Our endocrine system is one of the most important and most complex systems in the human body. All our body’s hormones, and the organs that produce them, make up our endocrine system. Specifically, our thyroid gland is a butterfly-shaped gland that resides at the base of the neck and is responsible for producing hormones that coordinate activities of the heart, brain, liver, kidneys, skin, and our metabolism. It is estimated that 52 million people in the United States have some form of thyroid disease and up to sixty percent of individuals with thyroid disorders are unaware.

The most well-known and most common thyroid disorder is hypothyroidism. Hypothyroidism occurs when there is an under-production of thyroid hormone or when the body does not use the thyroid hormone efficiently. Hashimoto’s thyroiditis is the most common form of hypothyroidism and occurs due to underactive thyroid with an overactive immune (autoimmune) response. Generally, laboratory findings of hypothyroidism consist of a high TSH and low T3 and T4.

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Why is our thyroid so complex?

First, our thyroid functions as a negative feedback loop. This means that hypothyroidism or the under-production of thyroid hormone causes the TSH levels to rise (high TSH = hypo/low thyroid). There are 3 main components of the thyroid hormone.

  • TSH (Thyroid Stimulating Hormone): TSH is released from the pituitary gland that resides in the brain. TSH differs from the other thyroid hormones in that it does not directly affect organ function (other than the thyroid gland), muscles, bones and tissues. Therefore, TSH provides information about hormone levels in the brain and not the peripheral tissues.
  • T3 (triiodothyronine) and T4 (thyroxine): T3 and T4 are the two main thyroid hormones made by the thyroid gland. T4 is produced in a greater amount than T3 (17:1), but T3 is 300% more biologically active at the cellular level than T4. Therefore, low T3 levels at the cellular level are responsible for symptoms of thyroid disease. In other words, T4 is the primary hormone released from the thyroid gland and the majority of T3 is produced when the body converts T4 to T3 in the liver, gut, brain, and skeletal muscle.
  • Total T3 and Total T4: Total T3/T4 is the combined amount of bound and unbound (free) thyroid hormone in the body. Bound T3/T4 is attached to a protein carrier. This protein carrier transports the thyroid hormones (T3/T4) throughout the body.
  • Free T3 and Free T4: Free T3/T4 hormones are separated from the protein carrier and make up the active form of thyroid hormones that can bind to cell receptors and be used by the body. Free T3 and free T4 are the only thyroid hormones that are available for the body to use.
  • Reverse T3 (rT3): rT3 is chemically similar to T3, but is completely inactive and lowers the amount of active T3 available. RT3 essentially ‘reverses’ T3. High levels of rT3 are caused by nutrient deficiencies, low levels of selenium, excess physical/mental/environmental stress, adrenal compromise, and high toxic burden.

Why the confusion?

Often, thyroid function is only tested by checking TSH levels, however, this only assesses the thyroid hormone level in the brain and not the peripheral tissues. Because the level of thyroid hormone in the peripheral tissues is what contributes to symptoms of thyroid disorder, diagnosing hypothyroidism is often missed. Some doctors will also check T4 with TSH, but remember that T4 is 300% less active than T3. T4 is checked because the first line treatment for hypothyroidism is levothyroxine (Synthroid, Levothroid, Levoxyl) which is synthetic T4 only. Remember, T4 is converted into the active T3, however, many people have difficulty converting T4 to T3 and therefore only testing and treating T4 levels can lead to lack of symptoms improvement. When a full thyroid panel is completed, we often find normal amounts of total T4 and total T3 and not enough active/free T4 and active/free T3.

Our endocrine system, especially our thyroid, is complex and extremely important for regulating all other bodily functions. Unfortunately, thyroid disease is often underdiagnosed and mismanaged which can lead to poor quality of life and long term decline in health over time. At Flourish Medical + Wellness, we understand the significance of the endocrine system and take the time needed to adequately assess, diagnose, and treat endocrine and thyroid disorders.

image of woman rubbing her neck where the thyroid is

What causes thyroid disease?

  • Stress
  • Depression
  • Weight gain
  • Leptin resistance
  • Insulin resistance
  • Diabetes mellitus
  • Low testosterone
  • Toxins
  • Autoimmune disorders
  • Iron deficiency anemia

What are symptoms of thyroid disease?

  • Cold, tired, fatigued, weakness
  • Thin hair, thin skin, thin nails
  • Dry, rough, pale skin and hair loss
  • Weight gain, increased body fat
  • Loss of energy & motivation
  • Loss of cognition, memory, mood
  • Poor sense of well-being, depression
  • Infertility, loss of libido, menstrual irregularities
  • Constipation, compromised gut motility


What does the body need for optimal thyroid function?

  • Tyrosine (facilitates conversion of T4 to T3)
  • Iodine (but not too much) (facilitates conversion of T4 to T3)
  • Selenium (facilitates conversion of T4 to T3)
  • Antioxidants
  • Iron (facilitates conversion of T4 to T3)
  • Vitamin A
  • Vitamin E
  • Glutathione
  • B vitamins
  • Zinc (facilitates conversion of T4 to T3)
  • Potassium

What foods help support thyroid function?

  • Steamed vegetables
  • Poultry
  • Fish
  • Organic eggs
  • Omega-3 fatty acids

What foods worsen thyroid function?

  • Sugar
  • Coffee
  • Dairy
  • Gluten
  • Refined sugar
  • Soy


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