What Is Hypothyroidism?

Hypothyroidism or under active thyroid is a medical condition that affects at least 5 in 100 Americans. Learn more about this form of thyroid disease here.

An In-Depth Look At Hypothyroidism

Thyroid disease is one of the most common medical conditions in the world. In fact, it is so common that some people don’t even know that they already have a thyroid problem until they begin to experience symptom.

In the United States alone, at least 20 million people have some form of thyroid disease and more than 12% of the population will have experience a thyroid condition in their lifetime. Unfortunately, up to 60% of those with thyroid disease are not aware of their condition.

Hypothyroidism is one of the most common types of thyroid disease with more than 4.6% of the population or 5 in 100 Americans aged 12 and older are suffering from the condition.

But what exactly is hypothyroidism and how does functional medicine play a role in helping individuals with the condition cope and recover?

What exactly is hypothyroidism?

Hypothyroidism or underactive thyroid is a medical condition where the thyroid gland is unable to produce enough thyroid hormones to help with the normal function of the cells, tissues and organs.

Located on the lower front of the neck, the thyroid is a butterfly shaped gland that’s responsible for creating thyroid hormones triiodothyronine (T3) and thyroxine (T4), both of which are primarily responsible for regulating metabolism.

Thyroid hormones play a crucial role in how every cell of the body works, especially in how energy is utilized in every organ.

It regulates how your heart beats and digest system functions, so when you don’t have enough of these hormones, your body’s natural functions are affected immensely.

What causes hypothyroidism?

Factors that could cause the thyroid gland to produce insufficient thyroid hormones are:
  • Autoimmune diseases

    The immune system’s primary role is to protect your body against any bacteria or viruses. So when anything foreign enters your body, your immune system quickly responds by releasing cells to counteract them.

    In the case of an autoimmune disease, however, your body cannot distinguish the difference between normal, healthy cells and foreign cells causing an autoimmune response.

    This means that your fighter cells will start attacking healthy tissues that would eventually cause medical conditions known as autoimmune diseases, some of which are responsible for hypothyroidism.

    Hashimoto’s disease is one of the primary causes of hypothyroidism. This autoimmune disorder causes the immune system to attack the thyroid until it becomes damaged and unable to produce enough thyroid hormones.

    Hashimoto’s disease affects 5 in every 100 Americans, making it the most common cause of hypothyroidism in the United States.

    Removal of the thyroid

    Thyroid problems like thyroid cancer, Graves’ disease and thyroid nodules can sometimes lead to the removal of the entire thyroid gland, which in turn causes hypothyroidism.

    This means that you would need to use thyroid medication for the rest of your life. In some cases, only the damaged part of the thyroid will be removed for it to still produce enough thyroid hormones.

    Hyperthyroidism treatment

    Hyperthyroidism is a condition in which the thyroid gland produces too much thyroid hormone causing several medical conditions.

    Medications indicated for hyperthyroidism help reduce thyroid hormone production, but it can sometimes cause the thyroid hormone levels to remain low, especially after treatment with radioactive iodine. This can then result to hypothyroidism.

    Congenital hypothyroidism

    Congenital hypothyroidism occurs when a child is born with an abnormal thyroid gland. In 80% of cases, the thyroid gland is completely absent, placed abnormally or severely reduced in size.

    These conditions are called thyroid dysgenesis because of how the thyroid gland failed to develop or function properly. In other cases, the thyroid gland is normal or slightly enlarged, but it doesn’t produce enough thyroid hormones or none at all.

    Congenital hypothyroidism occurs in 1 out of 2,000 babies born and it is more prevalent in females. In the United States, all newborns are tested for hypothyroidism so early treatment can be given.

    Radiation therapy

    Patients with Graves’ disease, thyroid cancer or goiter nodules are sometimes recommended to undergo radioactive iodine (I-131) therapy to destroy the thyroid gland, which is causing the diseases.

    Patients with cancer in the head or neck, lymphoma or Hodgkin’s disease are also treated with radiation therapy that can cause a partial or full impairment of the thyroid function.


    Some medications that are indicated to treat cancer, heart disease and some psychological conditions can lower thyroid hormone production.

    The most common drugs that cause hypothyroidism include lithium, amiodarone, interleukin-2 and interferon alpha. These medications usually trigger the condition, especially in patients who have a genetic tendency to autoimmune thyroid disease.


    Also known as the inflammation of the thyroid gland, thyroiditis is caused by either a viral infection or autoimmune attack. In its first stages, thyroiditis can cause the thyroid gland to dump all of its hormone production into the blood at once causing hyperthyroidism.

    But after that, the thyroid gland becomes under-active resulting to hypothyroidism.

    Damage to the pituitary gland

    Also called the “master gland,” the pituitary gland is responsible for sending the right message telling the thyroid gland how much hormone to make.

    So when it is damaged by a tumor, surgery or radiation, it also affects how the thyroid produces thyroid hormones resulting to hypothyroidism.

    Iodine problems

    Iodine is important in thyroid hormone production, so too much or too little iodine in the body also affects how the thyroid gland produces thyroid hormone.

    Rare disorders

    In very few instances, some diseases can cause abnormal deposits of substances in the thyroid gland affecting its normal function.

    Some examples include sarcoidosis that deposit granulomas and amyloidosis that deposit amyloid protein in the thyroid.

What are the risk factors for hypothyroidism?

