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Ever since Oprah decided that she couldn’t lose weight on account of her thyroid gland, all women with weight loss challenges have demanded that their thyroid hormones be tested. More often than not, these levels come back within the “normal” range on the conventional lab tests, leading to a lot of frustration. We all would like to blame an endocrine issue for the wall that we all hit around 35 when we actually have to start paying attention to what we’re eating. The trick is to figure out when weight loss issues can be attributed to a hypothyroid disorder. They are really just about necessary lifestyle changes, or a combination of both.

For starters, let’s go over the anatomy and physiology of the thyroid gland. The levels of thyroid hormone in our systems determine our body temperature, basal metabolic rate (metabolism), how quickly our digestion moves, how easily we transform food into energy, and how easily we can expend that energy. When the thyroid levels in our bodies start to go down, the anterior pituitary part of our brain signals the gland to make more thyroid hormones.

This signaling occurs using the hormone TSH, the hormone measured in the most common laboratory test used to assess thyroid health. When the thyroid can’t make any more thyroid hormones, the TSH level continues to rise. If the actual Thyroid hormones were to be assessed at this point, they would come out low.

Whenever having the Thyroid gland assessed by your Doctor, always ask for the TSH and the “free” levels of T3 and T4 (the two measurable Thyroid hormones). The reason for the many tests is that many women’s TSH levels will come back within the “normal” range when their Thyroid hormones come back low. This is a common situation that never gets discovered because it is normally only the TSH level that is tested.

This situation illustrates the point that we come back to in the hormone discussion. All people are different in their chemistry. Many of us do not fit into the “normal” ranges of conventional laboratory tests.

So, what to do if you feel like your metabolism is becoming sluggish, skin dry, hair falling out, constipation sets in, and you don’t feel like yourself? Ask for the tests above from your PCP or your friendly neighborhood Naturopathic Doctor. If indeed you are diagnosed with a hypothyroid disorder, you have a couple of options for treatment.

Conventional Doctors almost exclusively will prescribe Levothyroxine, or Levoxyl, a synthetic version of T4. The potential problem with this medication is that T4 is the inactive form of thyroid hormone. The body has to take it and convert it to T3, the active form of Thyroid hormone that is usable in metabolism.

Many people with the hypothyroid disorder are unable to do this conversion properly. This is how it happens that someone supplemented with Thyroid hormone can have a normal TSH level but actually be undermedicated and still have all the signs and symptoms of hypothyroidism. They are not converting the T4 into T3.

As it turns out, like all health issues, hypothyroidism cannot just be treated in isolation. That is to say. Your thyroid gland doesn’t just go south one day out of the blue. There are a whole lot of steps that lead up to dysfunction, including poor nutrition choices, adrenal fatigue (see Cortisol, Stress and the Adrenal Glands), and genetic defects that inhibit the body’s ability to process B Vitamins (more on “Methylation Defects” in next month’s newsletter). Prescribing hormones does not erase all of these pre-existing issues, so we should not be surprised when thyroid supplementation is not 100% effective.

From a naturopathic point of view, treatment looks much different than in conventional medicine. Treatment choices range from the conventional Levothyroxine to the more natural Naturethroid, to herbs and vitamins that support thyroid function. The treatment plan is selected based on many factors, including the extent of dysfunction, the amount of stress in the person’s life, how efficiently they are processing said stress, and the genetic ability to incorporate B (important cofactors for thyroid function) into the biochemistry. Again, we return to the fundamental premise of Naturopathic Medicine that everyone is unique and, therefore, must be treated uniquely.

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Integrative Concierge Care for the Treatment of Chronic Disease