By Dr. Laura Korman, DC  

Q: Why do I still have thyroid symptoms even though my other doctor tells me that all my lab tests are normal? 

 
A:  Hypothyroidism, or low-functioning thyroid, affects nearly five percent of the total population, and is five to eight times more common in women than in men. What most people are not aware of is that 95 percent of hypothyroid cases can be caused by a self-destructive process called Hashimoto’s. This is one of many auto-immune (AI) conditions, where the body's own immune system mounts an attack against self tissue—in this case, the thyroid gland.  

Hashimoto’s often goes undiagnosed because the only blood marker that is tested and monitored in thyroid disease is usually the TSH (Thyroid Stimulating Hormone). In order to diagnose the presence of Hashimoto’s, two blood tests, including a thyroid peroxidase antibody (TPO) and an anti-thyroglobulin antibody (TGAb), must be ordered to rule out any auto-immunity against the thyroid.  

The important factor to understand is that if auto-antibodies are present, the primary diagnosis then becomes an overreactive immune system that causes a secondary thyroid problem and subsequently shifts the treatment protocol to address the overzealous immune process. Another reason Hashimoto’s goes undiagnosed is that the symptoms of an AI (auto-immune) thyroid can be subtle, intermittent and different from one person to the next.  

Often times, I see a combination of both low and high thyroid symptoms like fatigue, depression, weight gain, constipation, anxiety, rapid or irregular heartbeat, weight loss and diarrhea. A patient might notice their symptoms remain unchanged even though their TSH falls in the “normal” range, or they require frequent changes in medication doses in order to help stabilize their thyroid function. 

Another issue to be aware of is that once a person experiences one AI process, it is more likely for them to develop an AI reaction against other tissues and organs like the gut, joints or brain. While AI diseases are considered permanent since they involve the part of the immune system that “never forgets,” these conditions can be carefully managed and monitored with functional medicine and lifestyle changes.  

Traditional medical treatment of an AI condition often involves prescribing medications that suppress inflammation or the immune system as a whole. This can make a person more susceptible to infection which can have obvious implications. The functional medicine approach is much different in that it looks to treat a person by supporting, rather than suppressing, their immune system. This can be done by assessing and then minimizing environmental, dietary or lifestyle triggers that could be responsible for activating an AI “attack.” 

The often occurring increase and decrease of symptoms is a classic pattern for patients with an AI disease. The waxing and waning of fatigue, pain, brain fog and excess weight are some of the signs of unmanaged inflammation which can be caused by the persistent on-and-off activation of the immune response. Factors such as, foods, infections, toxins, allergens, stress or even sleeplessness can also trigger unwanted “flair-ups.” 

The positive news here is that once the environmental or lifestyle culprits of immune activation are discovered with a thorough examination of medical history, as well as the correct functional lab testing, these issues can often be removed, treated or minimized for a more balanced approach to treatment. This can help to provide a long-term solution against the progressive and destructive processes of an AI condition.