January 20, 2017

Hidden Hypothyroidism

by Amanda Box, N.D.

You may have all the classic symptoms of hypothyroidism:

  • classic symptoms of hypothyroidism_2Cold hands and feet
  • Weight gain
  • Hair loss
  • Brittle nails
  • Dry Skin
  • Low body temp

Yet, your doctor has told you your blood work is normal and your thyroid is fine.  End of story, right?  Of course not!  Your symptoms didn’t just disappear with the results!  You still feel miserable and now it’s even worse because you are left without any answers.

Millions in America suffer from some form of thyroid disease.  It’s a bit of an epidemic really.  Synthroid, the synthetic thyroid hormone, is amongst one of the top 10 prescribed drugs.  But, this drug isn’t fixing the problem.  It may mask some of the symptoms, but much of what causes hypothyroidism is never addressed in a doctor’s office.

If hypothyroidism doesn’t have just one cause, then why does it only have one treatment?  Shouldn’t the underlying root issue be corrected?  This approach is much like filling a car with oil to keep it running, yet never fixing the leak!  What a waste of time and money!

Interestingly enough, a defective thyroid isn’t always to blame with hypothyroidism.  You can actually have a completely normal functioning thyroid yet have all the symptoms of hypothyroidism.  This is why it is important that doctors not rely solely on blood but a combination of blood work, signs, and symptoms.  When blood work comes back normal yet you have all the signs and symptoms, it just means it is time to dig a little deeper to find out what the underlying issue truly is.

Before I go into some of the hidden causes of hypothyroidism, I believe it is important that you at least have a foundational understanding of the thyroid’s function in the body.  Understanding how things are supposed to work, give you a better understand of what happens when something goes wrong.

The Workings of the Thyroid

Though the thyroid may be small, its job is quite mighty.  Click to Tweet.

The thyroid is an essential part of your endocrine system. It creates hormones that influence nearly every cell in our body!  Thyroid hormones directly affect our:

  • Metabolism
  • Heat production
  • Balance of sex hormones
  • The use of fat, carbohydrate, vitamins, minerals, and water in the body

Thyroid hormones affect our weight, mood, heart rate, mental stamina, and energy levels.  Click to Tweet.

In a healthy person, the course of action for the thyroid and its hormones looks like this:

  1. The pituitary gland releases the hormone TSH (thyroid stimulating hormone).
  2. TSH tells the thyroid to produce thyroid hormones T3 and T4.
  3. T4 circulates the body waiting to be converted to T3 by the liver.
  4. T3 is used as fuel by our cells for metabolism, burning fat, converting protein, and increasing energy throughout the body.

Hypothyroidism results from an issue compromising any of the steps above.  It can originate in the pituitary gland, the thyroid itself, the conversion by the liver, or the cells and their hormone receptors.  Unfortunately, most doctors don’t look much beyond the thyroid itself. They nearly always prescribe the same course of action to everyone, no matter the cause.

Digging Deeper

types of hypothyroidism

Like I had mentioned earlier, hypothyroidism isn’t always caused by a problem with thyroid itself. Your thyroid can be producing all the necessary hormones, but it doesn’t mean that your body is utilizing those hormones, as it should.  Dr. Mark Starr wrote a book titled Hypothyroidism Type 2 in which he addresses a form of hypothyroidism that isn’t yet acknowledged by mainstream medicine.

  • Type 1 hypothyroidism is when the thyroid itself isn’t producing enough thyroid hormone.
  • Type 2 hypothyroidism manifests similar to type 2 diabetes.  In type 2 hypothyroidism, the thyroid is working normally and the hormones are in normal numbers.  However, the cells of the body don’t recognize or utilize the hormones.

Just as type 2 diabetes is often referred to as insulin resistance, type 2 hypothyroidism is thyroid hormone resistance. Dr. Starr believes that thousands of people suffer with Type 2 hypothyroidism and are not diagnosed because it doesn’t show up on the typical blood tests.

