You probably don't have an underactive thyroid after all

Typical scenario:  Female becomes fatigued and maybe a bit depressed, starts putting weight on or struggles to lose weight and more than likely is experiencing some gut symptoms, most commonly constipation and bloating.  Female lands in doctors office, and before she realises it she's taking "thyroid medication" but still struggling with symptoms.  In my observations this scenario then plays out to doctor and patient in an endless dance between testing and adjusting meds and little relief of long term symptoms.

At no point as anyone bothered to find out what is really going on have they.  I'm going to help you with that right now.


To do this, we need a basic 101 on thyroid and metabolism. 


There are few sciency bits, so don't skim read or you'll miss the good stuff.

  • TRH (Thyrotropin Releasing Hormone, produced in the brain by the Hypothalemus)
  • TSH (Thyroid Stimulating Hormone, produced in the brain by the Pituitary Gland)
  • T4 (Thyroxine, produced in the thyroid gland).
  • T3 (triiodothyronine, mostly produced in the liver).

THE THYROID HORMONE PATHWAY EXPLAINED IN 10 SECONDS: TRH tells the brain to release TSH.  TSH tells the thyroid to make T4 and some T3.  Most of T4 then takes a trip to the liver and becomes T3.  T3 and T4 need iodine and selenium for their conersions.  When the brain doesn't see enough T3 or T4 it sends out another TRH signal to make more TSH and the cycle continues.  Simple enough?

In this basic pathway there are so many points for this to go wrong.  The brain, the thyroid gland, the liver and the nutrients required for the conversions.  My point here, is that you DO NOT have an underactive THYROID.  You have a DYSFUNCTION IN THE THYROID PATHWAY and if you ever want to stand a chance of speeding that thyroid up again, you and your health practitioner have to understand this.


Now we need a quick 101 on the stress hormone pathway.

  • CRH (Corticotropin Releasing Hormone, produced in the brain, by the hypothalemus)
  • ACTH (Adrenocorticotropic hormone, produced in the brain, by the pituitary)
  • Cortisol (Glucocorticcoid produced in the adrenal glands)

THE STRESS HORMONE PATHWAY EXPLAINED IN 10 SECONDS.  Something happens, the amygdala, hippocampus and other areas of the brain light up, the hypothalemus releases CRH, which signals to ACTH to tell the adrenal glands to release cortisol to deal with stress.

Stress Hormones Block the Action of Thyroid Hormones
Yep, you heard me.  When the HPA Axis (Stress Response) is fired up, then the HPT Axis (Metabolic Response) takes a nap.  Now if all your thyroid hormones are being affected by stress hormones, why the hell are we taking thyroid hormones then?  Oh hang on I know, because doctors are too "busy" to research your case properly, and they know how difficult it will be to help you manage your stress and convince you that you don't need a pill.  Afterall, you went to the doctor hoping to get a pill to fix your problem didn't you?

By the way, we are talking chronic long term stress here with regards to stress and weight gain.  Short term acute stress (end of a relationhip etc) can lead to weight loss in some individuals, but as observed in my clinic, that joy never lasts, the weight comes piling back on, and we're still dealing with stress.

Liver Congestion affects the coversion of Thyroid Hormones
Remember, we said that the majority of T4 is converted to T3 in the liver.  If your liver is congested, or you have a fatty liver or you've had a viral infection to the liver then you will struggle to convert T4 to T3.  But guess what!  Instead of you having to address the problem properly, your doctor will just give you a pill...for the rest of your life mwahahahahahaaaaaaaaa!

Your Nutrition is very likely contributing to your problem
If you can't even bother to eat the food NEEDED to make thyroid hormones, then good luck to you ever finding a way through your metabolic issues.  It's all very well to take thyroxine or whatever, but how the hell are you going to convert your hormones if you still refuse to eat a good diet?  Not only that, if you are eating foods that you are intolerent to and firing up the stress hormone pathway, then you will be stuck in the dance of nutrition creating stress creating thyroid slowdown.  If you wanna mop your floor, you better sweep it first.  If that didn't make sense, before you go crying to the doctor, get your lifestyle and nutrition sorted first, you may be able to fix your thyroid function yourself just by eating well and leaving out diagnosed food intolerences.

