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October 2, 2018

Hypothyroidism: the Symptoms, Cause, and First Steps to Take

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Hypothyroidism is a disease that’s rising at an alarming rate, especially in the United States. An estimated 30 million Americans have some form of thyroid disease, and up to 60% of those with thyroid disease are unaware of their condition.

On a global scale, 200 million have some form of thyroid disease. So, we need to take steps to educate ourselves and find out what we can do to reverse this problem! 

Hypothyroidism, the Symptoms, Cause, and First Steps to Take

There are many different forms of thyroid disease, and today we’re going to look at hypothyroidism. 

So let’s dive in…

What is hypothyroidism?

Hypothyroidism is most often diagnosed when TSH (thyroid stimulating hormone) levels are elevated, free T4 levels are low and/or free T3 levels are low. But, oftentimes a doctor will diagnose a patient with hypothyroidism when they see just high TSH levels. 

What is TSH and what is  “normal” level?

TSH is a hormone that the pituitary sends out to tell the thyroid how much or how little thyroid hormones to produce. 

Please note: TSH levels tell you what your pituitary is up to, but it’s not telling you what the thyroid is doing. 

Everyone is biochemically individual, but in our practice we’ve found that a TSH level between 0.5-2.0 is the range where people feel healthy and vibrant. Most labs have “normal” TSH ranges that span anywhere from 4.0-8.0, but most people with TSH levels this high don’t feel well and need to make some steps to reduce their TSH level. 

What is free T4 and what is a  “normal” level?

Free T4 is a hormone produced by the thyroid. You want free T4 levels to be in the middle of the lab range. So if the range is 1.0-3.0, you want your free T4 to be 2 (or close to it). Each lab has a different range, so you have to look at what the specific range is to know what number to look for.

What is free T3 and what is a “normal” level?

Free T3 is a hormone that mostly comes from T4. The thyroid makes T4 and sends most of it to the liver to be converted to free T3. 

You want free T3 to be in the middle of the lab range. So if the range is 1.0-3.0, you want your free T3 to be 2 or close to it. Each lab has a different range, so you have to look at what the specific range is to know what number to look for. 

What are the symptoms of hypothyroidism?

There are actually hundreds of symptoms, but here’s a list of some of the most common: 
Feeling tired
Anxiety
Thinning or loss of outer third of eyebrows
Depression
Weight gain
Feeling cold
Irritability
Hair loss or thinning
Weakness and aches in muscles and joints
Itchy and dry skin
Difficulty concentrating
Brain fog
Constipation
Heavy or irregular periods
Puffy face
Hoarseness in the voice
Muscle weakness
Elevated cholesterol 
Slowed heart rate
Low blood pressure
Insomnia
Brittle nails
Muscle loss
Low libido
Infertility and miscarriage
Lack of motivation
Digestive issues
Low vitamin D
Low B12
Weak immune system
Low ferritin (or anemia)
Needing a nap in the afternoon
Chronic fatigue
Diminished appetite
Low basal body temperature 
Frequent infections
Lump in throat

Why is my TSH high?

The pituitary, hypothalamus and adrenals (also called the HPA axis) are all part of the endocrine system and communicate with one another throughout the day. When the body perceives stress – emotional, mental, physical, environmental, mental, stress from disease, etc. – the hypothalamus tells the adrenals to work harder to put out additional cortisol, and it tells the pituitary to crank out more TSH so the thyroid will slow down.

So, a high TSH level isn’t actually a thyroid problem. Instead, there’s some sort of imbalance in the HPA axis. Your practitioner’s job is to now figure out why there is an imbalance. 

Why is my free T4 low?

Most often, free T4 is low because the thyroid doesn’t have the resources to produce the proper amount of T4. The thyroid needs iodine and tyrosine to produce thyroid hormones. Increasing the consumption of iodine-rich foods, reducing exposure to chlorine, fluoride and bromine (this is incredibly important!), and taking an iodine supplement can often help improve this imbalance.

If you’re concerned about taking iodine when you have thyroid disease, read this post and it should answer your questions.

Free T4 can also be low when thyroid antibody levels are elevated. When antibodies attack the thyroid tissues, this can make it difficult for the thyroid to produce enough fT4.

Another common cause of low FT4 is anemia. The body needs iron to make TPO, which is then used to make a thyroid hormone (FT4). When the body is deficient in iron, FT4 levels can drop, putting the body in a hypothyroid state. To read more about this, and see what steps you can take to reverse the issue, click here.

Remember to talk to a nutritionist or health practitioner who’s had lengthy training in nutrition to help you figure out how much supplementation your body needs. Self-diagnosing often doesn’t go well, so it’s worth paying a practitioner for their expertise.

Why is my free T3 low? 

The are three common reasons why free T3 can be low.

1. Free T3 can be low because there isn’t enough free T4 being produced by the thyroid to be converted into free T3.

2. If there are adequate levels of free T4, but there isn’t enough free T3, then this often indicates liver congestion.

Let me explain. . .

Your thyroid produces T4 and sends most of it to the liver to be converted into the active form, free T3. If you have enough free T4, but not enough free T3, then you don’t necessarily have a thyroid problem, instead, you may need to support your liver so it can efficiently convert T4 to T3 for you.

