Five out of 100 adults in the United States have hypothyroidism. Up to 60% are unaware they even have hypothyroidism. It’s more critical than ever to know what hypothyroidism looks like, where to get diagnosed, and how to permanently reverse it.
Even what conventional doctors call “permanent hypothyroidism” can be reversed most of the time. Here at PrimeHealth, our patients prove it!
The sooner you start addressing your hypothyroidism, the easier it will be to reverse.
If you may have hypothyroidism, sign up here for a free 30-minute consultation! If you want to learn more, we spell everything out below in simple English.
What is primary hypothyroidism?
Hypothyroidism means “underactive thyroid.” Your thyroid gland is a butterfly shaped organ that produces and secretes hormones, which controls your metabolism.
To stimulate your thyroid, the pituitary gland releases thyroid-stimulating hormone (TSH). TSH tells your thyroid to produce and secrete T3 and T4 hormones. If you have primary hypothyroidism, your thyroid isn’t producing enough T3 and T4, despite this signal.
In primary hypothyroidism (also called “hypothyroidism primary”), your thyroid is unable to maintain adequate T3 and T4 levels. The problem is with your thyroid. (In secondary and tertiary hypothyroidism, the problem lies more with your pituitary gland.)
Primary vs. Secondary vs. Tertiary vs. Subclinical Hypothyroidism
The differences between primary, secondary, and tertiary hypothyroidism are quite simple. It all depends on which of the interconnected hormone-secreting glands is underactive.
Primary hypothyroidism refers to a problem with the thyroid gland itself. Hypothyroidism primary results in low levels of thyroid hormones T3 and T4 and high circulating TSH.
Secondary hypothyroidism is when the thyroid gland functions normally, but a disorder in the brain causes lower signaling of the pituitary gland. This lessens secretion of TSH — also called thyrotropin, which also leads to low T3/T4.
Subclinical hypothyroidism is when the thyroid is normal, but the pituitary gland produces too much thyrotropin, often due to acute inflammation, like what you might see during a hospital stay. In some cases, this can progress into overt hypothyroidism.
Is Hashimoto’s primary hypothyroidism?
Hashimoto’s disease (also called Hashimoto’s thyroiditis or autoimmune thyroiditis) is an autoimmune disease closely related to thyroid disease.
90% of primary hypothyroidism cases are a result of Hashimoto’s. However, they are not the same condition.
What is the most common cause of primary hypothyroidism?
The most common cause of primary hypothyroidism is Hashimoto’s disease — 90 percent of cases, in fact.
Hashimoto’s disease can be triggered by a number of risk factors:
- Hormone imbalance — If your hormone levels are out of whack (not only your thyroid hormone levels), this can cause Hashimoto’s to flare up. Thyroid hormone replacement therapy may solve this problem.
- Infections — Tick-borne infections (like Lyme disease) and viral infections (like Epstein-Barr) may lead to Hashimoto’s disease and, therefore, hypothyroidism.
- Food sensitivities — Food allergens can trigger Hashimoto’s disease. For instance, celiac disease (a gluten allergy) has been linked to increased risk of autoimmune disease, such as Hashimoto’s.
- Nutrient deficiency — Nutrient deficiencies can trigger Hashimoto’s disease. The most common nutrient deficiency that leads to primary hypothyroidism is iodine deficiency.
- Toxin exposure — Harmful toxins wreak havoc on your health, especially your thyroid. Heavy metal exposure, mold toxins, and exposure to chemicals like pesticides and other industrial chemicals can trigger Hashimoto’s. Daily workplace exposure to toxins is one possible cause of hypothyroidism that should not be overlooked.
- Leaky gut — When the lining in your gut is chronically inflamed, the tight junction proteins in your intestinal wall may weaken and allow toxins to get into the bloodstream that would otherwise be flushed out. Called leaky gut syndrome, this is both a cause and a symptom of Hashimoto’s and, consequently, primary hypothyroidism.
Other causes of hypothyroidism include:
- Certain pharmaceuticals (like amiodarone)
- Postpartum thyroiditis
- Thyroid injury
- Subacute thyroiditis
- Thyroid cancer
- Radioactive iodine therapy
- Over-treatment of Graves’ disease, which itself causes hyperthyroidism (overactive thyroid).
What are the symptoms of primary hypothyroidism?
Symptoms of hypothyroidism are different from person to person. They will also depend on how far along you are in the disease and your individual levels of TSH, T3, and T4.
