“I went to my primary doctor because I just don’t feel well, but he checked my labs and said I’m fine. I wish I could figure out why my hair is falling out, I can’t lose weight, and I feel too tired to participate in life.”

This is a common theme I hear from my patients, every day as a gynecologist. The other sentence I hear too frequently is:

“I saw my endocrinologist, and he said my TSH level is fine, which means my thyroid is fine. So, why do I feel so terrible? I don’t feel like myself anymore.”

This is what I tell my patients:

Thyroid disease is complicated and thyroid dysfunction can be caused by many things. Unfortunately, conventional medicine is trained to screen for thyroid disease using one basic lab called TSH, which stands for thyroid stimulating hormone. This hormone is actually produced in the pituitary gland of your brain; it’s not even a thyroid hormone, yet it’s what the majority of physicians use to rule-out thyroid disease. This practice fails to diagnose the majority of thyroid diseases, and therefore patients suffer a lot longer than they should because they go undiagnosed. To complicate matters, even if a patient gets diagnosed with hypothyroidism, they are almost never evaluated for the autoimmune disease Hashimoto’s thyroiditis, so they continue to suffer and not feel better with medication.

What is Hypothyroidism?

Hypothyroidism is the clinical state in which your body doesn’t produce enough thyroid hormone for your body to maintain homeostasis. This condition is more common than the over-active state called hyperthyroidism, occurring in 4-10% of the U.S. population. The more concerning statistic is that 90-97% of those diagnosed with hypothyroidism are believed to have the autoimmune disease Hashimoto’s thyroiditis, but they just aren’t tested for it. 

When I look on the physician-led reference website UpToDate.com (like I was trained to do), they have a sentence published that explains that finding. Serum antithyroid antibodies need not be measured routinely in patients with overt primary hypothyroidism, because almost all have chronic autoimmune thyroiditis.

The problem with that? Patients with autoimmune thyroid disease need to be treated significantly differently than those with simple “sluggish” thyroids. The root cause of the autoimmune disease needs to be addressed, and because physicians aren’t checking antibody levels in patients, these patients aren’t being managed appropriately. This is why most patients don’t feel better once they start taking thyroid medication.

Patients with hypothyroidism suffer from:

  • feeling cold and rarely being able to sweat
  • constipation
  • weight gain or inability to lose weight
  • feeling unmotivated or depressed
  • sleeping a lot and still feeling tired
  • hair loss
  • dry skin
  • hormonal imbalance
  • menstrual irregularities
  • recurrent miscarriage/infertility

What Labwork Should I Get?

If you have been diagnosed with hypothyroidism, I recommend that you have your TPO (thyroid peroxidase) and TG (thyroglobulin) antibodies checked with a simple blood draw, along with the complete thyroid function panel that shows total and free T4 and T3 levels and reverse T3 levels.

How Is Hashimoto’s Thyroiditis Treated Differently?

Hashimoto’s thyroiditis (chronic autoimmune thyroiditis) needs to be treated with aggressive diet and lifestyle changes in order to regain homeostasis and feel like yourself again. This includes eating a low-inflammatory diet (like the highly effective autoimmune protocol diet), detoxing your system, actively managing your stress hormone levels, treating any underlying infections like systemic yeast overgrowth, SIBO (small intestinal bacterial overgrowth), hidden parasites, and healing the usual culprit- “leaky gut.”

If you are feeling frustrated because this sounds like your struggle, then I encourage to see a functional medicine physician. We are trained to get to the root cause of your diseases and truly heal what ails you. It’s not a quick fix; it’s a lifelong partnership to get you well and keep you well.  

Dr Tabatha

The Functional Gynecologist