Liver congestion is pretty common nowadays, and can not only cause low T3 in the body, it also can cause estrogen dominance, severe headaches, blood sugar imbalance, chemical sensitivities, skin issues, and dark circles under the eyes, among other things. Here is an article I wrote with specific steps you can take to improve this issue. 

3. Free T3 can also be low becuase there is excess cortisol (from adrenal imbalance) that is blocking the conversion of free T4 to free T3 and instead creating an excess of reverse T3.

What are steps to take to reverse hypothyroidism?

1.Ask your practitioner for a full thyroid panel. Remember, TSH tells you what’s going on with the pituitary, not your thyroid. So, getting a look at what’s actually going on with your thyroid will give you and your practitioner more insight as to what steps to take next.

Here’s the list of labs to ask for (if your practitioner will not order labs for you, you can order them yourself here):
TSH
TPOab
TgAB
Free T3
Free T4
Reverse T3

I also recommend getting a CBC, CMP with phosphorus, lipid panel and Vitamin D.

2. If your free T4 levels are low, then I recommend increasing your consumption of iodine-rich foods (sea vegetables, wild seafood, cultured yogurt, pastured eggs, etc.) and reduce your exposure to chlorine, fluoride and bromine (read this article to find out why this is important).

3. Take steps to support your adrenals. Why? Because anyone with thyroid disease is also dealing with some kind of adrenal issue. I can’t tell you how many people have taken the steps I list and come back a month or two later telling me how much better they are already feeling!

4. Reduce your sugar intake. Sugar and stress bascially do the same thing in the body (minus the calories), so to help balance your TSH, you need to watch your sugar intake. If you have massive sugar cravings right now (I’ve been there before!), make this recipe for buttermints and follow the directions listed. 

5. Remember that your practitioner is working for you, not the other way around. It’s ok to ask them questions about the root cause of what’s going on. If they don’t treat you respectfully when you ask them questions about what’s going on with your body, then it’s ok to find another practitioner to work with. It took me nine months of going doctor-to-doctor before I found someone who would listen to me and run tests. Being persistent to find the right practitioner to work with pays off!

6. Start moving away from processed foods and eat real, nutrient-dense foods. I’ve got hundreds of recipes here on my site and another 125 in my cookbook, The Grain-Free Family Table. Eating healthy foods will reduce the strain on your body and help bring things back into balance.

7. Make sure to get plenty of selenium, zinc, magnesium, iron, healthy saturated fats, Vitamin A (remember retinol/Vitamin A is only found in animal foods), B vitamins, Vitamin C and Vitamin E in your diet as they are all essential for thyroid support.

8. Support digestion so your body can utilize the nutrients in your food. Click here to read some practical steps to take.

If you’d like to learn from first steps you can take to help support your thyroid, check out my class, “3 Keys to Thyroid Hormone Balance”. It’s just 45 minutes and I promise you’ll learn something new!

Note: The purpose of this post is to give an overview of hypothyroidism from a holistic perspective. Due to biochemical individuality there can be many various reasons for the root causes of thyroid disease, and many ways to help improve thyroid in balance in the body. This information is not intended to take the place of your doctor’s advice.

 

Posts may contain affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase.

Filed Under: Thyroid Disease, Thyroid Disease, Uncategorized | 28 Comments

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28 Comments

  1. Melissa

    January 2, 2019 at 1:12 pm

    What meal plan do you recommend for Hypothyroid?
    to Melissa" aria-label="Reply to this comment to Melissa">Reply to this comment
    • Deliciously Organic

      January 3, 2019 at 12:00 pm

      Grab my cookbook, The Grain-Free Family Table, and start there! :) https://amzn.to/2VsN3AM
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
    • Jenny

      May 3, 2019 at 5:41 pm

      It is very difficult to get all these tests in Australia. Or they are very expensive outside of your garden variety GP
      to Jenny" aria-label="Reply to this comment to Jenny">Reply to this comment
  2. Kathleen Hereford

    January 6, 2019 at 1:38 pm

    Thank you for your wonderful site. I'm taking fermented cod liver oil. Would it be beneficial for me to add desiccated liver capsules? Thanks again, Kathleen
    to Kathleen Hereford" aria-label="Reply to this comment to Kathleen Hereford">Reply to this comment
    • Deliciously Organic

      January 7, 2019 at 10:32 am

      It's hard to say without knowing your full health history, but cod liver oil is completely different than liver capsules, so chances are your body could benefit from them.
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
  3. Yesendi

    June 14, 2019 at 10:53 am

    I think there is an error in the article in "What is Free T3 and what is "normal" level" the FT4 levels are listed again instead of the FT3.
    to Yesendi" aria-label="Reply to this comment to Yesendi">Reply to this comment
    • Deliciously Organic

      June 19, 2019 at 10:30 am

      Thanks for pointing that out! I just made the edit.
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
      • Maureen

        August 6, 2021 at 9:11 pm

        What is the correct level of fT3 please
        to Maureen" aria-label="Reply to this comment to Maureen">Reply to this comment
        • Deliciously Organic

