Hypothyroidism symptoms are vast…
From weight gain to digestive problems, fatigue and infertility, it can be easy to experience any one of these and immediately think they are symptoms of hypothyroidism and you have a dysfunction of your thyroid gland.
A quick Google search on thyroid health may even confirm your self hypothyroidism symptoms diagnosis.
Hence, it’s no surprise that doctors of natural medicine, like myself, are quick to consider “thyroid problems” for nearly everyone. It’s easy to assume your hypothyroidism symptoms MUST be related to “mild hypothyroidism,” “subclinical hypothyroidism,” Hashimoto’s, or thyroid-induced fatigue. But here lies quicksand.
Although doctors DO have incentive to find out what is wrong with you (And, understandably, you may want something to be “wrong”—at least to explain your suffering)… What if your perceived illness or hypothyroidism symptoms are actually your body doing exactly what it should be doing under the circumstances?
In other words: what if doctors are misdiagnosing hypothyroidism—confusing hypothyroidism with just a natural adaptation and survival response to your diet, lifestyle or other stressors in your life—your body’s natural reactions when it is stressed?
What if the real reason your thyroid is “off” or you have symptoms like unexplained weight gain, digestive problems, fatigue and infertility, is not because you have hypothyroidism, but instead because your lifestyle is out of balance?
And, lastly, what if you could naturally REVERSE your hypothyroidism symptoms, and get to the root of why you’re really gaining weight, constipated, tired or experiencing hormonal imbalances?
You just might be able to.
Thyroid Health 101
In order to address the differences in Hypothyroidism, versus signs and symptoms of stress in your body, it’s important to first understand hypothyroidism… and the role of the thyroid in the body.
Your Thyroid is a large gland in your neck that secretes hormones, regulating growth, cell function and your metabolism (how “fast” and efficiently your cells work and govern your bodily processes).
There are TONS of interactions between the thyroid gland and the rest of the body!
Body Systems & Conditions that Affect “Thyroid Health”
- The thyroid communicates directly back in forth with your gastrointestinal system. (GI dysfunction, like constipation or frequent bloating, can contribute to thyroid problems, and thyroid problems can contribute to GI dysfunction—also causing constipation or frequent “gut issues”).
- Your HPA axis (ie. “adrenal glands” or “stress hormones”) also interact with the thyroid gland (Your thyroid helps keep your cortisol production and use in tip top shape).
- Your blood sugar balance and thyroid have a strong connection (ie. your energy levels and ability to get the most out of your nutrients to use them for your workouts, your brain power and fending off sugar cravings).
- Nutrient imbalances can affect thyroid function—suppressing it if you don’t get the essential nutrient-rich foods your body needs to be balanced (especially selenium, iodine, folate, and B12 Vitamins).
- You tend to have a weaker immune system when you have a dysfunctional thyroid. And vice versa, you’re more likely to experience hypothyroid-like symptoms (like fatigue, low energy, easily cold) when your immune system is weak.
- Toxic burden—like heavy metal exposure or toxin exposure in your salmon or tuna for dinner, the mold in your apartment, or toxins in your plastic water bottle—also suppresses thyroid function, along with other functions in your body.
- And, lastly, chronic infections (underlying imbalances, like fungal overgrowth, parasites, bacterial overgrowth, etc.) can trigger “thyroid” symptoms (and vice versa).
In short: There are A LOT of factors that affect your thyroid health.
The thyroid has a bidirectional relationship with imbalances in your body. Thyroid “dysfunction” may not be a dysfunction of the thyroid itself, but instead related to another imbalance in your body.
Traditionally, hypothyroidism or “overt hypothyroidism” is diagnosed based on blood work lab markers—namely TSH and T3. By conventional medicine standards, if you have a TSH ABOVE 4.5 and a Total T3 level below 70 (Free T3 below 2), you have Hypothyroidism.
What does this mean?
Your metabolism and bodily processes are not functioning up to speed.
Approximately 12% (a little over 1 in 10) Americans will develop a thyroid condition. And of those 1 in 10, 60% of them are actually unaware that they have a thyroid condition.
Definition: “Subclinical Hypothyroidism” — One Step Further
Beyond conventional (read: old school) medicine labs and assessment, there is also what is known as “subclinical hypothyroidism”.
This is a diagnosis we see particularly in functional medicine and more cutting-edge research, that catches markers of Hypothyroidism earlier on before it is a full blown disease.
To officially diagnose “subclinical hypothyroidism,” a healthcare practitioner will run a complete thyroid panel, which includes functional lab testing markers for: TSH, total T4, free T4, total T3, free T3, reverse T3, free thyroxine index, T3 uptake, and TPO and thyroglobulin antibodies.
