Hello, health enthusiasts, and welcome to Rev Up Health, your go-to podcast for all things wellness. I'm Dr. Mark Hechler, and I'm Tandi Hechler. Together we're here to fuel your health journey with the best of functional medicine and holistic well-being. Each episode, we'll dive deep into topics that matter to your health, bringing you the latest insights, research, and inspiring stories. Whether you're on a quest for vibrant health or just looking for daily health tips, we've got you covered. So let's embark on this journey together and transform the way you live. So, Tandi, what's on our wellness radar for today?
Hello, hello, and welcome. We're so glad you're here. Today we want to take a minute to talk about the thyroid. It's one of those things that comes up a lot in all areas — it's a really big topic, so we might not even be able to hit everything we want to address today. If there are questions, let us know — type them in the comments and we'll get back to them. But for now, let's get educated on the thyroid.
What Does the Thyroid Do?
Dr. Mark here. So what does a thyroid do? This gland does a lot of things — a multitude of things. You may have had the symptoms — for instance, you've gone to your doctor saying, "I'm fatigued, I'm losing my hair, I'm excessively hot," or "I'm always cold," things along that line. They may draw some labs on you and say, "Well, everything is normal, so it can't be your thyroid." We beg to differ on that. Today we hope to educate you a little more on what the thyroid does and how your symptoms could potentially be thyroid-related.
In an overall nutshell, the thyroid is a gland that regulates metabolism. There's a lot it does — it affects a lot of glands, and it affects all the cells of your body. That tends to cause a lot of regulation, and dysregulation, which can result in various types of symptoms. It affects your growth and development, your heart rate, your muscles and strength, your digestion, even brain development, and of course your body temperature — whether you're hot or cold can sometimes be thyroid-related. It regulates cholesterol levels, and it can affect your menstrual cycle through estrogen and progesterone. So there are several things your thyroid does.
With metabolism, it can affect your weight — you can have weight gain or loss. Your metabolic rate controls how many calories you burn just sitting around breathing, sleeping, thinking, and digesting. Hair growth is one of those things too — there are other hormones that affect hair growth, but the quality, texture, and thinness of your hair could be affected by your thyroid function. Obviously, other influences on hair loss could be low iron, and even estrogen deficiency in menopause causes that too.
Energy levels are very subjective, so at this point, if you feel like you have a midday slump or need a cup of coffee, for various different reasons that may be your thyroid. Thyroid hormones help regulate the energy of your mitochondria through certain enzymes, and those enzymes and the mitochondria can affect your metabolism too. Something people don't realize is that your thyroid can also affect your estrogen and progesterone levels, even cortisol levels. Even a low testosterone level could be caused by low thyroid hormone, and menstrual cycle irregularities could be related to low thyroid hormone too.
Your thyroid regulates your mood as well, so depression or anxiety can even be an outward symptom of altered thyroid regulation. The inability to focus and concentrate — brain fog, as we say — is something that can be related to an alteration in thyroid function.
Why Is Thyroid Dysregulation on the Rise?
Another interesting thing: these types of issues have been around for a long time, but why is thyroid dysregulation becoming so prevalent? There's been a transition recently, and I think it's really important to talk about why the thyroid is having so much dysregulation. A lot of that has to do with the endocrine disruptors we come in contact with so much more today.
That's true. There are certain things — various toxins, what I call the three P's: pollution, plastics, and processed food. These things affect the way the receptors even work on your cells. All your cells respond to thyroid hormone, and when these receptors are blocked or disrupted — things like smoking and alcohol affect them too — you're going to have trouble processing the thyroid hormone in your system. This is the reason you may have a normal thyroid level but still be hypofunctioning in your thyroid output.
Why TSH Alone Isn't Enough
That's a really good point, and a good time to talk about the fact that typically, when you go to your traditional doctor and say, "I want to look at my thyroid," or "I think this might be an issue," probably 80% of the time they're only going to draw a TSH — and there's so much more we need to look at when assessing thyroid function. Can you tell us a little more about that?
Of course. There are several different tests that can be done. TSH is the most basic, and sometimes it's the only one that's even paid for, because of cost containment. But you need to look at the T4, your total T3 and free T3, and then there are thyroid antibodies, which can tell you more about autoimmune disorders of the thyroid. Those can cause either overactive or underactive thyroid function, and in the future those autoimmune conditions can lead to hypothyroidism. It's a long, slow process sometimes, but it can happen — and yet hardly anyone ever gets those antibodies drawn.
You can also tell on a physical exam — you can feel the firmness of the thyroid, which kind of indicates to me that someone may have a thyroid inflammatory process going on, and that's where we draw those extra labs. In our integrative practice, we're looking at all of those things, because, similar to some of the other things we've talked about, if you can look at the levels of certain things that would get dysregulated or abnormal first, that's what would eventually change the way the TSH comes through. That's the best thing, because if you can look at that and define it, you can keep that TSH from going the wrong way.
How T4 and T3 Work
Tell us a little about T4 and T3 and how that works. The thyroid is a pretty complicated gland. You've got T4 and T3. T4 gets produced but then gets converted into the active form, which is T3. The active form is what your cells see and use to produce metabolism and all the regulation that occurs within your system. So if we're not looking at our free T3 and total T3 levels, then we don't really know how our system is adapting to those levels of thyroid hormone.
