Northeast Wisconsin
  • Northeast Wisconsin
  • January 2014
Written by  Randi Mann, NP

Be proactive in getting an accurate hypothyroidism diagnosis

Symptoms of underactive thyroid are very common! Find a provider who believes in treating YOU and ALL of your symptoms, and who doesn’t rely solely on the TSH lab result!

Are you one of the millions of people whose doctor said your thyroid is working “just fine” because he/she only tested your TSH (thyroid stimulating hormone) level and the test result came back “in the normal range”? Or are you taking a “T4 only” thyroid medication (e.g., Synthroid) now, but your symptoms are still present?

In America, there are approximately 30 million people suffering from symptoms of underactive thyroid — a condition called hypothyroidism. Sadly, approximately 13 million people are yet to be diagnosed. Many people, once diagnosed, are still undertreated. Do you suffer from any of the following?

  • Tiredness and sluggishness.
  • Dryer hair or skin.
  • Gain weight easily.
  • Weaker muscles.
  • Constant feeling of cold (fingers/hands/feet).
  • Frequent muscle cramps.
  • Poorer memory.
  • More depressed.
  • Frequent mood changes.
  • Slower thinking.
  • Puffier eyes.
  • Difficulty with math.
  • Hoarser or deeper voice.
  • Constipation.
  • Coarse hair/hair loss/
    brittle hair.
  • Muscle/joint pain.
  • Low sex  drive/impotence.
  • Puffy hands and feet.
  • Unsteady gait 
    (bump into things).
  • Loss of outer third of eyebrow/thin.
  • Menses more irregular.
  • Heavier menses (clotting/3+ days).
  • Carpel tunnel syndrome.
  • Sleep more than usual.

If you have many of these symptoms, you may want to consider seeking treatment from a functional medicine provider — one who is trained to identify multiple causes and to treat many hormone imbalances, including hypothyroidism. A functional medicine approach is very comprehensive and may include the following lab tests:

  • Free T3.
  • Free T4.
  • TSH.
  • Reverse T3.
  • Estrogen.
  • Progesterone.
  • Testosterone.
  • DHEA.
  • 2 or 4 point cortisol.
  • B12 and folate.
  • TPO antibodies.
  • TG antibodies.
  • Ferritin.
  • Vitamin D 25 OH.

Hypothyroid symptoms may seem nonspecific. They may overlap with symptoms related to other conditions, such as food allergies, adrenal dysfunction, iron deficiency and hormonal imbalances. Careful evaluation of your symptoms, lab results, physical exam, deep tendon reflex speed, diet, medical and family history, and toxin exposure should be used to create a personalized treatment plan for you. This is important because each person may have different contributing factors that need to be addressed:

  • A poor diet that is low in iodine, L-tyrosine, zinc and selenium, which are vital components that the body needs to manufacture thyroid hormones. A pharmacy-grade, well-formulated, multivitamin and mineral supplement, along with eating a well-balanced, nutrient-dense diet is recommended in this case.
  • Hashimoto’s thyroiditis, a condition where the immune system starts to attack the thyroid gland. This patient may have elevated thyroid antibodies and may experience swings between hypothyroidism and hyperthyroidism symptoms (e.g., heart palpitations, fast heart rate, insomnia, hand tremors, sweating, nervousness, etc.) until their thyroid eventually is not able to function. This person’s treatment would include thyroid medication and education about ways to decrease the inflammation in their body.
  • Food and chemical sensitivity testing may be helpful to identify substances that may be causing low-grade, chronic inflammation. Reaction to gluten (the protein in wheat, rye and barley) may cause systemic inflammation for many, so it may be necessary to eat gluten-free for life.
  • Disrupted GI flora can also contribute to malabsorption, poor detoxification of toxins and poor conversion of T4 to the biologically active hormone T3.
  • Stress can cause high cortisol and estrogen levels, which prevent ovulation and are common in times of hormone transition, such as perimenopause. Female hormone testing and prescription progesterone therapy may be helpful. Certain supplements, foods and more fiber may be prescribed to help increase the clearing of excess hormones from the body.
  • Low vitamin D levels affect the cellular thyroid receptor response.
  • Low ferritin levels decrease the transport of thyroxine into the cell nucleus.

It is preferable that your lab values, including your thyroid, vitamin D and ferritin levels, be at the optimal end of the normal lab ranges. Many patients may respond better to a combination of T4 and T3 hormone medication.

As you can see, a TSH test alone may not properly diagnosis hypothyroidism, and it may take more than Synthroid medication to help you feel your best. At our wellness center, we offer a specialized, computerized assessment of the speed of your deep tendon reflex in your arm, along with thorough physical and symptom assessments and a personalized treatment plan. This information is invaluable to determine if you need to start thyroid medication or have your current level of medication adjusted.


Randi Mann, WHCNP-BC, NCMP, is the owner of Wise Woman Wellness LLC, an innovative wellness center in De Pere. She is a functional medicine provider offering natural treatments and prescription medications for thyroid and hormone imbalances, including customized, low-dose, bioidentical hormones. Please attend the seminar, Hypothyroidism — Why Do I Still Feel Bad If My Lab Results Are “Normal”? on 1/14/14 at 5:30 p.m. For details, visit http://wisewomanwellness.com. Call 920-339-5252 to register.

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