Do You Have Hypothyroid Symptoms?
…Yet Your Labs Are “Normal”?
Learn about the eight major types of hypothyroidism
And why only ONE is revealed by a typical thyroid lab test
A low thyroid—or hypothyroidism as its technically known—can sabotage your life. Do you suffer from hypothyroidism? Take a look at the symptoms below.
Early Symptoms of Hypothyroidism
- Fatigue, tiredness, exhaustion, low motivation
- Difficulty in losing weight despite normal diet and exercise, including rigid adherence to a low grain/low carb diet (especially in women).
- Skin that is dry, itchy, rough and/or scaly
- Hair that becomes coarse, brittle, grows more slowly, or falls out excessively
- Feeling cold/hard to keep warm. Or a sensitivity to cold with feelings of being chilly in rooms of normal temperature (when other people feel fine).
- Decrease or absence of perspiration (sweat). Even during exercise or hot weather.
- Constipation (that is resistant to mild laxatives, such as magnesium or aloe)
- Muscle weakness
- Fertility problems (with conception or maintaining pregnancy)
Late Symptoms of Hypothyroidism
- Thinning of the outer third of the eyebrows
- Additional weight gain (that will not budge!)
- In women, abnormal menstrual cycles
- Low basal body temperature
- Slowed speech and/or a hoarse, breaking voice and/or a deepening of the voice
- Dry puffy skin, especially on the face
- Impaired memory
- Impaired cognitive function (brain fog) and inattentiveness
- Reactive (postprandial) hypoglycemiaSluggish reflexes
- Severe hair loss
- Elevated blood cholesterol
- In men, gynecomastia (enlarged breasts)
- Difficulty swallowing
- Shortness of breath with a shallow and slow respiratory pattern
- Increased need for sleep, rest, naps
- Irritability and moodiness
- Yellowing of the skin (due to impaired conversion of beta-carotene into vitamin A)
- Myxedema (fluid retention that is complex, causing puffy hands, feet, face, etc.)
- Decreased libido (in men or women)
- Plus many more, ranging from kidney and heart problems to loss of taste and smell to different types of anemias, etc.
The Eight Types of Hypothyroidism
There are many reasons why your thyroid might be underperforming. Unfortunately, the basic lab test used to determine hypothyroidism—known as a TSH test —reveals only one of these causes. This leaves many people with hypothyroid confused when their “labs” come back normal.
As shown below, there are actually eight major types of hypothyroidism, and guess what? A TSH test by itself reveals only the first one.
- Primary Hypothyroidism
- Hypothyroid Secondary to Low Pituitary Function
- Inadequate Thyroid Conversion (Under-conversion)
- Excess Thyroid Conversion (Over-conversion)
- Thyroid Binding Globulin Elevation
- Thyroid Resistance
- Adrenal Fatigue
- Autoimmune Thyroiditis (Hashimoto’s)
If you have low-thyroid symptoms, chances are you suffer from one or more of these eight conditions. But whether you suffer one or a combination of them, the good news it’s possible to address your situation with a protocol that is tailored to YOU!
A More Detailed Explanation
To understand the relationship between the different types of hypothyroidism, a TSH test, and how to get your thyroid back on track, it’s helpful to examine each type of hypothyroidism more closely.
1. Primary Hypothyroidism: This is a true dysfunction of the thyroid gland itself, and it is the one type of low thyroid that can be indicated by a TSH test. Typically, it is the only thyroid disfunction that traditional medical doctors will look for. But even then, since the “normal” range for TSH values is actually too wide, doctors fail to diagnose many people with this condition.
A lot of people with this issue have an autoimmune thyroid condition called Hashimoto’s thyroiditis. (See more on Hashimoto’s below.) If this is the case, treatment requires correction of the autoimmune condition, which most medical doctors are not trained to do. In fact, the main reason doctors are often hesitant to even check for Hashimoto’s is that their treatment is the same whether you have it or not: They give you thyroid hormone. However, this does NOT address the underlying root issues!
2. Hypothyroid Secondary to Low Pituitary Function: Since the lab testing for low thyroid is typically a TSH test, many people think TSH is produced by the thyroid. In fact, TSH—which stands for thyroid stimulating hormone—is produced by the pituitary gland. If the pituitary isn’t producing enough TSH, then the thyroid will under perform as a result.
