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What are the causes of hypothyroidism? Is it the thyroid gland itself, another endocrine gland, estrogen dominance or illness?

Is low thyroid the problem or the symptom?

This is THE key question in a functional wellness practice. Is an issue a symptom of another problem? Or is it the actual key problem that needs to be addressed. Exploring this changes the supplements I would suggest or the type of tests I run.

Pros and Cons of Thyroid Medication

If you complain of chronic fatigue, weight gain or constipation, your doctor may suggest lifelong thyroid medication. Thyroid levels are easy to test, and “the prescription solution” is easy to prescribe. Doctors often don’t have time to puzzle out the cause of low thyroid. They want to help you quickly and move on.

Thyroid medication will do that for a while…

However, clients on thyroid meds frequently note a return of fatigue and a gradual need for increases in dose. Why is this happening?  Is it a clue that the thyroid gland itself may not really be the problem?

Is it Chronic Fatigue?

If fatigue is the main issue, this article will help you explore causes of ongoing fatigue. Hypothyroidism is only one cause. Take a look at the other nine.

Primary Hypothyroidism

Primary Hypothyroidism means the thyroid is incapable of producing sufficient hormone.  There are varying reasons for this, including the destruction of the gland from advanced auto-immune Hashimoto’s or the thyroid has been removed or irradiated.

Thyroid Stimulating Hormone (TSH) is released from the pituitary upon instructions from the hypothalamus.  If you have Primary Hypothyroidism, your TSH levels would be quite elevated, above 15, as the pituitary keeps signaling in vain for more hormone. I’ve seen TSH as high as 325 in a client unaware they had a thyroid problem.  I sent them immediately to their doctor’s office and called to make sure they were actually there.

The optimal range for TSH may be as narrow as 1 – 2 although lab ranges are usually .5 to 4.5.

Secondary Hypothyroidism means the Pituitary is not signaling properly.

So…. now what?

What you have is symptoms, an imperfect blood test, and no explanation for it.

Let’s review what blood tests should be run….

• TSH, Total T4 and FTI (Free Thyroxine Index) are the minimum tests most doctors will run
• For better information, you also need FREE T4 and FREE T3.  These tests measure the amount of T4 and T3 actually available, unbound to other proteins or toxins.  Total T4 does not tell this, nor does TSH. Always request these from your doctor, or run them yourself from Life Extension.
• Thyroid Antibodies. I am always amazed when antibodies are not monitored annually or never been tested.  If you have an auto-immune disorder, you should know about it. Since doctors think there is no “cure” for Hashimoto’s (or any other AI illness), they don’t really care to track it. But you should care! Are your antibodies slightly elevated, extremely elevated? Trending up or down?  Is a gluten free or Autoimmune Paleo diet helping? There are MANY success stories of the Autoimmune Paleo Diet and the possible addition of Bio-Identical Progesterone bringing those antibodies down.
• Reverse T3 (RT3) can be useful if you know how to interpret it…. Here’s a great article on RT3 from Stop The Thyroid Madness (listen to our podcast here for even more!).

I have several articles and podcasts on testing and treating Hashimoto’s.  Please visit this page for info on that. This page has links to my articles and podcasts on the thyroid.

Other Causes of Hypothyroidism

Assuming you still have a thyroid and haven’t had chronic, severe Hashimoto’s destroying the thyroid, where else should you look?

• The Adrenals

The most common reason the thyroid is not reaching lab ranges is that the adrenals are fatigued.  If the adrenals are fatigued, your body will prevent the thyroid from burning you out further. 

Think of the thyroid as the accelerator pedal in your car: you step on the gas to get going.  The adrenals are the engine of the car. If your engine is burnt out, you’re not leaving the driveway no matter how much you press on the gas.  The body will shunt off T4 to RT3 and not let you use it.

The opposite is also true.  High cortisol can also cause the thyroid to slow down to protect your engine from burn-out.  Please read my articles on adrenals and listen to my adrenal podcasts (here’s one) for more on adrenal care and recovery.  Here’s our top-selling adrenal support supplement too.

• Poor Conversion of T4 to T3

The thyroid makes and stores T4 – a hormone with 4 units of iodine. When active hormone is needed, we cleave off an iodine and create T3. (We can also create some T3 directly).  Vitamin A, Selenium, Zinc, Iodine and Iron are all needed here.  As well as Progesterone.

Selenium is found in fish, meats, mushrooms and is abundant in Brazil Nuts.  But selenium is used extensively in the body for detoxification of mercury and other toxins.  If you have (or had) old silver fillings, your selenium may be going to detox metal pollutants first, and convert T4 to T3 later. Supplement with a maximum of 200 mg. daily or eat a daily handful of Brazil Nuts.

• Stress

Stressful events take their toll on the Pituitary and Hypothalamus as well as our Limbic System. When the Pituitary and Hypothalamus are fatigued, they can’t play manage the thyroid.  Adaptogens prevent the Pituitary from getting exhausted and may help it “screen” out toxic levels of stress.  Adaptogens are meant to be be taken long-term, as they are neither stimulants nor sedatives.

Gotu Kola and certain Ginsengs are well-known adaptogens, but the product that works best for me and my clients is this one.  Adaptogen – R3 has unusual ingredients that help balance the effects of stress on the endocrine system.

There are many benefits from reducing stress…. the adrenals are not overworked; better sleep restores us; nutrients are not used up in crisis management, and the crippling effects of anxiety and depression are reduced.  (Here are the herbs I recommend for anxiety and sleep).

• Estrogen Dominance: a little-known cause

Estrogen dominance causes the liver to produce high levels of “thyroid binding globulin”, which binds thyroid hormone, decreasing the amount of thyroid hormone that can be utilized by the cells. I frequently see improper ratios of estrogen to progesterone. Toxins such as BPA and pesticides cause us to retain estrogen, lowering the ratio of progesterone to estrogen. Bringing these two into balance may require the use of Bio-Identical Progesterone as well as committing to a lower-toxin lifestyle. I run a Salivary Hormone Test to look at the female and adrenal hormones to help identify this. This is a test frequently run in my Consults. 

• Medications blocking the thyroid 

In brief, statins, beta-blockers and steroids can cause hormone dysregulation. Look up your meds and see if they interfere with thyroid function.

• Iodine Imbalance

Too much or too little iodine can cause thyroid problems. We get iodine naturally in seafood and seaweeds.  If you’re not eating ocean fish (lake and river fish don’t count) or having some seaweeds every week you may be iodine deficient. This product is an excellent balanced source of iodine, iodide and other thyroid minerals.

• Chronic Illness

As in the analogy of the engine and the accelerator pedal of the car, those of us with chronic illness may struggle with hypothyroidism as one of the body’s healing mechanisms.  If we’re not well, we’re supposed to be resting and recovering.

• Gluten Antibodies

There are statistically significant links between Hashimoto’s Disease and Celiac Disease.  In addition, non-celiac gluten sensitivity may play a role in hypothyroidism.  Another reason to stick with gluten free foods or the Paleo Diet!  I’ve had many clients see improvement in antibodies on a gluten-free diet. My DVD will help explain this.

• Overwork and undersleep

I find this product from Systemic Formulas to be extremely helpful when the body and thyroid are fatigued.  I sell Gf – Thyroid in my online store along with Ga – Adrenal.  I’ve used these products for decades.