The thyroid gland has many functions in the body as it plays a key role in metabolism, growth and development. It works through a negative feedback loop that starts in a region of the brain called the hypothalamus. The hypothalamus secretes thyroid-releasing hormone (TRH). TRH causes the pituitary gland to secrete another hormone called thyroid-stimulating hormone (TSH). TSH then binds to the thyroid gland tissue and tells the thyroid gland to start making and secreting the two main thyroid hormones, T3 and T4 into circulation. 

When levels of T3 and T4 get too high, this sends a signal to the brain and pituitary to decrease production. Similarly, if T3 and T4 levels are low this sends a signal to increase production. In this way, the body self regulates the amount of thyroid hormone in circulation. 

If this feedback loop fails, if there is an autoimmune attack on the thyroid, or if the body does not have all the vitamins and minerals needed to produce thyroid hormones, the thyroid gland is unable to produce enough T3 and T4 hormones. If the thyroid gland is under producing the T3 and T4 hormones this is called hypothyroidism. If the thyroid gland is overproducing the T3 and T4 hormones this is called hyperthyroidism.

Symptoms

Under active thyroid/hypothyroidism/Hashimoto's:

• Fatigue

• Brain fog

• Weight gain

• Low mood

• Constipation

• Heavy periods

• Infertility

• Dry skin

• Cold intolerance

• Hair loss

• Constipation 

Overactive thyroid/hyperthyroidism/Graves disease:

• Rapid heart rate

• Sweating

• Weight loss

• Tremors

• Anxiety or agitation

• Exophthalmos (bulging eyes)

Assessment

The health of the thyroid gland and thyroid hormones can be impacted by high cortisol, low iron, nutrient and mineral deficiency, high blood sugar, inflammation, and hormonal imbalance, just to name a few. Investigating these areas to understand what is driving the thyroid dysfunction is essential to proper treatment.

The function of the thyroid gland itself is typically assessed through a single measurement called Thyroid Stimulating Hormone, also known as TSH. If you are experiencing some of the signs and symptoms of a thyroid disorder, testing beyond TSH provides a more comprehensive look at how the thyroid is functioning.  Many patients experience symptoms of thyroid dysfunction despite having a normal TSH lab value.  

Depending on the individual, additional testing may include:

Free T3

The most active of the thyroid hormones. TSH and T4 levels can be normal but T3 levels can be low. Since T3 is the hormone that is most active, a low T3 will result in hypothyroid symptoms. If just TSH or T4 are tested this may be missed.

Free T4

The most abundant of the thyroid hormones. T4 is produced in much larger quantities than T3 and converted to T3 in our tissues. If you have low T4 levels but normal T3 this could be a sign that your body isn’t producing enough T4 and struggling to convert into the more active T3 hormone.

Anti-TPO & Anti-TG

Both of these are antibodies that are elevated in autoimmune hypothyroidism (also known as Hashimoto's hypothyroidism). Hashimoto's is the most common cause of hypothyroidism in North America. 

Reverse T3

In states of chronic disease and stress the body converts the active free T3 hormone to the inactive reverse T3. If free T3 is low and reverse T3 is high this could be an indication that chronic stress is impacting the function of the thyroid.

Treatment

Treatment varies based on the type of thyroid condition uncovered but can include; diet and lifestyle changes, herbs to support the function of the adrenal glands and stress hormones, herbs and minerals that support thyroid hormone production and conversion from T4 to T3, desiccated thyroid hormone replacement, and immune system support if the thyroid condition is autoimmune in nature.

Other HORMONE BALANCE conditions treated include:

Acne, Adrenal fatigue, Amenorrhea, Cortisol Imbalance, HPA axis dysfunction, Hyperthyroidism (Graves Disease), Hypothyroidism (Including Autoimmune Thyroiditis aka Hashimotos), Low libido, Menopause (hot flashes, vaginal dryness, sleep, mood), PCOS, PMDD, PMS, Post birth control syndrome