Functional lab testing markers are typically much tighter than traditional lab ranges. This is because traditional lab ranges are all about diagnosing people when they are already in a state of disease, instead of catching disease early and preventing it.
If your TSH is above 2, and your Total T3 is below 100, or Free T3 is below the “healthy range” of 2.5 to 4, then “subclinical hypothyroidism” may be suspected by your practitioner.
The reasoning? Research has shown that individuals in these blood marker categories have a greater chance of developing future clinical hypothyroidism is increased when TSH rises above 2.0.
Even more? Hashimoto’s—an autoimmune condition of the thyroid gland wherein the thyroid is attacking itself—may also be suspected, based on your levels of TPO and thyroglobulin antibodies. Hashimoto’s does NOT mean you have hypothyroidism. But it DOES mean your body has inflammation.
The bottom line?
Subclinical hypothyroidism and Hashimoto’s diagnostic markers are broad. Therefore, many doctors and healthcare practitioners often assume or suspect that patients have thyroid dysfunction when those hypothyroidism symptoms are present.
The Hypothyroidism Problem
While your thyroid health is certainly something to consider in an overall picture of health, your problem or symptoms still may not be a “thyroid problem.”
So what’s really the BIGGER elephant in the Room?
One word: Stress.
Stress is your body’s natural adaptation and survival mechanism to “fight” if it feels threatened by your current diet, environment or lifestyle. And stress often masks in disguise of hypothyroidism-like symptoms.
Translation: Your unwanted weight gain, “slow metabolism,” unexplained fatigue and hormone imbalances may actually be more of a stress. Stress can come from lifestyle, environment, and/or diet.
So is your hypothyroidism a stress problem, instead of a thyroid problem?
Check out these 7 areas to address first before diagnosing yourself with hypothyroidism.
7 Essential Diet & Lifestyle Factors to Address First BEFORE Diagnosing Yourself with Hypothyroidism
Remember, you ideally want “healthy” thyroid levels of the following:
- TSH: Between 0.5-2
- Free T3: 2.5-4
- Total T3: 100-180
- Free T4: 1.0-1.5
- Total T4: 6-12
- TPO Antibodies: 0-34
- Thyroglobulin Antibodies 0-0.9
These markers CAN be influenced by your stress levels, diet and lifestyle alone. Before jumping to conclusions you have a “thyroid problem” make sure you are fixing these things:
1. Diet: Are you eating enough energy?
Under eating is a sure way to send your body into “stressed out mode.”
Studies have shown that T3 levels are substantially reduced when we don’t eat enough calories (Wadden et al, 1990). This, in turn, can make it look like you have a thyroid condition on your labs, wherein the reality is: you just aren’t eating enough.
It has been well-accepted that under-eating also greatly reduces your metabolism for many years (Mole, 1990).
Your body doesn’t have to “work as hard” to digest, nor does it have enough nutrients it can depend upon for all your metabolic needs, so it learns to adapt.
Ancel Key’s Minnesota Semi-Starvation experiment (Keys et al, 1950) is perhaps the best known shining example of this. He took a group of healthy men and fed them an adequate 3200 calories per day diet for 3-months, followed by 6-months of “semi starvation” (on a 1600 calorie diet).
The men lost muscle mass and their basal metabolic rate decreased by about 36%. This metabolic reduction stayed that way, even when re-feeding ensued.
Recent studies of other “healthy” individuals confirm Key’s findings, finding that resting metabolic rate decreases with calorie restriction (Martin et al, 2007). The infamous “Biggest Loser” study that hit newsfeeds a few years ago also revealed the long-term side effects of chronic undereating on your metabolism (Fothergill et al, 2016).
Why this metabolic reduction happens?
Certainly your thyroid can be involved. But more than likely, it is not the root cause of why your metabolism or weight slows down. Instead a look at the HPA-Axis (your hypothalamus, pituitary and adrenal axis along with your thyroid) reveals that hormone production is thrown “off” when your body is short on nutrition.
Hence, cortisol (your stress hormone) goes up, driving inflammation and the body’s natural “fight or flight” mode as it tries to make due with what it can and ride the waves of the stress conundrum. The longer stress persists, the less able your HPA-Axis and hormones are able to recover. And instead of “working for you” it can seem like your body is working against you.
Again, these symptoms and this conundrum may not be related to a thyroid dysfunction or hypothyroidism alone. But instead, might be because of the simple fact that you are not eating enough.
Amount: How much do you need to eat?
While every body is different, a healthy minimum baseline for a moderately active adult woman is between 1800 calories to upwards of 2200 to 2400 calories, depending on activity.