According to studies, women are more likely to develop hypothyroidism than men and it is also common in individuals over the age of 60. Your risk for getting hypothyroidism also increases with the following factors:

  • You have a family history of thyroid disease
  • You have Turner syndrome, which is a genetic disorder commonly affecting women
  • You are pregnant or have been pregnant within the last 6 months
  • You have pre-existing medical condition like pernicious anemia, type 1 diabetes, Sjogren’s syndrome, rheumatoid arthritis and lupus
  • You have a history of thyroid problem

What are the signs and symptoms of hypothyroidism?

Some of the most common signs and symptoms of hypothyroidism include:

  • Dry skin
  • Fatigue and weakness
  • Low tolerance to cold temperatures
  • Sudden weight gain
  • Constipation
  • Decreased heart rate
  • Reduced sweating
  • Joint pain and stiffness
  • Elevated blood cholesterol
  • Thinning hair
  • Impaired memory
  • Menstrual changes and fertility issues

When you start to feel these symptoms, it’s very important to tell your family members right away because thyroid disease can be genetic.

You should also seek medical consultation right away and explore treatment options like functional medicine.

How does functional medicine play a role in dealing with hypothyroidism?

One of the reasons a lot of people don’t realize they already have hypothyroidism is the lack of thorough assessment when they consult their doctors.

In traditional medical practice, a physical exam and some lab tests are ordered to determine any abnormalities in the body. Doctors then use reference ranges to know whether your results belong within the “normal” values or not.

Unfortunately, these are not the most reliable sources of data when it comes to diagnosing hypothyroidism. So you could be experiencing the signs and symptom of hypothyroidism, but a doctor could still misdiagnose you for another condition.

Functional medicine takes on a different approach to diagnosing hypothyroidism.

Instead of just relying on the standard laboratory tests, a functional medicine practitioner will look deeper into your body’s function by ordering a battery of additional tests that will determine the health and functionality of your pituitary and thyroid glands. These include:

  • TSH: A TSH test is the standard laboratory test for determining thyroid function. An elevated TSH level usually mean that your pituitary gland is working double time indicated low thyroid production. A low TSH level, on the other hand, is indicative of excess thyroid supplementation, which is a sign of hyperthyroidism. Normal results, however, are not conclusive to the health of the thyroid. This is why a functional medicine practitioner orders further tests.
  • Total T4: T4 is where the thyroid hormone is stored, so it is measured and compared with the T3 uptake to give a better perspective of T4 activity.
  • T3 Uptake: This test is usually ordered to determine the activities of hormones like estrogen and testosterone to compare their behavior with that of the thyroid hormones.
  • Total T3: This test will determine the amount of active thyroid hormones in the body and it’s also an excellent way to gauge the body’s ability to convert T4 to T3, which is especially useful in ruling out hyperthyroidism.

What are the functional medicine interventions for hypothyroidism?

Since functional medicine takes on a different approach to addressing conditions like hypothyroidism, a treatment plan will not only address the low thyroid hormone levels but also make sure that the body is functioning properly to promote better thyroid health.

With the goal of getting to the root cause of the disease, a functional medicine practitioner will usually combine conventional hypothyroidism treatment with supplementation, proper diet, medication and even botanical medicine to get the best outcomes.


With conventional medicine, the primary treatment for hypothyroidism would be a daily thyroid hormone supplementation using synthetic levothyroxine (T4), liothyronine (T3) or natural desiccated thyroid, which is a combination of T4 and T3 to address low thyroid hormone levels.

But aside from this, a functional medicine practitioner will also recommend additional supplementation to correct nutrient deficiencies in the body that causes hypothyroidism. This includes:

  • Zinc to help improve thyroid functional and other hormone levels. It is also proven in studies to help with the thyroid function in overweight women.
  • Vitamin B12 is essential to thyroid function because it increases the energy production in cells and improves cellular response to thyroid hormones. This will help eliminate some of the symptoms of hypothyroidism including fatigue and muscle pains.

In some cases, practitioners will also use several herbs that have been proven to help with thyroid function. Ashwagandha, for instance, has been beneficial to thyroid function for subclinical hypothyroid patients.

Gum guggal is another herb that can be used to treat hypothyroidism because it helps to convert T4 to T3. Botanical herb should be used with caution, however, to avoid any serious complications or side effects.

All herbal supplementation’s should only be prescribed by a trained herbal medicine professional who knows the right dosage and frequency of these natural medications to prevent unwanted interactions, maximize treatment benefits and reduce side effects and complications.

Proper diet

Functional medicine believes that proper diet plays a huge role in preventing and managing medical conditions that cause hypothyroidism.

To address any microbiome imbalances in the body, practitioners will usually look into the patient’s diet and create a nutritional therapy plan that include a diets that are low in carbohydrates, sugar and starch to help reduce inflammation and boost the immune system.

Some practitioners will also order food allergy panels to help identify foods in the diet that trigger an autoimmune response, especially in the case of Hashimoto’s disease that’s the most common cause of hypothyroidism.

The bottom line

With millions of people suffering from hypothyroidism, it’s very important to look into more effective approaches to diagnosing and treating the disease.

Aside from relying on conventional medicine, which can still have loopholes that cause misdiagnosis, people should also start exploring up and coming treatment modalities such as functional medicine that offers a unique perspective to addressing a patient’s condition by looking into its root cause and analyzing the body as a whole so total well-being is achieved.