A thyroid hormone deficiency slows metabolism and disrupts many basic bodily functions.
When looking to understand your thyroid symptoms, you need to understand:
- What is causing your underactive thyroid in the first place.
- The impact hypothyroidism can have on both your physical health and your brain function if left unmanaged.
Causes of Hypothyroidism
There are a few possible causes of thyroid symptoms:
- Thyroid replacement medication issues: If you are already taking medication to regulate your thyroid hormones, you might not be taking the proper dose or could be on the wrong medication for your needs.
- Non-thyroid illness patterns (NTI): In this case, nothing is actually wrong with the thyroid gland. Instead, there is an issue with how the thyroid hormones are utilized once they leave the gland. Some examples include issues with converting inactive T4 thyroid hormone to active T3 or thyroid receptor site resistance.
- Endocrine disruptors in the environment: Endocrine disruptors found in many environmental chemicals can impact thyroid receptor sites and could be behind the low thyroid symptoms. BPA found in plastics has also been linked to thyroid autoimmunity.
- Autoimmune Hashimoto’s: An autoimmune disease called Hashimoto’s causes 95–98 percent of hypothyroid cases in the west. If you have hypothyroid symptoms, you should screen for Hashimoto’s with TPO and TGB antibody tests and learn strategies to manage autoimmune disease. This can help stop or slow damage to the thyroid gland, stabilize function, and minimize or eliminate symptoms.
Symptoms of hypothyroidism
The classic symptoms of hypothyroidism are:
- Fatigue
- Low libido
- Weight gain
- Hair loss
- Constipation
- Heart palpitations
- Cold hands and feet
- Depression
- Insomnia
- Nervousness and anxiety
Ongoing fatigue and depression are some of the most common symptoms among people with hypothyroidism, but there’s wide variation from person to person. Some may struggle with weight gain or hair loss while others don’t, and some may only experience a single symptom such as constipation.
This is because the hormones from your thyroid are necessary for every kind of cell in your body – including cells in your brain, organs, endocrine gland, skin, and nails. This means hypothyroidism can present differently depending on which part of the body is most affected. Diet, lifestyle, and genetics also play a role in which symptoms you experience.
As a result, your symptoms may be overlooked during visits to your doctor.
Doctors also don’t typically screen for hypothyroidism during routine exams and even if they do, the test is done with a thyroid-stimulating hormone [TSH] lab marker. TSH levels fluctuate regularly, so an annual checkup may miss a fluctuation that would be caught with more frequent testing.
Hypothyroidism and metabolism
The body’s basal metabolic rate is one of the areas most impacted by hypothyroidism. A lack of thyroid hormones impedes the cellular process to produce energy.
People with low thyroid symptoms often suffer from fatigue because of the effect on their metabolism. Since the body isn’t receiving enough energy to power even basic functions, they never feel rested regardless of how much they sleep.
Poor muscle endurance is another common symptom. Those with hypothyroidism often struggle to build muscle mass or perform tasks requiring strength and endurance.
Brain endurance is also impacted and patients often find they can’t read, drive long distances, or perform cognitive tasks like they used to.
Hypothyroidism and weight
The impact on the basal metabolic rate also leads to weight issues. Thyroid hormones co-activate a hormone in the body called hormone-sensitive lipase, which breaks down body fat and triglycerides into fatty acids.
While the overweight hypothyroid patient has improper fat storage and difficulty burning fat, the underweight thyroid patient cannot build muscle. Patients tend to either have chronically high or low blood sugar, with high blood sugar and insulin resistance found most often in overweight patients and low blood sugar in underweight patients.
In both patterns, patients struggle with fatigue, low energy, sleep issues, and hormonal imbalances as a result of their blood sugar imbalance.
Hypothyroidism and gut health
Thyroid hormones impact the gastrointestinal (GI) tract, including function of the gallbladder, liver, lipid and cholesterol clearance, protein metabolism, and blood sugar levels. A deficiency of these hormones leads to constant GI problems and symptoms that never seem to resolve no matter how well the person manages their diet or how many supplements they take – because the underlying thyroid condition is not being addressed.
