Did you know a lot of “thyroid” problems are not actually a problem with the thyroid? There are quite a few reasons why it might appear you have a thyroid issue when in fact it’s not actually the fault of your actual thyroid gland. 

Before we get into that, though, I want to point how just how common it can be to experience issues surrounding thyroid health.

Chances are you or someone you know has or will experience some form of thyroid dysfunction at some point. Approximately 12% of people will develop a thyroid condition. And a stunning sixty percent of people with a thyroid condition don’t even know it! Sheesh. And this isn’t because they don’t feel the symptoms. They probably do and either have been told it’s not a thyroid issue or they have just gotten used to feeling a certain way and don’t realize it’s possible to feel better.

Thyroid Lab work

Different forms of thyroid dysfunction:

You can experience hypothyroidism where thyroid hormone or gland function is suppressed, hyperthyroidism where it is increased, and/or an autoimmune condition of the thyroid – either Hashimoto’s Disease (more common, associated with hypo symptoms) or Grave’s Disease (not as common and associated with hyper symptoms)

I’m going to focus on the hypothyroid side of things in this article, since that is more commonly what people experience. 

Some of the common symptoms of hypothyroidism, whether autoimmune or not, include fatigue, weight gain or inability to lose weight, sensitivity to cold, constipation (if you’re not going daily, you’re likely constipated), hair loss, muscle weakness, thinning of the outer third of the eyebrows (yes, really!), dry skin, muscle or joint pain. Wow, so much fun stuff!

Unfortunately it’s not uncommon to have these symptoms, have your thyroid checked by the doctor and be told it’s “normal.”

There are a few reasons why this happens. Often, certainly not always though, when doctors test thyroid function, they just test TSH and maybe T4. This can give some information, sure, but as I hope I’ve gotten across in past posts, our bodies are so complex and there is a lot more to consider than just two markers! 

thyroid health

We’re going to get into what we can and cannot see from just testing TSH and T4 but first let’s back up and do a super quickie thyroid physiology lesson.

The thyroid is a butterfly shaped gland located in the neck. This gland plays a huge role in managing your metabolic rate, aka how your body burns those proteins, fats, and carbs. In controlling metabolism, it also regulates your body temperature, heart, muscle, and digestive function, as well as brain development and bone maintenance. In short, it is doing A LOT. 

The thyroid doesn’t just produce hormones on its own. First it has to be told to do so. The hypothalamus gland in the brain starts this process by sending a hormone to the pituitary gland, located at the base of the brain. Upon receiving this signal, the pituitary then signals the thyroid, via the hormone TSH (thyroid stimulating hormone) to produce and release thyroid hormones.

There are a few hormones produced in the thyroid, but the vast majority of this is T4. It also produces a small amount of T3, and a very small amount of reverse T3 (rT3). 

T4 is the inactive form of thyroid hormone, meaning it has to be converted into T3, the usable form, in order for your body to actually use it for all those metabolism-controlling actions. 

About 85% of your body’s usable T3 is produced outside of the thyroid through the conversion of that inactive T4 into the usable T3. And this conversion happens in various locations, with the majority being within the nucleus of the cells. Some of this conversion also happens in the intestines and the liver. 

So, once we have the thyroid hormone in the bloodstream, some of it makes its way to the brain, docking to the hypothalamus and signaling whether or not more thyroid hormone is needed.

TSH will go UP if the brain thinks the body needs more thyroid hormone. What should then happen, is the thyroid gland will produce more T4, to increase the amount that will then be converted into T3. OR if adequate amounts are sensed, the pituitary will reduce the amount of TSH so that less T4 is made. This is a negative feedback loop which is how many of our hormone systems in the body work. 

Okay, so let’s go back to the problem with just testing TSH and T4. First we’ll cover what this can and then what it cannot tell you. 

TSH will tell you what the pituitary is saying to the thyroid gland, T4 will tell you some of what the thyroid is producing. If TSH is high and T4 is low that can indicate that your brain is trying to get your thyroid to make more hormones but it isn’t doing so. This could likely be because of a nutritional deficiency; your body just might not have the raw materials to actually make the hormones. 

You might be put on medication in this case but if we don’t dig a little deeper, those nutritional deficiencies inhibiting your body from producing enough T4 on its own aren’t going to go away. The thyroid isn’t the only part of the body that needs those nutrients. Maybe medication is necessary for some time but I would still encourage working on that root issue!

Now what TSH and T4 cannot tell you is if there are problems outside of the thyroid itself. This is often the case when people feel symptoms of poor thyroid health but TSH and/or T4 are “normal.”

You might make enough TSH and T4 but because of chronic infections, inflammation, oxidative stress, etc. your cells are not converting that T4 into the usable T3. So you end up still feeling fatigued, maybe run down, depressed, constipated, and have a hard time losing weight. Just taking thyroid medication isn’t going to fix this problem! Most thyroid meds are T4, but if you can’t convert it to T3, you’ll continue to feel off.

The markers that I look at for thyroid health help us see if there are nutrient deficiencies behind the inability to make T3 or if the lack of T3 is linked with inflammation or infection. 

Another possible scenario is the symptoms of low thyroid function could be secondary to low pituitary function. If your TSH (remember this is the message from the pituitary to the thyroid to produce T4) is low AND your thyroid hormones are low, this means there is likely a disruption in that communication. 

There are several factors that influence your thyroid gland and hormone output:

  • Underlying gut infections or pathogens (which are more common than you might realize!)
  • nutritional deficiencies (which can be from lack of consuming them and/or compromised digestion)
  • stress
  • other hormone imbalances (which themselves are a result of other root issues)
  • medications
  • and even issues like thyroid hormone resistance (which is a discussion itself!) 

These are all influences of thyroid health and therefore your overall health. As I try to stress with all of these posts is that your body is complex. But, when things seemingly go wrong, it’s not that your body is doing something wrong – it’s doing what it needs to in order to survive! If we address underlying issues by bringing balance to the body through a nutritionally therapeutic approach, you can break free of the symptoms dragging you down!

I know all of this can sound quite confusing. My goal here is to empower you with some knowledge of how your body functions and some of the reasons you might be struggling. If you would like to learn more about how a comprehensive, holistic approach could benefit you, and how we might make all of this make sense for your situation, sign up for your free discovery call here!


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