Yeah, ok sometimes it is the Thyroid Gland - or is it really the Gut?
In Hashimotos (an autoimmune condition) the body mounts an immune response against the thyroid gland.  And yes, the gland itself may need some support.  Your immune system is in your gut, and when we have poor function here (leaky gut, crypt hypoplasia, etc) we end up with things like food intolerences (where the immune system attacks your food) and autoimmune conditions (where the immune system attacks you!).  You might want to get that gut repaired, or Hashimotos might not be the only autoimmune condition you end up with. 

Now this will explode your brain.  What if, you had Hashimotos AND a congested liver.  Hmmm, now we're talking about a client who has been giving thyroid meds but the LIVER still can't complete the conversions properly.  Oooooooh, but what if stress hormones were also interferring with the meds.  Holy Thyroid Batman!!!  Yeah, that's right, even you guys with Hashimotos can't just sit there and blame your problems on the gland 100% either.

Oh and BTW, gut dysfunction is an INTERNAL STRESSOR.  So if you think you're not stressed out, you might be wrong.

Don't forget the brain
Let's say you are one of these holistically smart thinkers and you have done ALL the medical stuff and ALL the natural stuff, you've done all the gut repair and stress management and your liver is as clean as a whistle and you follow a nourishing diet.  In theory, you should be feeling on top of the world.  If not, then either one of these pathways hasn't been cleaned up properly (hey, it happens) or there might be something going on up in the brain with those first signalling hormones.  At this point you are probably under the care of an endocrinologist.  I have a client who has a small tumour on her pituitary gland, it is not causing major issues except that it is affecting the thyroid hormone pathway.  This girl does not have an "underactive thyroid" does she?  And this is my point, not all slow metabolisms are "underactive thyroids".

While we're here, we better just pay respect to our genes.  Yes sometimes it just goes wrong genetically, don't you panic though, most thyroid path dysfunction is not at this level.

My name is Stacey and I have a slow thyroid function.
Say this after me "I have a slow thyroid function".  Replace the words "underactive thyroid" and call it what it is, "slow function of the pathway".

Are you about to cry yet?
Depression and hopelessness is a common symptom of poor thyroid pathway function.  So if you are about to cry over this information, it's normal.  It's also normal to feel a bit sad about the fact that perhaps your long term thyroid battle could have been solved by now.  It's also normal to feel upset and overwhelmed about where you are going to start this holistic journey.  It's very normal to feel confused and upset, after all, this is new information to you and it wasn't given to you by your doctor... the very MD that you should be able to trust.

You may also be upset that your Naturopath, Herbalist etc hasn't gone this in depth with you either. It's ok, every practitioner is working to their level of knowledge, if they don't know - perhaps we can teach them too!  There was a time I didn't know this stuff either.  Everyone is doing the best they can with the knowledge and time they have.  Remember also, if you want an MD to spend an hour with you, it's going to cost you $120+, if you want your naturopath to spend 2 additional hours researching your case you can pay them to do that.  You DO have that option.

A ray of hope
You can trust your MD.  But for now, he/she just doesn't have the time or skills to be holistic with you.  It's ok, because there are plenty of natural health practitioners who can help with the underlying causes, while allowing you to remain on your thyroid medication.  You can do both for now!

As an FDN (Functional Diagnostic Nutritionist) it is my job to look at your thyroid numbers holistically along with the rest of your hormones, gut and liver function.  It is my job to clean up the dysfunctions in these areas, allowing your thyroid pathways a clean and clear run.  We are able to undertake targetted lab testing to find hidden dysfunctions within the body and we can use all those lovely blood tests from your doctor to find out what part of the thyroid pathway is struggling and what we need to do to correct it.

If your natural health expert doesn't agree with this blog, or understand the information then they are probably going to be unable to help you either.  On that note, if you do have a natural health person who disagrees with this, I'd love to hear from them, so I can help their knowledge base.

Go forth and rejoice!
I don't know about you, but I don't want ANY gland or organ failing before I'm at least 90 years old, so to learn that we might not have an underactive thyroid is pretty cool huh? 

What?  No?

If you're still not convinced after I've just given you textbook information on hormone pathways, or if you've stuck your head in the sand because its "all too hard" then best of luck to you and your metabolism.