The Functional Medicine Approach To Hypothyroidism

Hypothyroidism occurs when the thyroid is not functioning as it should. The thyroid produces 2 very important hormones, triiodothyronine and thyroxine. They are responsible for controlling the metabolic rate of cells within the body, affecting how much fuel they burn and therefore the amount of energy they produce.

Problems occur when the thyroid gland can not produce sufficient thyroxine, hypothyroidism, along with various problems utilising thyroxine. These problems can be caused by various factors.

Thyroid disease affects women 5 to 10 time more than it does men1, predominantly post-menopausal and is believed to affect roughly 2% of the population within the United Kingdom1. Due to poor diagnosis, a large number of people are unaware that they have a thyroid condition.

• A systemic lack of Iodine. The hormones produced by the thyroid contain Iodine and they can not be made without it. Too much Iodine present within the body can also reduce the production of these hormones.
• Nutrients and minerals such as vitamin A, selenium, zinc iron and copper are required for thyroxine production², so any deficiency of these will cause a reduction in thyroxine. There is also a direct link with vitamin D deficiency and the autoimmune on the thyroid itself.
• High oestrogen levels as well as other hormone imbalances.
• Poor gut health can result in autoimmune responses on the thyroid.
• Fluoride in toothpaste and tap water can lead to thyroid suppression.
• Physical damage to the thyroid gland, such as surgery, inflammation after a viral infection or radiation, can be related to hypothyroidism.
• High levels of continuous stress can lead to elevated stress hormones that can interfere with production of triiodothyronine and thyroxine³.
• The Liver is responsible for the formation of Thyroxine so poor liver function can have a direct affect⁴.

The thyroid produces 2 very important hormones, triiodothyronine (T3) and thyroxine (T4). They differ in potency and function. T4 acts as a reservoir for T3, converting to T3 by enzymes called deiodinase in the liver.

Thyroid disorders are traditionally diagnosed through simple blood tests. They look at the levels of hormones thyroid stimulating hormone (TSH) and thyroxine (T4). TSH is produced within the pituitary gland when the brain recognises that there are low levels of thyroxine in the blood.

If the blood tests show that the T4 levels are low and TSH is high it indicates hypothyroidism. The pituitary gland in the brain is recognising that levels of thyroxine are low as trying to tell the pituitary gland to produce more but there is only minimal response and production.

It is not that simple though, there are so many various causes that can lead to poor production of T4 and T3. Autoimmune attack, poor liver function, poor gut health, etc. Just look above! The tests are also taken and compared to broad reference ranges and may appear within the “normal” boundaries but they may not be normal for you. This is why so many people are misdiagnosed regarding hypothyroidism, Thyroid function appears within acceptable ranges but still suffer many of the symptoms that are listed above.

Once diagnosed conventionally, hypothyroidism is treated by prescribing a synthetic form of T4. This does not always work, many people still have symptoms because they may not have a problem with T4 production but may struggle with converting it to T3, the more active form.

Taking the prescription of T4 will only make things worse for these individuals because the pituitary gland recognises the body has excess T4 circulating, thus reducing the release of thyroid stimulating hormone released which in turn reduces thyroxine, T4, production further still.  This, unfortunately, means that doses of thyroxine, T4, for these individuals needs to be increased over time.

Discovering and specifically understanding why your thyroid gland is not functioning correctly is key to the correct treatment of hypothyroidism.

Functional testing will accurately examine levels of active T3 and can detect any antibodies produced that may damage your thyroid. Along with measuring T4 and TSH levels we can understand what is going wrong.

Testing will also show if stress hormone levels are impacting your thyroid and if individualised stress-management techniques are required.

Supporting your liver with supplements whilst avoiding alcohol and processed foods can help T4 to be converted to T3.

Good liver function as well as optimal gut health can help to balance high oestrogen levels, as can avoiding environmental oestrogens from personal care plastics and cleaning products. Along with avoiding consumption of foods containing natural plant oestrogens.

The holistic approach that Functional Medicine offers involves the assessment of clinical imbalances, in depth examination of the patient’s medical history, a physical examination and laboratory testing. Functional medicine also investigates the genetic makeup of each individual and the impact environmental factors, such as physical activities, diet, previous traumatic experiences and exposure to toxic substances. Along with this Functional medicine practitioners also consider the spiritual, psychological and social element that all influence a patient’s health.