Low-pituitary hypothyroidism is actually a pretty common pattern, and it’s usually the result of the hormone cortisol suppressing the pituitary as a result of stress. This stress can be internal, such as a food sensitivity, childbirth, a neck or back problem, etc., or it can be external—a fight with our significant other, death of a loved one, loss of a job, and so on. We ALL have stress, and most people do not realize the severe impact it is having on them.
3. Inadequate Thyroid Conversion: The main hormone produced by the thyroid is thyroxine, or T4. However, T4 is not very metabolically active, and it must be converted to triiodothyronine, or T3, for use by your cells. Thus, when not enough T4 is converted to T3, a person suffers hypothyroidism symptoms. Since a TSH test does not measure T3 or T4, this condition often goes undiagnosed!
Why might T4 conversion be lacking? Deficiencies of nutrients such as iodine, iron, selenium, zinc, and vitamins A, C, and the B complex, especially B12, can all inhibit the conversion of T4 to T3. Also, the use of certain medications, including beta blockers, birth control pills, estrogen, iodinated contrast agents, lithium, phenytoin and theophylline, can also inhibit conversion. Other factors that can cause inhibition include aging, alcohol, liver congestion, heavy metal toxicity, diabetes, fluoride, lead, mercury, pesticides, radiation, stress, surgery and elevated or diminished cortisol levels. And while the primary place for T4 conversion is your liver, about twenty percent of your T4 is converted to T3 in your intestines, making issues such as leaky gut or dysbiosis (overgrowth of bad bacteria) a common, often ignored culprit behind low thyroid.
4. Excess Thyroid Conversion: Sometimes too much T4 is converted to T3—for instance, when an individual, whether male or female, is producing too much testosterone. Too much T3 might not sound like a problem, but it can actually cause our cells to become resistant to thyroid hormone. That is, not enough of thyroid hormone gets into our cells, and this results in hypothyroid symptoms. Again, with this condition, there is no effect on TSH levels, so a standard TSH test will not reveal this type of hypothyroidism.
5. Thyroid Binding Globulin Elevation: Thyroid binding globulin (TBG) is a protein that binds thyroid hormone in order to carry it to different places in the body. If there is too much of this binding agent, then too much thyroid hormone is tied up—as opposed to the metabolically-active free state. Your thyroid may be in perfect shape, but if the hormone it produces is all bound up, it can’t get into the cells, and hypothyroid symptoms occur.
Elevated TBG is most commonly caused by elevated estrogen (or “estrogen dominance”) in both men and women. Some causes of elevated estrogen include taking birth control pills, hormone replacement therapy, excess body fat, ingesting phytoestrogens (from plastic water bottles left in the sun, for instance, or from plastic food containers heated in the microwave). Again, this pattern has no effect on TSH, so a standard thyroid test will not detect the issue.
6. Thyroid Resistance: This is another stress-related pattern in which both the thyroid and pituitary are working correctly, but the thyroid hormones are not getting into the cell to do their job for some reason, such as cell-receptor-site defects or blockages. If thyroid hormone cannot get into the cell, there will be low thyroid symptoms despite normal thyroid hormone levels measured in the blood. This is an example of how you can even have normal results of more advanced thyroid testing—direct measurement of T3 and T4—and still have a form of hypothyroidism.
Reasons for cell receptor defects are inflammation in the body (from poor diet or exposure to toxins), elevated homocysteine, or a vitamin A deficiency—which can also be a side effect of primary hypothyroidism—and high levels of cortisol, as seen in stage one of adrenal fatigue. Speaking of adrenal fatigue…
7. Adrenal Fatigue: The adrenal glands play a key role in helping our cells use thyroid hormone. If the adrenals become fatigued, the body will tell the thyroid to produce less thyroid hormone in order to ease up on the worn-out adrenals, and bingo, you’ve got hypothyroid symptoms! This is known as secondary hypothyroidism because the symptoms are caused by a system other than the thyroid. Since adrenal fatigue is probably the most common cause of secondary low thyroid function, it is critical to assess and address adrenal health in any treatment of hypothyroidism. (Click here to take your Adrenal Fatigue Quiz [link].)
8. Autoimmune Thyroiditis (Hashimoto’s): One last pattern, mentioned earlier, should be discussed, especially since it is found in 90 percent of sluggish thyroid conditions. The condition is called Hashimoto’s thyroiditis. It’s an autoimmune disorder where the body actually attacks the thyroid gland. In simple terms, it does this because your thyroid tissue has become sick and is producing harmful dead cells. Your immune system attacks these sick cells to protect the rest of the body from them, but unfortunately it also attacks the healthy tissue, ravaging your thyroid gland and compromising its function. Having an autoimmune condition such as Hashimoto’s does NOT necessarily mean that something is wrong with your immune system (though this can also happen); it means that your main issue is that some tissue in your body is under attack! In this case, it’s your thyroid tissue.
