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Hypothyroidism or Low Thyroid Disorder


by Nancy Russell, M.D


The thyroid gland, a small butterfly shaped gland in the front part of the neck is like the body’s gas pedal. It controls how fast or slow your system goes. When the thyroid gland doesn’t produce enough thyroid hormones ( thyroxine T4 or triiodothyronine T3) the diagnosis is hypothyroidism. Symptoms of hypothyroidism include sluggish metabolism, unexplained fatigue, dry skin, infertility, depression, weight gain, slowed digestion with constipation, low body temperature, cold hands and feet, cold intolerance, hair thinning, decreased ability to think clearly and others. 

The treatment for hypothyroidism is straightforward: Replace the missing thyroid hormone. The medication typically prescribed by medical doctors is a synthetic form of stored T4 hormone, called Synthroid or the generic version, levothyroxine. If the dose is optimally adjusted, this treatment works fine for many people. The problem is that many people can’t convert the stored T4 in the active hormone, T3, so they need a medication that contains T3. There is a synthetic T3 called Cytomel that can be added to the Synthroid in some cases. 

Other prescription options for thyroid medication are desiccated thyroid (a natural form that contains both T3 and T4) called Armour thyroid, Naturethroid, or NP thyroid. Another option necessary for some people is a compounded thyroid (customized), formulated by a compounding pharmacy that combines any amount of T4 and T3.

Blood tests to determine the efficacy of treatment include a TSH, Free T-4 and Free T-3. 

When hypothyroidism is diagnosed, it is imperative to assess whether there are antibodies against the thyroid. Hashimotos’s thyroiditis is when the immune system attacks the thyroid gland. The immune system mistakes the thyroid gland for a foreign invader. Blood tests to be assessed are anti-thyroglobulin and anti-TPO antibodies. If a person is diagnosed with Hashimoto’s thyroiditis and not feeling better on the correct doses of thyroid hormone, further evaluation is needed. As an autoimmune disorder, other systems of the body may be affected. 

An excellent resource for further evaluation is a book, “Hashimoto’s: 90 day protocol” by Izabella Wentz, PharmD, Doctor of Pharmacy. She explains an autoimmune protocol diet as well as work up that may be needed to assess gut dysfunction, adrenal dysfunction, nutrient deficiencies, heavy metal toxicity and other issues.

If fatigue is present after treatment with thyroid medications, the thyroid numbers need to be assessed closely. To feel well, the TSH, thyroid stimulating hormone goal is .05 to 2 and the free T3 needs to be in the mid to upper range. 

Nutrient levels required are a vitamin D level between 60 to 80, Vitamin B-12 over 700 and ferritin (storage iron) 90-110. If these levels are deficient, nutrients can be given to achieve better levels with close monitoring. Other nutrients that can be helpful for energy are thiamine 600mg a day or Acetyl-L carnitine 2000mg per day. 

Assessing for food sensitivities by a blood test or an elimination diet is a good step to help with weight loss as well as helping with energy and food cravings. If food sensitivities are found, a comprehensive stool analysis can assess the need for digestive enzymes, L-glutamine,hydrochloric acid and pepsin. The stool analysis can also assess for blood and mucous in the stool as well as beneficial bacteria, bacterial overgrowth, SIBO small intestinal bacterial overgrowth, candida and other yeasts and parasites. 

Balancing blood sugar is also important, which can be achieved with a low-carb diet such as Paleo, Whole 30, or an auto immune protocol diet. Another area to consider is heavy metal toxicity from exposures such as amalgam (metal) fillings, leaded gasoline exposure and other exposures. This can lead to a congested liver and NAC, N-acetyl cysteine or metal chelation may be helpful. 

Consult an integrative or functional medicine provider to assist on the journey to optimal health and wellness. This is a multifaceted approach that can be complicated, so remember to seek out guidance when necessary. 




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Nancy Russell, M.D. has been a holistic Internal Medicine physician in the Kansas City northland for over 30 years at 5140 N. Antioch Road in Kansas City, MO.


Her phone number is 816-453-5545 and website is where you can get more information. Dr. Russell is board certified in holistic medicine and is a member of the American Holistic Medical Association and a prior board member.

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