The thyroid system plays a critical role in your metabolism. Along with insulin and cortisol, your thyroid hormone is one of the big three hormones that control your metabolism and weight.
The key is the right testing to confirm that a sluggish thyroid is contributing to a stalled metabolism and other problems. Once you know this for sure there are many ways to help correct thyroid problems.
There are so many reasons for low thyroid function, yet we see many patients whose doctors have ignored this problem.
How do we know that a patient has low thyroid function? We ask about symptoms, perform a physical examination, and consider potential causes of thyroid problems. Then we do the right tests.
There is no one perfect way, no one symptom nor test result, that will properly diagnose low thyroid function or hypothyroidism. The key is to look at the whole picture – your symptoms and your blood tests – and then decide.
Most doctors just check something called thyroid-stimulating hormone (TSH) and sometimes your free T4 level, which doesn’t give a full picture of the thyroid. In fact, even the interpretation of this test is incorrect most of the time.
Many doctors think that only a TSH over 5 or 10 is worth treating. Unfortunately, this leaves millions suffering unnecessarily.
The newer guidelines of the American College of Endocrinology consider anybody with a TSH level over 3.0 as hypothyroid. While an improvement, practitioners following these guidelines may still miss many people who have normal test results and a malfunctioning thyroid system.
To get a complete picture, we recommend looking at a wider range of functions:
Thyroid-stimulating hormone (TSH), the ideal range is between 1 and 2 m IU/ ml
Free T4 and free T3 (the inactive and the active hormone)
Thyroid antibodies (TPO), looking for an autoimmune reaction that commonly goes undiagnosed if the other tests are normal, as doctors don’t routinely check this
Thyroid-releasing hormone (TRH) stimulation test
A 24-hour urine test for free T3, which can be helpful in hard-to-diagnose cases
Besides TSH, Functional Medicine practitioners perform other essential tests including free T3, free T4, and thyroid antibodies. We also look for associated problems such as gluten intolerance, food allergies, and heavy metals, as well as deficiencies of vitamin D, selenium, vitamin A, zinc, and omega-3 fats.
Correcting thyroid problems requires an integrative approach. It involves more than simply taking a thyroid pill. It involves nutritional support, exercise, stress reduction, supplements, reducing inflammation, and sometimes eliminating certain foods and detoxification from heavy metals (such as mercury and lead) and petrochemical toxins (such as pesticides and PCBs).
Autoimmune Thyroiditis: Hashimoto’s and Graves’ disease
About 10% of the worldwide population suffer from a form of over 80 different autoimmune diseases (AID), the common ones being thyroid disease, coeliac disease, rheumatoid diseases, Multiple Sclerosis, and Type 1 diabetes. If you have one AID you are at greater risk to develop another.
Autoimmunity is a loss of immune tolerance.
If you have autoantibodies against your thyroid gland, it can work both ways:
Either your thyroid becomes underactive or hypothyroid. This is caused by thyroid peroxidase and thyroglobulin autoantibodies and is called Hashimoto’s thyroiditis.
Or you have thyroid-stimulating autoantibodies to the TSH receptor (TSHR) which causes Hyperthyroidism in Graves’ disease
To make it even more complicated, in some Graves’ patients, thyroiditis becomes sufficiently extensive to cure the hyperthyroidism with resultant hypothyroidism. T regulatory cells (Treg) seem to be involved in the natural progression of hyperthyroid Graves’ disease to Hashimoto’s thyroiditis and hypothyroidism in humans. Vitamin D seems to help to improve the function of the Treg cells.
In order for an autoimmune disease to develop, in addition to genes, a trigger, and a leaky gut barrier must be present. Healing the leaky gut can put the autoimmune condition into remission.
Choose the Right Thyroid Hormone Replacement
Ultimately, to properly balance a thyroid that is severely out of balance, you will need to go on some type of thyroid hormone replacement therapy.
Altering your diet and your lifestyle will certainly help tremendously, but if your thyroid isn’t functioning properly, you may need to take some additional thyroid hormones to supplement its output.
