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Let's help you understand your thyroid dysfunction and the symptoms it causes.

So -- you got diagnosed with thyroid dysfunction or you have all the classical symptoms of thyroid but your blood work is "normal".

Now what?

Either you have been taking levothyroxine or a compound and continue to suffer from these dreadful symptoms of thyroid or you stopped taking what was given to you because it was NOT helping.

In both cases, you are frustrated, angry and without hope for any improvement.

Your conventional doctors have told you there is nothing else that can be done, and maybe they have also hinted that all these symptoms are in your head (which upsets me beyond!).

But let me tell you the thyroid dysfunction leads to symptoms like: brain fog, fatigue, weight issues, hair issues, constipation...and these are ALL REAL.

You are not making them up, even though no one around you can relate to these.

And these symptoms are NOT because of deficiency of thyroid hormone, it’s SO much more than that.

Thyroid disorder is the most mismanaged disease in the medical world currently. And the worst news is that the number of cases of thyroid patients is increasing exponentially.

Conventional medicine has no answer to the thyroid symptoms and often the healthcare providers either keep increasing the medicine or blame you for your symptoms.

For example --

They never believe that you're trying hard to improve your diet to lose that belly fat, and keep saying you are not serious about it. You need to "workout more and eat less". I think we all have been there and tried that, with very little (if any) success. Even any success you did have, wasn't sustainable. 

Increasing the levothyroxine dosage does NOTHIN for the patients, who often continue to struggle with symptoms.

Ultimately with no answers, people start looking for information on the internet.

Initially, the internet search results are exciting because it gives you hope -- there might be an answer!

But slowly and slowly people realize that there is so much information out there, and it’s so overwhelming and they don’t know what and who to believe. Everyone has their opinion and experience, right?

I am sure you would have tried some kind of diet or a supplement or essential oil, thinking that will be the answer to your thyroid problem.

But did that really resolve all your thyroid problems? Probably not completely!

The reason being is thyroid disorders are more complicated than we think they are. And most of the time people don’t address the full scope of the problem, but only put on bandaids because they just want their symptoms gone.

Now, on the other hand someone qualified and experienced will give you an actionable plan, and they can find what is best for YOU.

Because what is needed for thyroid patients is to find all the factors playing a role in their thyroid disease and fix them.

It sounds overwhelming for a lot of people, and it sounds scary!

But in reality, it is a very simple step wise approach that can be implemented by anyone, when they have the right plan. So now you know the secret to understanding thyroid health: UNDERSTANDING THE ROOT CAUSE OF THE THYROID PROBLEM!

I get so many questions from my clients and potential clients about which labs to get for thyroid conditions and where to get them. Figuring out which tests you should do can also be one of the things I previously mentioned that is overwhelming because there’s once again, so much information out there. Hopefully I can provide a starting point to help you determine which lab tests will be most helpful for uncovering YOUR triggers.

I highly recommend working with an educated and experienced practitioner on your thyroid journey - someone dedicated to preventing, finding, and treating underlying causes of chronic illness, rather than merely treating the symptoms and slapping on a bandaid.

If you have a practitioner who is willing to work with you, that practitioner can order most of the tests listed here. If you don’t have a practitioner like this on your team, I'm more than willing to help you and tell you which labs you can run through insurance and which ones you can use Health Savings Accounts for.

Comprehensive Thyroid Testing

Establishing a baseline for your thyroid health and testing on a regular basis is a CRUCIAL first step in understanding how possible “root cause” triggers may be affecting you. If you haven’t had any of the following thyroid tests done in the last three months, I recommend having them done ASAP.

TSH Test

TSH is a pituitary hormone that responds to low and high amounts of circulating thyroid hormone. This lab test reveals elevated TSH in people who have advanced Hashimoto’s or primary hypothyroidism. However, levels of thyroid hormone can fluctuate, so this test can potentially be misleading. For example, some people with Hashimoto's may have a normal TSH, while those with Grave's disease may have a low TSH. Something to note: conventional ranges are a lot different than functional ranges. The TSH level considered “normal” in conventional medicine has been skewed for years because the original data collected included elderly patients and people with compromised thyroid function. 

The TSH test can be useful in optimizing thyroid function by ensuring the TSH levels stay within the optimal reference range WHILE implementing lifestyle interventions and medication dosage changes.