- Enlarged thyroid (goiter)
- Weight gain
- Muscle/joint pain
- Hoarse voice, snoring
- Puffiness in the face
- Dry skin
- Thinning hair
- Brittle nails
- Cold intolerance
- Myxedema coma, in severe situations
Diagnosis of Hypothyroidism Primary
When discussing the diagnosis of thyroid disorders, there are conventional methods, and there are more functional methods, which we use here at Prime Health Denver.
Though some only test for TSH levels and free T4 levels, conventional healthcare providers might use these two methods to diagnose thyroid disease:
- Thyroid function test makes sure TSH levels are at a normal range, and you don’t have low serum T3 and/or T4 levels. (When your thyroid is underactive, your pituitary gland will make more TSH. So higher levels of TSH indicate thyroid problems.)
- Antibody test can identify certain antibodies that your body would release if you have Hashimoto’s. (One in ten people have these antibodies, but their thyroid function is normal.)
However, we at PrimeHealth take a comprehensive approach to diagnosis. With blood tests, we assess:
- Serum TSH
- Total T4/T3
- Free T4/T3
- Reverse T3
- Anti-thyroid peroxidase (TPO), anti-thyroglobulin (Hashimoto’s antibodies)
- Thyroid-binding globulin (TBG)
Normal range of TSH levels, for instance, should fall between 0.4 mIU/L and 4.0 mIU/L (milli-international units per liter). However, the optimal range for TSH is generally 0.5 to 2.5 mlU/L.
If you work around toxins, we would focus our diagnostics on identifying those toxins.
For pregnant women, we approach diagnosis and treatment with that in consideration.
We sometimes also check for hyperthyroidism (hyper, not hypo). Hyperthyroidism exhibits a few similar symptoms, and over-treatment of an overactive thyroid can actually trigger an underactive thyroid.
Diagnostic plans should be individualized for each unique patient. Diagnosis can take hours of investigation, but we believe it’s worth it to be able to, in many cases, permanently reverse hypothyroidism.
Conventional Treatments & Limitations
How is primary hypothyroidism treated? It depends on who you ask.
Conventional medicine says primary hypothyroidism can almost never be reversed. These doctors go about the treatment of hypothyroidism by subscribing you pharmaceuticals indefinitely.
An endocrinologist might prescribe a dose of levothyroxine (brand name Synthroid), a synthetic T4 hormone. Levothyroxine is the most common hypothyroidism medication.
In 2004, the FDA approved the use of generic levothyroxine in place of brand-name Synthroid. However, the Endocrine Society, the American Thyroid Association, and the American Association of Clinical Endocrinologists did not agree with the FDA’s conclusion that generic levothyroxine was as high-quality as the brand-name equivalent.
PrimeHealth would disagree further, arguing that traditional medication, including levothyroxine, is often unnecessary and sometimes harmful.
Here is a condensed list of side effects for levothyroxine:
How to Reverse Hypothyroidism
Is primary hypothyroidism curable? The thyroid experts at PrimeHealth would say YES, it’s curable. We talk more in depth about how to permanently cure hypothyroidism in this article — the most important takeaway being that each person is dealing with a specific set of triggers. There’s not just a one-size-fits-all approach.
But here is a quick rundown on how to permanently reverse primary hypothyroidism and become euthyroid (have a normal functioning thyroid).
First, a hypothyroidism diet can be quite restrictive, in part to determine if you have any food sensitivities. We suggest the Autoimmune Paleo Diet for the best results, which should be used for anywhere between 1-6 months.
Foods to avoid:
- Nuts, seeds
- Nightshade vegetables
- Vegetable oils
- Alternative sweeteners
- Processed foods
Food to eat:
- Non-nightshade vegetables
- Cruciferous vegetables
- Herbs like garlic, turmeric
- Green tea
- Small amounts of honey, maple syrup, fruits
There are also natural dietary supplements that can help reverse primary hypothyroidism:
- Iodine helps prevent autoimmune diseases like Hashimoto’s. Iodine deficiency is a leading cause of goiters, a thyroid disorder.
- Probiotics treat leaky gut, a major risk factor for Hashimoto’s and hypothyroidism.
- Glutathione fights oxidative stress, which can increase the severity of hypothyroidism if left unchecked.
Hypothyroidism and Stress
Finally, stress is a major risk factor in developing thyroid dysfunction. Alleviate stress with:
Hypothyroidism and Safe Medication
If we feel medication is safe and necessary, we will prescribe a levothyroxine (or synthroid), desiccated thyroid medication of T4 and T3 (ratio 4:1), or a compounded synthetic combination of T4 and T3 that can be personalized for your unique situation.