For a man, those numbers shift to 2200 calories to upwards of 2600 to 3,000+ calories, depending on activity levels. Calories aren’t the end all be all, but ENOUGH food that’s balanced, real-food nutrition is. Go for proteins, fatty acids and carbohydrates, particularly colorful veggies (or enough healthy fat to compensate for those who thrive upon a lower carb intake).
The Bottom Line: Eat enough food.
2. Nutrients: Are you eating the right nutrients?
You can be eating enough—but not nourished. There is a difference. And when it comes to your daily nutrients intake, there are two considerations.
Number one is ensuring nutrient balance: the right types of nutrients in the right amounts. Number two is avoiding substances that interfere with proper thyroid function.
So what kind of nutrients do you need?
As a foundation, you cannot go wrong with eating real food. Simply put: a paleolithic-inspired diet consisting of:
- Sustainable proteins (wild caught fish, pastured chicken, grass-fed beef)
- Colorful, organic produce (particularly veggies)
- Variety of plant and animal fats (avocado, olives, raw nuts and seeds, coconut oil, coconut butter, olive oil, lard, tallow, ghee, grass-fed butter, grass-fed dairy if tolerated, sustainable fatty animal meats, etc.)
Best Foods for Beating Hypothyroidism Symptoms
Aside from basing your balanced meals on these foods, thyroid-supporting nutrients include:
- Iodine: Sea vegetables, grass-fed dairy, iodized salt
- Selenium: Wild-caught fatty fish, Brazil nuts, ham
- Iron: Oysters, clams, liver, lamb, grass-fed beef, some chicken
- Zinc: Oysters, liver, grass-fed beef, lobster, crab
- Vitamin B12: Clams, liver, oysters, mackerel, sardines
- Vitamin B2: Liver, mushrooms, seaweed, spinach
- Vitamin A: Cod Liver Oil, organ meats, wild-caught seafood, grass-fed dairy, orange vegetables
- Vitamin C: Spinach, broccoli, citrus fruits, strawberries, kiwi, red pepper
- Vitamin D: Cod Liver Oil, cold-water fatty fish
- Magnesium: Dark leafy greens, clams, spinach, beet greens, kelp
Unfortunately, most people in modern day do not eat organ meats, seafood and fish on a regular basis, where the power-packed versions of these nutrients lie. Hence, a “thyroid” imbalance or problem may present on paper, where, in actuality, you just aren’t getting enough nutrition.
Some simple hacks for including more of these foods and nutrients in your diet are:
- Consider making liver capsules to consume like “pills” or liver meatballs once or twice per week for organ meats
- Take a high-quality Cod Liver Oil
- Aim to consume a pound of fatty cold-water fish every week (about 2 servings), such as wild-caught salmon, mackerel, tuna, halibut, cod or herring
- Get your greens on—add greens to at least one to two meals every day (cooked, in a smoothie, in a casserole, alongside your dish, as a salad, etc.)
3. Digestion: Are you absorbing your nutrients?
The gut is currently being called “part of your endocrine system.” It’s responsible for the production of 31 different hormones, many of which regulate your metabolism, hunger-fullness levels, and energy.
A thyroid “condition” may actually be a gut condition. Think about the digestive system like a domino.
Your gut is the gateway to health. Thus, if you knock down the primary domino (your gut), then what do you think happens?
Other body systems, thyroid included, take a hit.
Research shows that hypothyroidism and thyroid imbalances are directly connected to small intestinal bacterial overgrowth (1, 2), constipation (3), IBS (4) and low stomach acid, as well as bloating and indigestion (5).
The bigger question with such evidence?
Which came first—the thyroid condition or the gut imbalance?
As noted earlier, the thyroid and gut work in a bidirectional manner. Sometimes the thyroid is the cause of the other imbalance, and sometimes a GI disturbance is the cause of the thyroid dysfunction.
The Bottom Line: Before jumping straight to conclusions that your gut issues are due to a thyroid problem, consider the role your gut health plays in supporting your thyroid health. Address your digestive health first. Assess through clinical testing whether or not other gut conditions—such as SIBO, fungal overgrowth, low stomach acid or a “leaky gut” are present. And support your overall gut health with these basic must-dos:
Support Your Gut Health
- Taking a quality soil-based probiotic and eating fermented probiotic and prebiotic foods
- Chewing your food well
- Drinking half your bodyweight in ounces of clean filtered water
- And, considering supporting digestion with apple cider vinegar, bone broth and ginger (such as herbal tea) on a regular basis
4. Exercise: Finding the “just right” (Goldilocks) amount
Intensive exercise, such as strenuous interval training, results in significantly lower T3 that persists over 24 hours (Figen et al, 2005). Even moderate exercise, for more than 20 minutes, results in lower T3 levels (Rosolowska-Huszcz, 1998). Just like not eating enough is stressful, so is too much activity.