Like many other diseases, stress can also be a hidden trigger for hypothyroidism.  Stress can provoke autoimmune and inflammatory responses in the body that can lead to Hashimoto’s disease.  Hashimoto’s disease results from the body’s immune system attacking the thyroid gland.  This causes a drop in its hormone production and therefore hypothyroidism.

Stress can also have a dramatic effect on the conversion of inactive T4 to active T3 in the body.  Chronic stress leads to adrenal fatigue, which causes a prolonged increase in cortisol in the body.  When cortisol levels are high, it shuts down the enzyme in the liver that converts T4 to the active T3 hormone.  Without adequate T3, hypothyroid symptoms are the result.

When the adrenal glands are the underlying problem, not the thyroid, treating only the thyroid will do little to nothing.  Most natural health practitioners won’t recommend thyroid boosting supplements or natural thyroid medication for hypothyroidism until the adrenal glands are restored.  Many times, because the hypothyroidism is secondary, it disappears once stress levels decrease and the adrenal glands are balanced.

The symptoms of adrenal fatigue are:

  • Needing at least 10 hours of sleep to function, extreme fatigue in the mornings, exhaustion again around 2pm, and more awake after 6pm with difficulty going to sleep.
  • Sugar, caffeine and salt cravings
  • Brain fog
  • Depression
  • Lowered immunity
  • Blood sugar highs and lows

correct adrenal fatigueCorrecting adrenal fatigue starts with decreasing ALL forms of stress in your life.  This includes both psychological and physical.

  • Find a safe emotional outlet for your stress like journaling, counseling, yoga, prayer, etc.
  • Cut out all stimulants like sugar and caffeine.
  • Adopt a healthier diet by cutting out processed foods, sugar, and refined flours.
  • Take a stress-buffering supplement like Holy Basil, Ashwagandha, or Rhodiola.  (I recommend Gaia’s Adrenal Health as it contains all three herbs)
  • Get your daily dose of B vitamins in a quality multi-vitamin.  B vitamins help you manage your stress levels.

Latent Thyroid Problems

You may have what you believe to be a particular health issue, but the actual underlying cause may be related to the thyroid.  Thyroid problems can masquerade themselves often manifesting as other health issues. Over 20 million Americans today have some form of thyroid disease (1).  Over 60% of these people have absolutely no idea that they have a thyroid problem and instead blame their ailment on other health issues.

Health problems that can originate from thyroid issues include:

  • Depression
  • PMS
  • High cholesterol
  • Chronic fatigue
  • Fibromyalgia
  • Infertility
  • Unexplained weight gain/loss

So, how do you know if thyroid problems are behind your health problem?  The first thing you’ll want to do is have a full blood workup done including TSH, T3, T4, and a thyroid antibody test.  But remember, even if your results come back in “normal range,” you can still have hypothyroidism.  Before 2003, the range for TSH (thyroid stimulating hormone) was 0.5-5.0.  It was then changed to 0.3 to 3.04. Some doctors believe the normal range in thyroid tests should be revised again. They believe levels of TSH over 1.5 should be considered as possible hypothyroidism.

At-Home Tests

mirror lookHowever, as I keep pointing out, blood work and hormone levels aren’t the sole indicator. One of the easiest tests you can perform at home is the basal body temperature indicator.  Most people with hypothyroidism run a slightly lower temperature, typically below 97.8.

In order to check your basal temperature, you must do it first thing in the morning before getting out of bed.  Women who are still menstruating should ideally do this test the week of their period.  However men, post-menopausal women, and children can perform this test at any time.  Take your temperature upon waking 3 days in a row and write down your results.  Again, if your temperature falls below 97.8, it is likely you have a form of hypothyroidism.

There are other interesting ways to test potential hypothyroidism, as well.