Free T4 and Free T3 Tests

Doctors usually measure total T3 and T4, which can be misleading because T3/T4 hormones are often bound to different types of proteins and aren’t available for proper use in our body. T4 is known as prohormone and is 300 percent less biologically active than T3. ^[1) T3 is the main biologically-active thyroid hormone that runs our metabolism and gives us beautiful hair and energy.

Most of the commonly prescribed thyroid medications, like Synthroid (levothyroxine), only contain T4 and need to be converted to T3 in the body. In theory, the T4 to T3 conversion works as it’s supposed to, but in reality, we may not always convert T4 to T3.

Some clinicians may only test for free T4, but free T3 is also important to test, because some people may not be converting the T4 to the active T3 hormone properly. Therefore, people may have normal T4 levels, but low T3 levels.

Thyroid Peroxidase (TPO) and Thyroglobulin Antibodies (TgAb) Tests

The TPO and TgAb tests measure the antibodies that are the markers of autoimmunity, letting us know that the immune system is not being nice to the thyroid gland. In reality, the higher the TPO and TgAb numbers, the more aggressive the autoimmune attack is on the thyroid. While not everyone with Hashimoto’s will have these antibodies, those that do can use them as a gauge of how aggressive the attack is on their thyroid, and can track the antibodies over time to see if their current lifestyle interventions are working. A reduction in thyroid antibodies is usually an indication that their lifestyle changes are helping.

Nutrient/Mineral Testing

People with thyroid disorders are at a greater risk for nutrient depletions. ²⁾

Nutritional deficiencies are a two way street. Nutrient deficiencies can contribute to thyroid symptoms and can even trigger or exacerbate thyroid disease. Thyroid hormones determine our metabolism throughout the entire body. And our precious digestive tract is not spared, particularly the intestines. An insufficient amount of thyroid hormones makes nutrient extraction more difficult and less efficient, and can in itself lead to nutrient deficiencies.

Also, I've found that most people with thyroid conditions will have low stomach acid, and we need good stomach acid to break down protein. This can lead to a depletion of amino acids, B vitamins, iron, zinc, and other nutrients obtained from protein.

Also, test for minerals. It doesn’t show disease states, but shows function VERY well, especially thyroid function and adrenal gland function. A hair test is often a far more sensitive test than serum or other hormone tests. This means it will detect subtle thyroid imbalances, and at times, much sooner than other assessments. The hair test also offers clues as to the cause.

Adrenal Testing

In my experience, almost all of those with Hashimoto’s specifically, will be affected by adrenal dysfunction.

Treating hypothyroidism without treating the adrenals is one of the biggest reasons people continue to feel exhausted despite receiving treatment with thyroid hormones.

The adrenal glands release hormones such as cortisol and adrenaline. These “stress hormones” impact many important functions throughout the body. They help establish our stress tolerance, reduce inflammation, regulate blood sugar and body fat, control potassium and sodium levels (which impact blood sugar).

There are a few potential patterns of adrenal dysfunction that include low cortisol levels all day, elevated cortisol levels, and a flipped curve, meaning cortisol is high when it should be low and vice versa.

These patterns of dysregulated cortisol can be consistently and accurately linked to symptoms. For example, we see excessive fatigue, low blood sugar, and low blood pressure when low cortisol is present; and we see anxiety, racing thoughts, high blood sugar, and high blood pressure when there are high levels of cortisol.

PLEASE do not just start supplementing with adrenal support - you may actually hurt your adrenals and thyroid if you don't know the whole picture. This is why I always perform a DUTCH test, that assesses your adrenal function through urine testing.

Many symptoms of hypothyroidism actually overlap with poor adrenal function, so it’s important to get an understanding of how well your adrenals are working as you work to address your own root causes.

Food Sensitivity Testing

Discovering and removing reactive foods changed my life. I felt incredibly better physically (after getting through the emotional aspect of personally not being able to eat eggs, gluten, coconut, almonds, avocado, olives, soy and corn).

You can identify food sensitivities by noting your reactions after eating. When we eat foods we’re sensitive to, our body gets exhausted and depleted in energy. Reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients, and can also produce intestinal permeability (aka leaky gut) whenever they are eaten.

Sometimes, our body will react to our food sensitivities quickly, and we may experience acid reflux, bloating, irritable bowel syndrome, palpitations, joint pain, anxiety, tingling or headaches.

