A Shocking Number of Undiagnosed Thyroid Disorders

By Holly Lucille, ND, RN

Have you been feeling a little "off" lately? Lack of energy, always feeling cold, trouble concentrating, or unexplained weight gain could be a sign of an underactive thyroid. According to the American Association of Clinical Endocrinologists, upwards of 27 million Americans suffer from some type of thyroid disorder. Of those, it's estimated that half remain undiagnosed.

Misdiagnosed and Misunderstood

Hailed as "the master" of our endocrine system, second only to the pituitary, the thyroid is a small gland shaped like the outspread wings of a butterfly that sits at the base of the throat. It excretes two hormones— thyroxine (also known as T4) and triiodothyronine (or T3)—that regulate metabolism within every cell in the body. Low levels of these hormones slow everything down, and it's why symptoms of hypothyroidism often include weight gain and fatigue, as well as constipation, depression, irritability, low body temperature, sleep disturbances, forgetfulness, edema (fluid retention), hair loss, decreased libido, joint pain, and a hoarse voice. Yet, because these symptoms can resemble a host of other diseases, the thyroid is often overlooked by physicians.

When doctors do test for thyroid dysfunction, they typically rely on a single blood test that measures thyroid stimulating hormone (TSH). Since TSH rises as thyroid function wanes, levels over 5.0 mU/L are considered an indication of hypothyroidism. The problem is, many people with TSH values between 3.04 and 5.0 mU/L—values considered normal under current guidelines— display numerous symptoms indicating that their thyroid is underperforming. As a result of these outdated lab values, borderline hypothyroid patients often go undiagnosed. A far better method of evaluating thyroid function is by expanding the testing process to include additional thyroid markers. It's also critical to look for clinical signs such as thinning hair, dry skin, goiter, or a low basal body temperature. Looking beyond TSH levels can give a much clearer picture of thyroid health. In fact, the British Medical Journal has acknowledged that TSH test results can be ambiguous and suggested that the best way to determine who should receive treatment is not by a number, but by how a patient feels.

The most prevalent cause of an underactive thyroid is Hashimoto's thyroiditis, an autoimmune condition in which the immune system attacks the thyroid, damaging its ability to produce hormones. If you've been diagnosed with Hashimoto's, your doctor may prescribe T4 hormone replacement. Yet, because T4 is simply a precursor to the active thyroid hormone T3, this strategy may not work if you have trouble converting T4 to T3. Factors that can interfere with this conversion process include chronic stress, hormonal and digestive imbalances, nutritional deficiencies, and exposure to environmental toxins like mercury. The good news is that a proper diagnosis, thyroidfriendly diet and lifestyle modifications, and natural alternatives to synthetic thyroid replacement therapy can often restore thyroid function and relieve symptoms.*

Thyroid Tune Up

Adopting a regular exercise program that includes both aerobic and weight-bearing activities can stimulate thyroid secretions and increase tissue sensitivity.* Exercise also boosts heart health—an important consideration since hypothyroidism increases the risk of cardiovascular disease. Plus, regularly walking, biking, swimming, or lifting weights may also help to counter fatigue and ease everyday stress.

What you eat matters too. Since gluten can interfere with the absorption of T4, avoiding breads, baked goods, cereal, pasta, and other sources of gluten may improve thyroid function. It's also a good idea to avoid some otherwise healthy foods because they can depress thyroid activity. These include broccoli, cabbage, Brussels sprouts, cauliflower, kale, spinach, turnips, soy, beans, and mustard greens. Instead, focus on foods high in thyroid-friendly vitamins and minerals such as beans, nuts, and seafood. Add plenty of anti-inflammatory fruits and vegetables to your diet, opting for organic whenever possible.

Supplemental Support

Supplements can offer additional nutritional support. Start with a good quality multivitamin that provides the basic vitamins as well as iodine, iron, selenium, tyrosine, and zinc. Because many people with hypothyroidism are deficient in vitamin D, it's smart to also add a separate supplement that provides a dose well above the recommended Daily Value.* Adding a good quality omega-3 supplement supports a healthy inflammatory response and enhances heart health, according to research published in The American Journal of Clinical Nutrition.* Because an imbalance in gut flora can also contribute to hypothyroidism, including a multi-species probiotic in your basic supplement regime will help support intestinal health.*

Thyroid specific supplements also play a critical role. Forskolin, from the colorful coleus plant, helps to regulate cellular response to thyroid hormones.* The ayurvedic herb ashwagandha increases T3 and T4 levels.* And guggul, best known for its cholesterol-lowering abilities, stimulates the synthesis of T3.* Glandular extracts are also important tools for treating hypothyroidism. These freeze-dried products do not replace thyroid hormones the way pharmaceutical thyroid drugs do. Instead, glandulars supply therapeutic amounts of active peptides shown to effectively improve thyroid function.*

Becoming a proactive partner in your treatment plan can significantly improve your thyroid health. But it's also important to work with a healthcare provider who looks beyond lab results. Discovering and treating the underlying problem can help restore thyroid function and move you closer to reclaiming good health.


Blackwell J. J Am Acad Nurse Pract 2004;16:422-5.

Canaris GJ. Arch Intern Med 2000;160:526-34.

De Caterina R. Am J Clin Nutr 2006;83:421S-6S.

O'Reilly DS. BMJ 2000;320:1332-4

*This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.