Autoimmune conditions happen for a reason. A good practitioner will find and address the root of this reason and work with your body to heal itself. If you suffer Hashimoto’s, helping your condition begins with giving your thyroid the specific and powerful nutritional factors it needs to heal and stop releasing damaged cells that are causing your body to attack itself. (It’s usually a lack of these powerful nutritional factors that lead to a sickly thyroid in the first place!) At Natural Thyroid Healing, we use targeted techniques to shield the thyroid gland from the body’s attack while supplying specific nutritional components to restore itself. The result is success where conventional treatment often fails.
Testing for Hashimoto’s involves specific labs that measure the amount of anti-thyroid antibodies in your blood. Like most of the other hypothyroid conditions we’ve talked about, Hashimoto’s is NOT revealed by a TSH test!
For more information on these tests as well as other lab tests essential for assessing one’s thyroid health, see “Essential Thyroid Labs.”
Customize Your Treatment
As you’ve seen, you can suffer low thyroid symptoms for many reasons, and almost none of them are indicated by a TSH test. Therefore, it’s not only critical you get the right lab testing done, you also need to have someone help you find the ROOT issues of what is causing your particular hypothyroid symptoms. If not, you will just get a band-aid approach—and those do not last!
At Natural Thyroid Healing, we’ll help you determine the right labs to have done, and we’ll develop a treatment that is customized to treat the causes of your specific situation. This approach leads not just to quicker response times; it means genuine, optimal health to last a lifetime.
Q & A
1. I’m still a little confused on how the pituitary and hypothalamus are part of the function of my thyroid. Can you explain that part again?
Your hypothalamus (located in your brain) monitors the levels of your thyroid hormone. When thyroid hormone levels get too low, the hypothalamus sends a signal to your pituitary in the form of a hormone known as thyrotropin releasing hormone, or TRH.
When your pituitary receives TRH, it in turn sends thyroid stimulating hormone (TSH) to your thyroid. Your thyroid then makes specific amounts of thyroid hormone according to how much TSH it receives.
Well…this is how it SHOULD work, anyway! As you now now, there can be many different breakdowns in the process!
2. If T4 is not an active form of thyroid hormone, why does the thyroid even make it?
While the thyroid gland produces a number of different thyroid hormones, over ninety percent of that output is in the form of thyroxine, or T4. Normally, T4 is easily and quickly be converted into T3, the metabolically active form of the hormone. Because T4 is inactive, the body can convert it and use the active form as it’s needed—kind of like drawing money from your savings account only when you need cash. This avoids the body being in a situation where it has to use thyroid hormone immediately as it’s produced. Pretty brilliant, eh?
3. I never knew that thyroid hormone was activated in my gut. Wow! And I have horrible digestive issues, so I’m wondering if they could be causing a problem with my thyroid hormone?
About twenty percent of inactive thyroid hormone is converted to free T3—the active form of thyroid hormone—by good bacteria in your gut. So while digestive issues in and of themselves do not necessarily interfere with the activation of thyroid hormone in the gut, they could be a sign that you don’t have enough good bacteria in your intestines. So keep that gut healthy!
It’s Not Too Late!
Evaluating TSH, free T4, free T3, reverse T3, thyroid antibodies, cortisol, vitamin D, ferritin, medication use, and nutritional habits can, altogether, help a health care provider determine the cause of a patient’s thyroid symptoms. With this information, an appropriate care plan can be developed that corrects nutritional deficiencies, addresses lifestyle habits, and adjusts medication dosages based on a detailed patient history and evaluation of the lab values mentioned. (For more information on thyroid labs, see the article “Essential Thyroid Labs: Which Tests Do You Really Need?”
For additional reference and reading material, please refer to our list of books below. While we cannot and do not endorse 100 percent of the information found in these books, we have found—through trial, error and extensive research—that the majority of this information to be beneficial, useful and informative.
- Hypothyroidism: The Unsuspected Illness by Broda Barnes and Lawrence Galton
- Why Do I Still Have Thyroid Symptoms? When My Lab Tests Are Normal by Datis Kharrazian
- Hypothyroidism Type 2 by Mark Starr
- Overcoming Thyroid Disorders by David Brownstein
- Thyroid: Guardian of Health by Philip G. Young
- Healing is Voltage by Jerry Tennant