What does a holistic approach to thyroid concerns look like?
Thyroid dysfunction affects 1 in 7 people, most of whom are women. Development of a thyroid disorder can occur at many different moments in life but people often become aware of a thyroid issue when they are planning a pregnancy, actively pregnant, or experiencing a hormonal transition in perimenopause or menopause. Despite the prevalence of thyroid disorders, many primary care providers do not routinely screen for them. At Tendwell, we take a different more nuanced approach to thyroid assessment and treatment. In this functional medicine blog, I will discuss some of these approaches.
Thyroid dysfunction should be screened for annually in all people but especially in women. This means not only assessing TSH (thyroid stimulating hormone) but also looking for thyroid antibodies and looking at my favorite: Free T3. Free T3 is vital to look at as it is the active form of the thyroid hormone. Taking reverse T3 and T4 levels also provide valuable information into how our thyroid is working and whether we are converting T4 to T3 in adequate amounts. We also love looking at each person’s micronutrient levels. These are essentially the building blocks for thyroid hormone production. At Tendwell we look at iodine levels (urinary is best), iron, selenium and zinc. Knowing what the optimal levels are and not just whether one’s levels are “within normal limit” is the approach used by the best functional medicine clinicians. Of course, in true functional medicine style, we look at a lot more than just these nutrients.
In addition to assessing micronutrient levels, it's essential to highlight the role of nutrition in supporting thyroid health. We encourage a food first approach—with a diet rich in iodine, selenium, and zinc, which are crucial for thyroid function. Integrating nutrient-dense foods such as seaweed, nuts, seeds, and lean proteins can contribute to optimal thyroid performance.
Full thyroid assessment may also mean ordering a thyroid sonogram or ultrasound to look directly at the gland itself. Thyroid nodules, cysts and goiters are quite common. Most of these are benign findings but it is important to look, especially if there is family history of thyroid cancer.
At Tendwell, we consider the connection between stress and thyroid function. Chronic stress can negatively impact the thyroid, affecting hormone production and conversion. We will often test cortisol levels. Even without testing, incorporating stress management techniques like meditation, yoga, and deep breathing exercises can be beneficial for overall thyroid health.
Environmental factors can contribute to thyroid dysfunction. Exposure to endocrine-disrupting chemicals found in certain plastics, pesticides, and household products may influence thyroid function. At Tendwell, we provide guidance on minimizing exposure to such substances as part of a holistic thyroid care strategy.
Finally, we consider the multitude of symptoms that can present with thyroid disorders. Most people think of weight gain or weight loss, and fatigue as the main symptoms. But mood disorders like anxiety, depression and PMS can also be symptomatic of thyroid disorders. So too with irregular menstrual cycles, fertility issues, hair loss, issues with skin and nails, brain fog, memory problems, constipation, diarrhea, IBS, high cholesterol, palpitations, insomnia, and hypersomnia. The list goes on. The thyroid is a major player and the hormones it produces touch all aspects of our health.
