Hypothyroidism - Primary

What Is Primary Hypothyroidism?

The thyroid gland, located in the front of the neck, plays a critical role in regulating metabolism, energy production, temperature control, and cellular repair. In primary hypothyroidism, the thyroid gland itself is impaired and unable to produce adequate levels of thyroid hormones despite proper signaling from the brain.

This condition differs fromsecondary hypothyroidism, where dysfunction originates in the pituitary or hypothalamus. In primary cases, the thyroid gland is the primary source of dysfunction, often due to autoimmune damage, nutrient deficiencies, or environmental toxins.

Recognizing the Symptoms

Because thyroid hormones influence nearly every organ system, the symptoms of hypothyroidism are diverse and often nonspecific, making diagnosis challenging without proper testing.

Common Symptoms Include:

• Fatigue and sluggishness
  
• Weight gain or difficulty losing weight
  
• Cold intolerance
  
• Dry skin and hair thinning
  
• Constipation
  
• Depression or mood changes
  
• Menstrual irregularities and fertility issues
  
• Muscle aches and stiffness
  
• Puffy face or swelling in extremities
  
• Slowed heart rate
  
• Hoarseness
  
• Elevated cholesterol levels

   

Over time, untreated hypothyroidism can impair cardiac, reproductive, and cognitive function.

Functional Medicine Approach to Diagnosis

At Intercoastal Health, we take a comprehensive view of thyroid function, integrating advanced testing and a detailed patient history to uncover the underlying contributors to thyroid dysfunction.

Key Diagnostic Tests:

• TSH (Thyroid Stimulating Hormone): Elevated TSH suggests the pituitary gland is trying to stimulate a sluggish thyroid.
  
• Free T4: Low levels confirm an underactive thyroid.
  
• Free T3 andReverse T3: Provide insights into peripheral hormone conversion and tissue activity.
  
• Thyroid Peroxidase Antibodies (TPOAb) andThyroglobulin Antibodies (TgAb): Elevations suggest autoimmune thyroiditis, particularly Hashimoto’s disease.
  
• Iodine, zinc, selenium, andvitamin D status evaluations.

   

Root Causes of Primary Hypothyroidism

Common Causes:

• Hashimoto’s Thyroiditis: Autoimmune destruction of the thyroid gland.
  
• Iodine Deficiency: Essential for thyroid hormone production.
  
• Nutrient Deficiencies: Zinc, selenium, iron, tyrosine, and vitamin D are critical cofactors.
  
• Medications: Lithium, amiodarone, and interferon-alpha can interfere with thyroid function.
  
• Radiation Therapy or Thyroidectomy: Direct loss of thyroid function.
  
• Environmental Toxins: Exposure to endocrine disruptors (e.g., BPA, fluoride, perchlorates).
  
• Chronic Stress: Cortisol dysregulation impairs T4 to T3 conversion.

   

Interfering Factors in Lab Interpretation

Several factors can complicate thyroid function testing:

• Acute illness or stress can transiently suppress TSH.
  
• Pregnancy or estrogen therapy can elevate thyroid-binding globulin.
  
• Corticosteroids or dopamine agonists can suppress TSH secretion.
  
• Biotin supplementation can falsely alter lab results if not discontinued before testing.

   

Clinical Implications of Untreated Hypothyroidism

• Cardiovascular Disease: Hypothyroidism elevates LDL cholesterol, promoting atherosclerosis and hypertension.
  
• Reproductive Challenges: Disrupts ovulation, menstruation, and pregnancy outcomes.
  
• Mental Health: Linked to depression, cognitive slowing, and mood instability.
  
• Myxedema Coma: A rare, life-threatening emergency due to extreme hypothyroidism.