          August 9, 2021 at 9:49 am

          I explain this in the post above.
          to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
  4. Marie-Line

    August 19, 2019 at 8:52 am

    I would be nice if we could print the article. Thank you so much for all this information.
    to Marie-Line" aria-label="Reply to this comment to Marie-Line">Reply to this comment
  5. Robin Pagé

    November 10, 2019 at 1:58 pm

    I believe that the article contains an error: “The hypothalamus .... tells the pituitary to crank out more TSH so the thyroid will slow down.” I understand that TSH actually stimulates the thyroid to produce more T4 not less.
    to Robin Pagé" aria-label="Reply to this comment to Robin Pagé">Reply to this comment
    • Deliciously Organic

      November 11, 2019 at 10:19 am

      The statement is correct. When TSH goes up, fT4 goes down. When TSH goes down, fT4 goes up.
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
      • Denise Michel

        May 14, 2020 at 7:35 pm

        I am confused. Can you explain more about that?
        to Denise Michel" aria-label="Reply to this comment to Denise Michel">Reply to this comment
        • Deliciously Organic

          May 19, 2020 at 12:29 pm

          I don't really know how to explain it any further. If you'd like to learn more specific details about how these hormones work together, I do go through everything step-by-step in my online thyroid course.
          to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
  6. Kathy Abbott

    April 27, 2020 at 5:39 pm

    Hello Carrie, Thank so much for all or your wonderful posts! I am trying to more forward with your suggestions regarding my hypothyroidism by requesting additional blood labs from my doctor. I find 9 suggested labs on your web site: TSH, TPO, TAA, Free T3, Free T4, ReverseT3, T3, T4, and T3 uptake. I find found 6 suggested labs on one of your Instagrams: TSH, FT3, FT4, RT3 and two additional I did not find on the web site, TPOab & TgAB. I may be very confused?! I just want to request every lab you feel is going to be helpful? If you could let me know if all 11 should be ordered or not, I will move forward. Thank you again! Kathy Abbott, Phoenix Az, 505-238-7907
    to Kathy Abbott" aria-label="Reply to this comment to Kathy Abbott">Reply to this comment
  7. Jana

    September 28, 2020 at 7:42 pm

    I was diagnosed having Graves' disease and then had my thyroid removed. Now I'm taking meds for hypothyroidism. So I'm not quite sure if I should be following your guidance for Graves disease or hypothyroidism. Can you please clarify for me? Thanks,
    to Jana" aria-label="Reply to this comment to Jana">Reply to this comment
    • Deliciously Organic

      September 29, 2020 at 10:17 am

      I would follow both. When the thyroid is removed, this does not improve the Graves' antibody situation, so steps should still be taken to support the immune system. I would also read my article about steps to take when you've had your thyroid removed. I hope the tips help! :)
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
  8. Arleen Resztak

    October 15, 2020 at 3:06 pm

    I am trying to connect to the thyroid master class right now but it is circling, saying "joining now"
    to Arleen Resztak" aria-label="Reply to this comment to Arleen Resztak">Reply to this comment
    • Deliciously Organic

      October 24, 2020 at 12:00 pm

      So sorry this happened. Were you able to catch the replay that I sent via email?
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
  9. Tracy

    January 30, 2021 at 4:41 pm

    Any advice for someone who lost their thyroid due to thyroid cancer. I have everyone of those hypo systems - my life has never been the same.
    to Tracy" aria-label="Reply to this comment to Tracy">Reply to this comment
    • Deliciously Organic

      March 3, 2021 at 11:57 am

      This article might help: https://deliciouslyorganic.net/steps-to-take-if-you-had-your-thyroid-removed-or-ablated/
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
  10. Lc

    November 5, 2021 at 12:59 pm

    I can't access the trial of the Thyroid and Thrive .. there is the blocker from "Click Funnels"
    to Lc" aria-label="Reply to this comment to Lc">Reply to this comment
    • Deliciously Organic

      November 9, 2021 at 11:54 am

      Here is the link: www.thyroidandthrive.com
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment
  11. Z

    May 12, 2022 at 3:55 pm

    Do you know anyone who has been able to wean themselves off levothyroxine/Synthroid? I had Hashimoto's and have tried to stop taking the medication, but I feel very tired.
    to Z" aria-label="Reply to this comment to Z">Reply to this comment
    • Deliciously Organic

      May 16, 2022 at 10:35 am

      Yes, but this looks different for each person. If that is a goal for someone, then it's best to first work on supporting the immune system and overall health of the body to reduce the antibody attack, then work on getting thyroid hormones back in check and then talking with your doctor about the best course of action for your meds. I walk through all of these things in my online thyroid course. You can use the code ORGANIC10 to save 10%: https://deliciouslyorganic.net/thyroid-online-course/
      to Deliciously Organic" aria-label="Reply to this comment to Deliciously Organic">Reply to this comment

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Hi, I’m Carrie Korem, FNTP
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Through unprocessed, organic food and detox I’ve reversed Hashimoto’s disease, chronic migraines, IBS and eczema.

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