Exercise is all about that sweet spot for a balanced body.
If your thyroid labs come back with suppressed T3 function, it may be worth checking in with yourself to address how much you are exercising. Also note if you are properly recovering, refueling and supporting your activity levels with nutrition and variety.
In addition, it’s also important to note that often times as you get fitter, the hypothyroid effect of exercise is naturally reduced. So sometimes fitness is just a matter of time as your body adjusts to a new normal.
The Bottom Line:
A lower T3 may technically not be a “bad” thing, if the other markers on a complete thyroid panel are relatively normal. Every BODY is unique and completely different.
5. Environment: What’s in your water?
There are more than 85,000 toxic chemicals that are deemed legally safe in the U.S. Thousands of these are banned in other countries. Nearly 70% of all Americans consume the cancer-causing chemical Chromium-6 in their water supply alone.
Toxins in our beauty supplies, toothpastes, face washes, cleaning supplies, plastic water bottles and more are well-known “endocrine” disruptors. These are all also correlated with suppressed thyroid function. T3 levels, once more, take a hit with toxic burden (1, 2, 3) primarily due to the stress response and immune dysregulation such substances project.
The Bottom Line:
Detox your environment.
Check out the Environmental Working Group’s website for tons of information on ways to detox your environment. Chris Kresser also has an excellent article (2016) on the effects of toxins on thyroid health.
6. Age: Are you living in reality?
Sometimes we discount the fact that age happens, and can be a natural reason why your metabolism, hormones, or energy levels aren’t what they “used to be.” Hate to break it to you, but age happens, and is a natural adaptation process every human experiences.
Granted, lifestyle factors can make us all feel like a million bucks (and can even make some folks feel younger than they did in their 20’s when their diet and lifestyle was centered on Taco Bell drive-thrus and video games). But overall, age is a fact-of-life that does shift our metabolism and other health markers (thyroid included).
In fact, get this: Over 65 years of age, lower T3 is linked to longevity and longer life is linked to higher TSH, a sign of slightly lower thyroid activity.
In other words: The game for your thyroid health itself also changes entirely as your body ages.
The Bottom Line:
Lower thyroid function is a part of the aging process.
7. Stress: The big elephant in the room
Stress is the number one driver of 99% of all imbalance and disease. And under stressful situations, the body lowers T3 to fight stress.
Say for instance, you had a thyroid panel run on a morning that you worked out, didn’t sleep as much, or have been under tight deadlines at work. Chances are, your thyroid levels may come back a little “off.”
It’s vital to consider the stressors at play in your life when facing a diagnosis of hypothyroidism or subclinical hypothyroidism… because stress alone could be the “elephant in the room” driving your hypothyroidism symptoms or lab results.
Common Sources of Stress
Stress goes far beyond mental stress too. Common sources of everyday stress include:
- High exposure to artificial light (at night)
- Blue light exposure (looking at screens all day)
- Burning the candle at both ends
- Social Media comparison (not feeling good enough)
- Overtraining (under-recovering)
- Lack of sleep
- Poor quality food (GMOs, non-organic foods, processed foods, fast foods, restaurant foods)
- Low water intake
- Toxic exposure
- Medicines or NSAIDs you take
- Sugar intake
- High caffeine intake
(Just to name a few).
When our amount of stress outweighs our body’s natural ability to recover from that stress, imbalances or your hypothyroidism symptoms may occur.
Your Take Home Message
Medical providers and Google searches are often quick to tell you what is wrong with your body, rather than what is right. Your thyroid doesn’t need to become the next scapegoat. Always check in to address diet, lifestyle and environmental factors first before assuming the “problem” of your hypothyroidism symptoms—or other imbalances—is the “root cause” itself.
About the Author: Dr. Lauryn Lax
Dr. Lauryn Lax is a Doctor of Occupational Therapy, Nutritional Therapy Practitioner, Functional Medicine Practitioner, author and speaker, with over 20 years of clinical and personal experience specializing in digestive health, intuitive eating, disordered eating, hormone balance and women’s health. She is a published journalist and speaker, and her work has been featured in Oxygen Magazine, Women’s Health, Paleo Magazine, Breaking Muscle, CrossFit Inc, USA Today, ABC and CBS News. She operates a virtual Functional Medicine practice, Thrive Wellness & Recovery, LLC, working with clients and patients around the world to get unstuck from their health, food, mindset and fitness ruts.