Doctor Why Do I Still Have These Thyroid Symptoms?

Not a day goes by that I don’t see a patient currently on thyroid replacement hormones ask me why they still suffer with all of their thyroid symptoms. Thyroid problems are extremely common, especially in women. Unfortunately most women receiving replacement therapy still suffer with all of the typical thyroid symptoms:

• Tired, Sluggish
• Can’t lose weight even with exercise
• Feel cold in hands, feet, or all over
• Require excessive amounts of sleep to function properly
• Increase in weight gain even with low-calorie diet
• Gain weight easily
• Difficult, infrequent bowel movements
• Depression, lack of motivation
• Morning headaches that wear off as the day progresses
• Outer third of the eyebrow thins
• Thinning of the hair on scalp, face or genitals or excessive falling hair
• Dryness of skin and/or scalp
• Mental sluggishness
• Nervous and emotional
• Insomnia
• Night sweats

The most common scenario is: a patient presents to their primary doctor with the symptoms described above. A very basic panel is run, and the TSH (the hormone the brain releases to tell your thyroid to produce more hormone) is found to be high, and then the patient is placed on synthetic thyroid hormone. In a couple months they do another panel, this one more limited than the first panel, only measuring the TSH. The TSH has now dropped into “normal” range and the doctor considers the management a success. There is only one problem. The patient still suffers with the same symptoms despite a normal TSH. The remaining symptoms are written off as depression or psychosomatic and the patient is given antidepressants.

The TSH was managed but not the patient. I bet you know someone in that exact same position. Thyroid problems are extremely common and extremely mismanaged.Women on replacement hormones continue to feel lousy because: There are over 30 different ways that the thyroid can go wrong…over 30! And only ONE of these will respond well to taking thyroid hormones. Proper management of any thyroid condition requires a complete evaluation. The traditional one-size-fits-all “replacement” model of taking thyroid hormones is just not good enough — thyroid problems are much too complex. Some of the ways that your thyroid can go wrong include:

• Primary Hypothyroidism - this is the one thyroid pattern that responds well to replacement hormones. It is also the least common cause of thyroid dysfunction.
  
  
• Hypothyroidism secondary to Decreased Pituitary Output – if your pituitary gland (located in your brain) is not producing enough releasing hormone, your thyroid suffers. Giving thyroid hormone further suppresses the pituitary output and you end up worse in the long run.
  
  
• Thyroid Underconversion - your thyroid produces most of its hormone in a non-active form. Conversion to the active form of the hormone requires proper enzyme function in the liver and in your stomach. No amount of replacement hormone will fix this unless all of the things that affect conversion are fully evaluated and fixed. This is why we do a full metabolic workup and a complete thyroid panel to evaluate thyroid problems.
  
  
• Thyroid Overconversion - some people, due to various metabolic imbalances convert too much hormone into the active form. This sounds like it would be beneficial but it is not. It causes the cells to produce less receptor sites because they are being bombarded with thyroid hormone, resulting in symptoms of hypothyroidism despite high levels of hormones in the body. Sadly most people with thyroid overconversion are still placed on replacement, making the problem worse.
  
  
• Thyroid Binding Hormone Elevations – many women, especially those on replacement estrogen suffer from this. Another concept you must understand about thyroid hormones is that because they are steroid based, meaning they do not mix well with water, they must be bound to proteins in order to be transported through the blood to cells. If your body creates too much binding protein then you don’t have enough hormones in a “free unbound state” to bind to receptors on cells. This will create symptoms of hypothyroidism despite normal thyroid levels on lab testing.
  
  
• Autoimmune Thyroid – this is where your body attacks and kills your thyroid cells. This is the most common cause of low thyroid function in the United States.

These are just a sampling of some of the common hypothyroid patterns. In every case if you present to your doctor you are going to get replacement hormone and the likelihood of it resolving your symptoms is highly unlikely. We take a natural, functional approach to thyroid problems. We understand the importance of a complete evaluation and we understand the 30 known thyroid dysfunctional patterns that exist.

Proper management starts with the complete understanding of what is going wrong. We are not going to look at a couple limited markers and give you a generic management plan. We ARE going to do a complete metabolic workup that is going to look at everything that has the potential to affect thyroid function. Your hormone system, immune system, and neurological system all work in harmony and any effective management must look at all of these at once.

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