  1. Check for a goiter.  Your doctor will check this as well.  A goiter is an enlargement of the thyroid gland, which is located about midway down your neck.
  2. Look in the mirror with your arms to your side.  If your thumbs face your outer thighs with your palms towards the back, you may have hypothyroidism.  Those with a healthy thyroid tend to have their palms facing their outer thighs.
  3. Take a good look in the mirror.  Look for puffiness, bags under your eyes, hair missing from your outer eyebrows, and a swollen tongue.  These are all signs of hypothyroidism.

And don’t forget the common signs and symptoms of hypothyroidism, some of which I mentioned in the very beginning.

  • hypothyroidism testWeight gain or inability to lose weight
  • Cold hands and feet
  • Constipation
  • Brittle nails
  • Very dry skin, especially the elbows
  • Coarse hair or hair loss
  • Low heart rate
  • Heavy periods
  • Infertility

Treating Hypothyroidism

Let’s say you now you know you have hypothyroidism.  Maybe blood tests confirmed it or you are sure based on your symptoms and at-home tests.  Although a doctor will likely prescribe Synthroid no matter the cause, different types of hypothyroidism often require different treatments.

However, all forms of hypothyroidism can benefit tremendously from a healthy diet.  Eating health-promoting foods increases nutrients needed by the thyroid and helps to decrease inflammation in the body, which can lead to both adrenal fatigue and Hashimoto’s induced hypothyroidism.  A nutrient dense and anti-inflammatory diet includes:

  • Eliminating sugar and refined flours
  • Increasing your colored vegetable intake
  • Cutting out all artificial colors, flavors, and preservatives
  • Avoiding fast foods and processed foods
  • Replacing vegetable oils and trans fats with healthy fats like coconut oil and olive oil

Hashimoto’s and Type 2 Hypothyroidism

If you have Hashimoto’s disease, then you must focus on resetting your body’s immune response.  In order to do this, it often takes a complete overall of your body and mind.  Lower your stress levels via stress reduction techniques, drastically change your diet to a healthier one, and begin taking anti-inflammatory and anti-oxidant rich supplements like Turmeric and Astaxanthin.  Stay away from iodine and even natural desiccated thyroid as they can actually increase the attack on the thyroid.

Type 2 hypothyroidism can be remedied from this approach, as well.  Your body can only reset and work as it was designed to by changing your lifestyle and diet.

Type 1 Hypothyroidism

Your run-of-the-mill type 1 hypothyroidism is typically caused by a lack of iodine, other nutrients, and/or stress.  Using a thyroid supplement from you local health food store can be helpful.  They contain the most essential nutrients for thyroid health, including iodine.  My favorite is Europharma’s Thyroid Care.

Also, if your doctor wants to write a prescription, request the natural thyroid medication.  The two most common brands are Armour and Nature-throid.  These aren’t synthetic like the typical drugs prescribed.  They are instead made from desiccated porcine thyroid.

Remember, there isn’t just one face to hypothyroidism.  It’s causes can be hidden and much more elusive.  There is no one-size-fits-all when it comes to treating hypothyroidism.  Don’t be discouraged any longer by your “symptoms without a cause.” There is always a cause; it’s just finding the right one.

Finding the root behind your hypothyroid symptoms is key to choosing the right approach. Take note of your symptoms, get the appropriate blood work done, and address any issues like adrenal fatigue.  Resolving hypothyroidism can be done both naturally and efficiently.  It ultimately lies in finding the root, not bandaging the symptoms.


Amanda BoxAmanda Box is a Traditional  Naturopath and a graduate of Clayton College of Natural Health. She’s been in the health and wellness industry for over 12 years and currently practices naturopathic consulting in the Kansas City, Missouri area.  Her passion is helping others achieve wellness of the whole person – mind, body, and spirit. If you don’t have a good local naturopathic practitioner to turn to for your personal needs, Amanda does phone consultations! She can help you with weight loss, detox/cleansing, acute and chronic illnesses, skin and body care, grocery shopping, pantry overhauls, and more! Visit her blog “My Life in a Healthnut Shell” at http://amandabox.blogspot.com/ for contact info.


1. http://www.thyroid.org/media-main/about-hypothyroidism/


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