced lab tests—such as TSH, Free T3, Free T4, and Reverse T3—is essential.
These tools not only confirm the presence of hypothyroidism but also help distinguish between primary hypothyroidism and secondary hypothyroidism linked to conditions like Adrenal Fatigue. Addressing adrenal health is critical in such cases, as, in some cases, it plays a key role in restoring thyroid function.
If you’re experiencing symptoms of an underactive thyroid and seeking a whole-body approach to recovery, we’re here to help. Call us at +1 (626) 571-1234 for a free initial consultation, and take the first step toward better thyroid and adrenal health.
Support Your Thyroid Functioning
National Institute of Diabetes and Digestive and Kidney Diseases. "Hypothyroidism (Underactive Thyroid)." 16 Nov. 2022, www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism.
Panda, Sasmita, and Anand Kar. "Guggulu (Commiphora Mukul) Potentially Ameliorates Hypothyroidism in Female Mice." Phytotherapy Research, vol. 19, no. 1 Jan. 2005, pp. 78–80. https://doi.org/10.1002/ptr.1602.
Wang, Zhihua, et al. "L-tyrosine Improves Neuroendocrine Function in a Mouse Model of Chronic Stress." PubMed, vol. 7, no. 18 June 2012, pp. 1413–19. https://doi.org/10.3969/j.issn.1673-5374.2012.18.008.
Wiciński, Michał, et al. "Can Ashwagandha Benefit the Endocrine System?—A Review." International Journal of Molecular Sciences, vol. 24, no. 22, Nov. 2023, p. 16513. https://doi.org/10.3390/ijms242216513.
Whilst hypothyroidism can be a result of AFS, you can also experience AFS as a result of hypothyroidism. This is because of the ovarian-adrenal-thyroid axis. Low thyroid levels can cause imbalances within the reproductive hormones, which can affect cortisol levels. This increases the chance of AFS occurring. And addressing adrenal health is important to managing thyroid health.
