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Thyroid Dysfunction: 7 Diagnostic Factors Your Doctor Isn’t Checking


Reviewed by Dr. Wally Taylor of Forum Health Austin

Millions of Americans suffer from some sort of thyroid dysfunction. What’s shocking is that most people don’t even know it. The American Thyroid Association estimates that one in eight women will develop a thyroid disorder in her lifetime, suffering from unpleasant and debilitating symptoms. 


To better understand thyroid conditions, it’s important to know about the three main disorders we commonly see with imbalanced thyroid hormones: Thyroiditis, Hypothyroidism, and Hashimoto’s. Here’s what you need to know about each.  



Thyroiditis is a general term that refers to inflammation of the thyroid gland. There are several types of thyroiditis, including Hashimoto’s thyroiditis, subacute thyroiditis, silent thyroiditis, and postpartum thyroiditis. 


The causes of thyroiditis vary depending on the type. Hashimoto’s thyroiditis is caused by an autoimmune reaction, while subacute thyroiditis is often caused by a viral infection. Silent thyroiditis and postpartum thyroiditis are believed to be related to immune system changes during pregnancy. 


Symptoms of thyroiditis can vary depending on the type but may include fatigue, weight changes, neck pain or swelling, palpitations, and mood changes. It is typically diagnosed through blood tests to measure thyroid hormone levels and antibodies, and imaging tests like ultrasound. 


Treatment for thyroiditis depends on the type and severity of the condition. Treatment may include medications to reduce inflammation, thyroid hormone replacement therapy, or in some cases, surgery to remove part or all of the thyroid gland. 


Hashimoto’s Thyroiditis 

Hashimoto’s thyroiditis is an autoimmune condition where the immune system attacks the thyroid gland, leading to inflammation and damage. It is the most common cause of hypothyroidism.  


The exact cause of Hashimoto’s thyroiditis is not known, but it is believed to be a combination of genetic, environmental, and hormonal factors. Symptoms are similar to hypothyroidism and can include fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation, and depression. 


Conventional treatment involves taking synthetic thyroid hormone medication to replace the hormones that the thyroid gland is not producing enough of. 



The most common problem we see with the thyroid is called hypothyroidism, which means the thyroid is underactive and slows down all metabolic processes in the body. 


Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. This can lead to symptoms such as fatigue, weight gain, constipation, dry skin, hair loss, and sensitivity to cold.  


The most common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune condition where the immune system attacks the thyroid gland. Other causes include thyroid surgery, radiation therapy, certain medications, and congenital factors. 


Treatment for hypothyroidism usually involves taking synthetic thyroid hormone medication to replace the hormones that the thyroid gland is not producing enough of. 


It’s important to consult with a healthcare provider for proper diagnosis and treatment if you suspect you have any of these conditions. Schedule a visit with your Forum Health provider to discuss your thyroid health. 


If you have been diagnosed and are being treated for thyroid dysfunction or you have the symptoms listed above and suspect you thyroid is out of whack, be aware of these common missteps conventional doctors make in diagnosing thyroid dysfunction. 

1. You have the symptoms, but they don't check for thyroid dysfunction

If you have conditions such as fibromyalgia, chronic fatigue, or an autoimmune disease, your symptoms often will overlap with thyroid dysfunction and your doctor simply may not order thyroid lab testing. 


Symptoms of thyroid dysfunction can be vague and often mistaken for signs of aging or stress. If someone is suffering from fatigue, anxiety, hair loss, weight gain, depression, or other symptoms they may just think that’s what happens as you age, however this is not the case. With that said make sure your doctor is testing for a complete thyroid panel on your next checkup. 

2. They don’t test ALL thyroid markers 

When your doctor checks thyroid levels, they commonly check two thyroid markers called thyroid stimulating  hormone (TSH) and T4. Medical doctors typically use TSH levels as the key marker in diagnosing thyroid dysfunction, this is because the majority of patients suffer from under active thyroid in which TSH would be elevated. 


At our office we recommend everyone have extensive blood work testing that includes a complete thyroid blood panel so that we are able to get a whole picture of how your thyroid is functioning. 

3. They rely on a “normal” range instead of optimal levels 

Many patients come to our office saying their doctor told them their thyroid levels are normal, however they still have symptoms. As a functional medicine clinic, our optimal thyroid ranges are much narrower. This is so that we can catch thyroid dysfunction sooner rather than later. 

4. They don’t test for autoimmunity 

Thyroid problems are epidemic right now. 90% of low thyroid (hypothyroidism) is autoimmune, this is a condition called Hashimoto’s. Hashimoto’s is not a problem with your thyroid itself, it is the immune system that is attacking the thyroid. Conventional medicine uses the same treatment protocol for autoimmune and non-autoimmune thyroid dysfunction. 


We understand that there is a difference and that if your condition is autoimmune, there is a different treatment plan. Many factors such as diet, gut health, toxins, infection, and stress are the root causes to this thyroid dysfunction and that’s what we address. 

5. They don’t test for nutrient deficiencies 

Listed below are vital nutrients that are needed for optimal thyroid function. These nutrients help you produce thyroid hormones that convert them from their storage form to active form. In addition they help support healthy immune function. 


  • Iodine 
  • Tyrosine 
  • Selenium 
  • Zinc 
  • Iron 
  • Vitamin A 
  • B vitamins 
  • Vitamin D 
  • They don’t test hormone levels 


Stress hormones and estrogen levels have a remarkable impact on thyroid function. The primary stress hormone, cortisol, can lead to underproduction of thyroid hormones. This impacts thyroid receptors causing the thyroid hormones to stay in their inactive state where our body cannot use them properly. 


Patients who suffer from adrenal fatigue, due to chronic stress, may also have some thyroid dysfunction. Women who are on birth control pills may also suffer from thyroid problems due to the excess estrogen that binds up the thyroid hormones. 

6. They don’t address the root cause of the thyroid dysfunction 

So many patients come into our clinic who are on thyroid medication such as levothyroxine, however they’re still experiencing the same symptoms such as brain fog, fatigue, thinning nails and hair, weight gain or weight loss resistance etc. Why is this? Their conventional doctor may have run a few thyroid labs and put them on medication to help with the symptoms, which  may have worked at first, but they are not addressing the root cause of their thyroid issue. They may not be looking at the whole picture or the person as a whole. They may not be addressing all of the factors that influence thyroid function. Environmental factors play a huge role in thyroid health some include leaky gut, diet, toxins, chronic infection, and stress. 


As opposed to a conventional doctors approach, in functional medicine we spend far more time learning about our patient’s’ health history, we order comprehensive blood work, and find ways to optimize lifestyle changes specific to each person. We know there is no magic pill and while this approach takes time and commitment, it leads to far better results! 

7. They don’t understand that symptoms of thyroid disease can mimic other disease processes and can only be treated once these causes are identified 

Tests other than thyroid may be necessary to identify mitochondrial disorder, other hormonal disorders, environmental toxic illness and persistent infections causing inflammation that often acts like thyroid disease. 

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