The notoriously missed underlying factors causing hypothyroidism
- Renee Grandi
- Apr 14
- 4 min read
Updated: 6 days ago
If you've ever been told your thyroid is "fine" while feeling anything but exhausted, gaining weight, losing hair, emotionally flat, anxious, or constantly cold — you're not alone. Many women are told that their symptoms are unrelated to their thyroid simply because their TSH (thyroid-stimulating hormone) falls within the standard range. But here's the truth: thyroid dysfunction is rarely isolated. More often, it's a symptom of a deeper imbalance in the body. And if you're not looking at the full picture, you're missing vital answers.
The Thyroid Doesn't Fail Without a Reason
The thyroid gland is a responsive organ. It's sensitive to what's happening across multiple systems: the gut, liver, immune system, adrenal glands, and even the brain. When your body is physically, emotionally, immunologically, or nutritionally stressed, the thyroid often downregulates as a protective response.
Think of it less like a broken gland and more like a thermostat that’s been turned down to conserve energy. Your body is smart. It may reduce thyroid output to protect you if it senses inflammation, infection, micronutrient depletion, or chronic stress.
That’s why addressing the thyroid in isolation with medication — without asking why it’s slowing down in the first place — often doesn’t work.
Signs and Symptoms of Thyroid Dysfunction
You don’t need to have all of these to qualify. Often, just a few are enough to indicate your thyroid needs attention:
Persistent fatigue (especially morning sluggishness)
Weight gain or difficulty losing weight
Cold hands and feet, or heat intolerance
Hair thinning or loss (especially outer third of the eyebrows)
Brain fog or memory issues
Mood changes (depression, anxiety, low motivation)
Menstrual irregularities or heavy periods
Dry skin, brittle nails
Puffy face or swelling
Constipation
Low libido
These symptoms can occur even with a "normal" TSH, which is why comprehensive thyroid testing is essential.
What to Actually Test (Beyond TSH)
To understand thyroid health properly, you need to look beyond TSH. Here are the tests I run in clinic:
TSH (Thyroid-Stimulating Hormone): A signal from the brain to the thyroid. High = underactive; low = overactive.
Free T4: The primary hormone made by the thyroid. Inactive but necessary.
Free T3: The active thyroid hormone that regulates metabolism. Low levels cause symptoms even if TSH is normal.
Reverse T3: An inactive version of T3, often elevated during stress, inflammation, or chronic illness. It blocks active T3 from working.
TPO and Tg Antibodies: Autoimmune markers for Hashimoto's thyroiditis (hypothyroidism) and Graves' disease (hyperthyroidism).
Nutrient Depletions That Impact Thyroid Function
Your thyroid can’t function without key nutrients. Even suboptimal levels can disrupt hormone production, conversion, or receptor sensitivity.
1. Iron (Ferritin)
Iron is essential for the conversion of T4 into T3, the active thyroid hormone. Low ferritin (<70 µg/L) can result in fatigue, hair loss, and low T3 levels even if your thyroid is producing enough hormone.
2. Zinc
Zinc is required for TSH production, T4-to-T3 conversion, and immune modulation. Zinc deficiency is common in women with digestive issues, heavy periods, or stress.
3. Selenium
Selenium supports the deiodinase enzymes that convert T4 into T3. It also protects the thyroid from oxidative damage and reduces thyroid antibodies.
4. Magnesium
Magnesium is needed for ATP production, enzyme function, and nervous system regulation. Chronic stress and inflammation deplete it quickly.
5. Vitamin D
Vitamin D plays a critical role in immune regulation and autoimmunity prevention. Low levels are common in Hashimoto’s and can worsen antibody levels.
6. B12 + Folate
Vital for methylation, red blood cell production, and neurological function. Deficiency can mimic or worsen hypothyroid symptoms like fatigue, brain fog, and mood issues.
7. Iodine (with caution)
Iodine is a raw material for thyroid hormone, but too much can trigger or worsen Hashimoto's. Testing is essential before supplementing.
Biochemical Connections You Shouldn’t Ignore
The thyroid is part of an intricate hormonal and neurological web. When it's not functioning properly, you must investigate what’s affecting it:
Cortisol & HPA Axis: Chronic stress raises cortisol, which suppresses TSH, increases reverse T3, and depletes T3.
Gut Health: Over 20% of T4-to-T3 conversion happens in the gut. Dysbiosis, leaky gut, and infections can all impact thyroid health.
Liver Function: The liver converts over 60% of T4 to T3. Poor liver detoxification or congestion blocks this process.
Sex Hormones: Oestrogen dominance lowers thyroid hormone availability. Progesterone deficiency impairs T3 receptor sensitivity.
Mitochondrial Function: Without enough cellular energy (ATP), the thyroid can't signal effectively or convert hormones optimally.
The Root-Cause Approach to Thyroid Healing
When we approach thyroid dysfunction from a root-cause perspective, we shift the goal from “managing symptoms” to “healing the system.”
That includes:
Full pathology testing (thyroid + nutrients + inflammatory markers)
Treating gut inflammation and restoring the microbiome
Addressing stress + nervous system regulation (vagus support, adaptogens, trauma work)
Rebalancing hormones and detox pathways
Restoring mitochondrial health with nutrients, sleep, movement, and anti-inflammatory nutrition
Final Thoughts
If your thyroid isn’t working properly, it’s not always the root issue — it’s the messenger of deeper imbalances. And the good news is: when you investigate what’s underneath, support your system comprehensively, and give your body what it needs, the thyroid often begins to recover naturally.
Don’t settle for being told you're "fine" if you still feel flat, fatigued, or out of alignment. You deserve answers. You deserve healing. And most importantly, you deserve to feel like yourself again.
Kommentare