Due to the impact low thyroid hormones have on the gut, patients have a greater risk of high cholesterol, fatty liver, gallbladder sludge, and gallstones. Thyroid hormones are also involved in the contraction of muscles to move food through your intestinal tract, which leads to constipation in patients with an underactive thyroid.
Dysbiosis, or an unhealthy population of gut bacteria, is another common symptom which can be compounded by a diet high in sugars, fruits, and starchy foods.
Cytochrome P450 pathways in the liver are also affected, which impedes the process by which chemicals are cleared out through biotransformation. The hypothyroid patient has more difficulty with liver biotransformation, which can increase the toxic burden on their body and increase the risk for chemical sensitivities.
Hypothyroidism and bone health
People with unmanaged hypothyroidism are very susceptible to osteoporosis and osteopenia, as thyroid hormones have a significant impact on both bone density and, most importantly, bone quality.
The bones of patients with long-term hypothyroidism show poor micro-architecture, microscopic damage, poor collagen quality, and increased breakdown, all of which make the bone more prone to developing fractures.
Hypothyroidism and cardiovascular health
Another place thyroid hormones are essential is the cardiovascular system and blood cells.
As we age, our blood vessels can be injured and develop inflammation and plaque, which thickens and hardens the arteries. As a result, circulation worsens, the heart is strained, and blood pressure rises, increasing the risk of an embolism, embolic stroke, or even hemorrhagic stroke.
Some people eat healthy diets and exercise regularly and still suffer from high coronary calcium scores and cardiovascular disease – and hypothyroidism can help explain why.
Hypothyroidism and brain health
Thyroid hormones are vital to dampening inflammation in the brain, so an underactive thyroid results in increased brain inflammation.
Patients with unmanaged hypothyroidism typically present with multiple brain-based symptoms such as inability to focus, difficulty concentrating, depression, and poor memory. The most common symptom is brain fog, which may worsen after eating certain foods, smelling certain chemicals, or from over stimulation.
Years of undiagnosed hypothyroidism can accelerate degeneration of the brain and raise the risk of neurodegenerative disorders such as dementia.
If you find yourself struggling with symptoms like these and are interested in learning more, download my free guide Hashimoto’s and the Brain here.
Hypothyroidism and hormone health
Women and men experience hypothyroidism differently because of the impact it has on their hormone levels.
In women, thyroid hormones play a significant role in the feedback loop between progesterone receptors and the pituitary release of luteinizing hormone, as well as pituitary release of follicle-stimulating hormone and activation of the follicle. It’s not uncommon for women with low thyroid status to experience infertility, irregular menstrual cycles, heavy or light bleeding, or even complete loss of the menstrual cycle.
In men, thyroid hormones activate the leydig cells which are responsible for the creation of testosterone. Due to this, many hypothyroid male patients present with low testosterone.
How to address the impact of hypothyroidism on health
Unfortunately, thyroid hormone medications alone are unlikely to reverse all these health problems – but they are a great starting point. Such medications can allow the body to recover enough to allow you to take the necessary steps to completely restore your health.
But if you are experiencing any of the symptoms mentioned in this article while being prescribed a thyroid hormone medication, the first thing to do is make sure that you’re taking the correct dosage or the right medication for you. It’s very common for Hashimoto’s patients to see a gradual decline of their thyroid health over time as the autoimmune disorder continues to destroy the thyroid gland. Therefore, they may need adjustments to their dose.
Equally important is addressing the underlying mechanisms of their autoimmunity, which while different for everyone, always involves identifying and addressing inflammatory triggers.
If you’re interested in learning more strategies for managing Hashimoto’s, take a look at a course I created called Hashimoto’s: Solving the Puzzle. To download my free guide Hashimoto’s and the Brain and to learn more about the course, click here.