When we start looking at the lab values of the thyroid, the "normal" ranges are given by grouping a population of people who've had their thyroid labs drawn. What happens is you get folks in a range of normal that simply reflects a standard bell curve of everybody who gets blood drawn. So you've got all the metabolically dysfunctional people who have their labs drawn, and that's where they fall — but does that tell you the true picture of how they function, how the thyroid is actually functioning, or how the cells are functioning related to that thyroid? We need to look at that. We like to have folks on the higher side of normal with the free T3, and that's usually a good place to start for some folks who may have fatigue, general weakness, tiredness, or a weight-gain problem.
T4-Only vs. Combination T4/T3 Replacement
As we're talking about T4 and T3, here's another comparison with traditional medicine and how we're a little different. One thing you'll notice is that when folks have a thyroid issue, they'll frequently be put on levothyroxine, which is just T4 — the kind of inactive part of your thyroid hormone that your body still has to convert from T4 to T3. One of the things we do differently is replace both T4 and T3. You can do that with a bioidentical hormone replacement, with desiccated thyroid, or there are pharmaceutical options — T4 and T3 separately, and a synthetic one as well.
It's almost imperative to replace thyroid hormone with some T3, whether you add a separate medication or you do a combination medication. Armour and NP Thyroid are very good classic examples that you can get at traditional pharmacies. These desiccated thyroid pharmaceuticals are more bioidentical, so your system is going to like them and use them better. We also look at the antibodies to see whether this is something you're going to have trouble with in the future — elevations or decreases in your thyroid, or whether you'll have to change your thyroid supplementation.
In general, you may have people with these endocrine-disrupting situations who just need to be on a higher level, or on thyroid in general. You may be "normal" but still need to be on thyroid replacement to function or feel more natural. And then you can work on: what else am I doing about these toxins in my system? What do I need to do to detox myself? There's a lot we can work on there.
Supplements and Lifestyle for Thyroid Health
Some things we can do for supplementation, outside of just taking thyroid, are to look at your zinc and iodine levels, and vitamin D. But it doesn't have to be something you take — it can be as simple as doing a certain amount of exercise each day, which will help your thyroid work better. Getting good sleep — seven or eight hours a day — will help your whole system reset and make it easier for you to be more optimal.
One thing that's very important is gut health. If your gut's not healthy, you're not going to absorb things, no matter what you take. So you really have to look at that, and the gut is becoming more and more a system that needs to be optimized and given attention. That leads back to the processed foods and the three P's I spoke about — the processed food and all the toxins in our system, our groundwater, and our soil. Everything our animals are eating, we're eating that stuff too, so it gets into our system.
Thyroid and Mental Health
One other thing I wanted to mention really quick that's been interesting as we look at research and different studies: depression and anxiety. They've actually used desiccated thyroid to treat non-responsive depression, and have had a lot of luck there. It's just fascinating to me, all the things the thyroid does, and it's pretty interesting to know that all of these things are so related. I'm happy that folks are finally looking at the root cause of why some of these things are happening, and why they were so dysregulated.
Find the Root Cause
The key is to find the root cause of all this. You may feel fatigued, you may have all these other symptoms of hypo- or even hyperthyroidism — get to that root cause so you can get to a point where you maybe don't need replacements or supplements, or you can do some basic things to improve your own health.
So often we get to a point where our body just isn't able to allow us to do the things we know we should — the activity we need to be doing. It's not really motivation; we just get into a state where we don't feel like we can do the things we need to do. Supplements and pharmaceuticals can give us a chance to get to a place where we can start to do those things. I always say medication is great when you need it — and there are times you need it. Take high blood pressure, for example: you can treat the high blood pressure, and treating it allows you to get to a point where you can do the things like diet and exercise, so that then you don't need that medication anymore. That's the goal — to get the body back to a steady state where it doesn't need those things.
Wrapping Up
In a nutshell, to wrap this up: you really need to see what symptoms you have, and ask whether these symptoms are potentially related to thyroid function. I say "function" because it doesn't necessarily mean your labs dictate that you're normal. If we have to convey anything to you, it's this: don't rely on your labs to tell you that you're normal. You may not be — you may be suboptimal — and at that point there are things that need to be looked into to try to improve. We can actually correct the dysregulation going on in your system.
So check out your symptoms, see what's going on, do your own education, and get yourself informed. You don't have to do this on your own — we're happy to help, of course. Here at Revelation Health and Wellbeing, you can contact us and ask us questions. If you have concerns, shoot something to us by email or Instagram. We're happy to help, and we hope to see you on the healthy side.
Thank you for tuning in to another episode of Rev Up Health. We hope you're leaving with some valuable insights to supercharge your health journey. Don't forget to follow or subscribe to Rev Up Health wherever you listen to your podcasts, and if you enjoyed today's episode, please leave us a rating and review. Have a topic you want us to explore? Reach out to us on our social media channels — we love hearing from our wellness community. Until next time, keep thriving, and remember: your journey to health is a journey to a better you. Stay well, and we'll connect with you again soon. This is Tandi, and this is Dr. Mark, signing off from Rev Up Health. Take care.
The information provided in this podcast is for educational purposes only and is not intended as medical advice. The content is designed to support, not replace, the relationship that exists between a patient and their healthcare provider. Always consult with a qualified healthcare professional before making any changes to your healthcare regimen, including diet, exercise, or treatment plans. The views and opinions expressed in this podcast are those of the hosts and guests and do not necessarily reflect the official policy or position of Revelation Health and Wellbeing.