It’s important to note that food sensitivities cause different types of reactions to foods than food allergies. Food allergies are immediate and often cause life-threatening reactions (picture the child who stops breathing after eating nuts), and are readily acknowledged and tested for by conventional medical doctors, especially allergists.

However, food sensitivities (IgG) can take up to four days for them to manifest, and this is one of the reasons why it’s so hard for most people to correlate food sensitivities with symptoms. For example, you may eat corn on Monday and have a panic attack on Wednesday!

In my experience, whenever we eat foods that flare up our IgG system, this also seems to flare up thyroid antibodies.

Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts, and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies!

If you think you are struggling with specific foods, reach out and we can walk through a pulse test or run a food sensitivity test.

Gut Testing

Comprehensive Gut Testing

A variety of gut infections and parasites have been implicated in triggering autoimmune thyroid conditions such as H. Pylori, Candida, and Blastocystis hominis. I’ve found that my clients who do not get better with dietary and nutritional interventions alone, usually have one or more gut infections present, exacerbating their condition. Finding and treating these infections often results in a significant reduction in symptoms, and can even lead to remission.

FYI, most people with Hashimoto’s will have some degree of intestinal dysbiosis (an imbalance in the gut microbiome). ^[Like food sensitivities, dysbiosis can cause intestinal permeability and contribute to the autoimmune process and symptoms.

To identify these triggers, the test I use checks for bacteria, fungi, parasites and viruses in the gut. It also measures bacterial balance of normal flora and digestive markers, like elastase and secretory IgA, which provide further insight on overall digestive and intestinal health.

A bit of a personal story, I ran this test on our middle child who had tons of skin breakouts and upset stomach. We found through this test that he had H. Pylori, and a strong intolerance to gluten. Once we addressed the H Pylori and removed gluten from his diet and started working through his low stomach acid, his symptoms were gone! He still needs to be gluten free, and he's actually ok with it!

This test isn't the easiest to read and interpret, so I highly recommend you have a qualified and trained practitioner order and interpret the results for you, as well as correlate your symptoms and health history.

Toxin Testing

Mold

Mold is a surprisingly common trigger of Hashimoto’s and autoimmune disease in general. It's one that really sucks and hits the entire body pretty darn hard. 

I recommend the MycoTOX test, which identifies mold metabolites in your urine and determines if mold has taken up residence in your body. It can detect 11 different mycotoxins from 40 species of mold, so this can help you determine specific protocols.

The Organic Acids Test can also be useful, (which is included in the DUTCH test I run), as it checks for colonization of mold in your body (whether that is in your gut, your sinuses, or somewhere else), yeast overgrowth, mitochondria, certain nutrient deficiencies, and alterations in neurotransmitters.

Chronic Infection Testing 

Infections are extremely common in those with Hashimoto’s. Sometimes you’ll experience symptoms of the infection, and other times you won’t even know you have it. When I started supporting people with Hashimoto’s who didn’t get better with the usual nutrition, liver, adrenal and gut protocols, I realized that some of them struggled with chronic infections that may be a bit challenging to identify. 

Here's the thing most people don't know: Infections often trigger Hashimoto’s through molecular mimicry. Molecular mimicry is a bit like it sounds. Bacterial or viral cells look a lot like the cells and they mimic the good guys. Our immune system gets in “fix it” mode and starts killing off the infection, but in the process, it starts killing off the cells that look a lot like the infection as well. This is a doorway for autoimmunity to usher itself in.

Some chronic infections include Epstein-Barr, dental implant infections, and Lyme disease.

Next Steps

I hope these tests help you on your healing journey. I highly recommend working with a holistic health practitioner as you navigate testing. 

Testing can be costly, but it’s an important piece to your remission puzzle. I gave up shopping during my process to pay for certain tests. That was a big deal for me since shopping helped me cope with feeling so awful all the time. In the end, getting my Hashimoto’s into remission made the trade off so worth it! I hope ordering tests will help you uncover your root causes and feel better as well.

xoxo,
Vennessa McConkey
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References:
^[1] Peeters RP, Visser TJ. Metabolism of Thyroid Hormone. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc.; January 1, 2017.

^[2] Hu S, Rayman MP. Multiple Nutritional Factors and the Risk of Hashimoto’s Thyroiditis. Thyroid. 2017;27(5):597-610. doi:10.1089/thy.2016.0635