While desiccated thyroid gland medications, like Armour Thyroid and Nature Throid, offer a more complete composition of T4, T3, and even the less commonly known thyroid hormone T2, it can sometimes cause a worse autoimmune reaction in people with Hashimoto’s thyroiditis. This is why having the ability to compound a medication with synthetic T3 and T4 in the ratio of our choosing, is such a wonderful option. It allows us to give a more complete thyroid treatment, without any added autoimmune reactivity, which is completely personalized to the individual.
Outlook for Patients with Primary Hypothyroidism
We at PrimeHealth believe primary hypothyroidism — sometimes called permanent hypothyroidism — can be reversed. The long-term outlook for hypothyroid patients should be hopeful.
A hypothyroidism-healing diet can be tough to get used to. However, without the side effects of all those pharmaceuticals, your quality of life should increase overall. And your body will probably thank you for the healthier diet anyway.
If you think you have hypothyroidism (and live in the greater Denver area), sign up here for a free 30-minute consultation!
- Primary hypothyroidism refers to an underactive thyroid. (Secondary hypothyroidism refers to an underactive pituitary gland, and tertiary hypothyroidism refers to an underactive hypothalamus.)
- Hashimoto’s disease causes 90 percent of hypothyroidism cases. Hashimoto’s is an autoimmune disease caused by:
- Hormone imbalance
- Food sensitivities
- Nutrient deficiencies
- Toxin exposure
- Leaky gut
- Symptoms of primary hypothyroidism include:
- Muscle/joint pain
- Dry skin
- Cold intolerance
- Weight gain
- Diagnosis can include checking free thyroxine (T4) and serum thyroid-stimulating hormone (TSH) levels. However, we prefer to check all related hormone levels, so as to better understand the full picture.
- Medications that can be used to treat hypothyroidism include Levothyroxine, dessicated thyroid medication, or compounded synthetic T4/T3 medication.
- We suggest the Autoimmune Paleo Diet for hypothyroid patients. There are also some dietary supplements, like iodine and probiotics, that can alleviate symptoms.
- Primary hypothyroidism is almost always reversible, unlike what conventional doctors might say. Our patients at PrimeHealth are the proof.
- Kim, H. S., Unalp-Arida, A., Ruhl, C. E., Choung, R. S., & Murray, J. A. (2019). Autoimmune and allergic disorders are more common in people with celiac disease or on a gluten-free diet in the United States. Journal of clinical gastroenterology, 53(10), e416-e423. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30045167
- Anderson, J. M., & Van Itallie, C. M. (2009). Physiology and function of the tight junction. Cold Spring Harbor perspectives in biology, 1(2), a002584. Full text: https://cshperspectives.cshlp.org/content/1/2/a002584.full
- Kapil, U. (2007). Health consequences of iodine deficiency. Sultan Qaboos University Medical Journal, 7(3), 267. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074887/
- Gaitonde, D. Y., Rowley, K. D., & Sweeney, L. B. (2012). Hypothyroidism: an update. South African Family Practice, 54(5), 384-390. Full text: https://medpharm.tandfonline.com/doi/pdf/10.1080/20786204.2012.10874256
- Eghtedari, B., & Correa, R. (2019). Levothyroxine. In StatPearls [Internet]. StatPearls Publishing. Full text: https://www.ncbi.nlm.nih.gov/books/NBK539808/#_article-24233_s4_
- Duntas, L. H. (2015). The role of iodine and selenium in autoimmune thyroiditis. Hormone and Metabolic Research, 47(10), 721-726. Full text: https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0035-1559631
- Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky gut as a danger signal for autoimmune diseases. Frontiers in immunology, 8, 598. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440529/
- Chakrabarti, S. K., Ghosh, S., Banerjee, S., Mukherjee, S., & Chowdhury, S. (2016). Oxidative stress in hypothyroid patients and the role of antioxidant supplementation. Indian journal of endocrinology and metabolism, 20(5), 674. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040049/
- Olivares, E. L., Silva-Almeida, C., Pestana, F. M., Sonoda-Côrtes, R., Araujo, I. G., Rodrigues, N. C., … & Rocha, F. F. (2012). Social stress-induced hypothyroidism is attenuated by antidepressant treatment in rats. Neuropharmacology, 62(1), 446-456. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21903114
- Hirotsu, C., Tufik, S., & Andersen, M. L. (2015). Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science, 8(3), 143-152. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/
- Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and urban planning, 105(3), 221-229. Full text: https://www.sciencedirect.com/science/article/pii/S0169204611003665