Traditionally trained doctors prescribe synthetic T4 thyroid hormone called Levothyroxine. But that doesn’t make it the best treatment for everyone. Some people benefit from it, but in some cases the symptoms don’t seem to go away using only T4, even if their tests return to normal. A Functional Medicine practitioner knows is that no one treatment works for everyone. A combination of experience, testing, and trial and error becomes necessary to get any treatment just right.
We have discovered that the majority of our patients benefit from a combination hormone treatment including both T4 and T3. Levothyroxine is just T4, the inactive hormone. Most doctors assume that the body will convert it to T3 and all will be well.
Unfortunately, pesticides, stress, mercury, infections, allergies, and selenium deficiencies can block that process. Since 100 percent of us have pesticides stored in our bodies, we will all likely have some problem with Levothyroxine.
The most common treatment we use is Nature-throid, a prescription drug made from desiccated (dried) porcine thyroid. It contains the full spectrum of thyroid hormones, including T4, T3, and T2 . That last one – T2 – is a little-known product of thyroid metabolism that actually may be very important.
Whilst the majority of our patients does well on Nature Throid, everybody is different and therefore we adjust out treatment plan to each client. Some benefit from a combination with Levothryoxine, some need extra T3 and some only T3. We have a few patients on Armour Thyroid and Erfa. Ultimately, we use the combination that works best for each individual client.
Sometimes the only way to find out if you have a thyroid problem is a short trial of something like Nature thyroid for three months. If you feel better, your symptoms disappear, and you lose weight, it’s the right choice. Once started, you needn’t take it for life.
Sometimes, once all the factors that disturbed your thyroid function have been corrected, you may be able to reduce or discontinue the dose.
Careful monitoring is essential. Taking too much thyroid hormone or taking it if you don’t need it can lead to undesirable side effects, including anxiety, insomnia, palpitations, and, over the long term, bone loss.
How to get started:
1. Register with our practice
If you want to be looked after in our thyroid health clinic, you first need to register as a patient. Please click on the link below, complete our registration form and either email it to us at firstname.lastname@example.org or post it to:
CountryHealth, Cornwallis Chambers, 23 Great Colman Street, Ipswich, IP4 2AN
We would like to invite all of our patients at least once to our practice for a registration health check and a face-to-face consultation. If this is not possible at all, we can also arrange a telephone consultation - you can book the registration health check online or by calling Dena on 01473 218 373 during office hours. To book a face-to-face consultation with Dr Frey, please call Dena.
2. Provide Up-to-date blood results
If you have a complete panel of thyroid blood results not older then 3 months we can use them.
The results should at least include TSH, FT4 and FT3. If you had no antibody test in the past, TPO and TG antibodies should also be tested.
Ideally, you should also test your Vitamin D and Ferritin level together with Vitamin B12, Folate and hs-CRP. The Medichecks Ultravit is the perfect test for this. You can find a link to Medichecks Tests HERE.
You can come and see us for the blood test or use a remote service with Medichecks or Thriva who send test kits for self testing out or organise a nurse to come for a blood sampling [for an additional fee].
We recommend ordering the test kits through us as we will then get the results directly which will speed things up.
3. Order our Thyroid Report
Once we have your results, we prepare our Thyroid Report for you. It provides a lot of useful information about thyroid function, explains the different tests, recommends lifestyle and diet changes and supplements to help you get better.
Our treatment recommendations are not only based on numbers, but on how you feel. We will therefore send you a Direct Message and ask to complete an online questionnaire to find out about your current symptoms. For this we need a valid email address and mobile number.
We put your TSH, FT4 and FT3 on a scale of [-10] to [+10] in colour coded format to help you understand your results better. Based on our findings we make bespoke recommendations for treatment changes - if this is indicated. The fee for a private prescription is included in the report fee. We send the prescription to one of our partner chemists which will send you the tablets once you paid them directly. Our prescription is timed to last until the next test is due.
.We recommend to retest in 2-3 months if any adjustments to your treatment plan were necessary and to keep your NHS GP informed.
Use our services when you need them
Once you are registered, we can offer you all of our services.
Join our Thyroid Club
If you want to save some money, our Thyroid Club is just right for you. For a small monthly payment you are entitled to the following benefits: