Subclinical Hypothyroidism - Blood test results are good but symptoms are still there!!!

Posted by Melissa Callaghan on



Subclinical Hypothyroidism

As a Naturopath I feel that it a very important for everyone to have an understanding of what all of the thyroid hormones are doing not just TSH (thyroid stimulating hormone). Further testing may be required to gain an understanding of this, if these tests haven't already been done in the past. 

Often is the case that testing has been done for thyroid and you have been told everything is normal, this usually means that what has been tested is within the "reference range".  There is a big difference between reference range and optimal range.  Quite often only TSH has been requested and that is purely because Medicare wont pay for anything else and even if the GP requests the other tests they will only be done if TSH is our of the "reference range" because Medicare wont pay for it.  You can however, tell the GP that you will pay for it and get it done. 

When we discuss under active thyroid it is important to understand how this happens.  It is a bit complex so this is a very basic overview.

To begin with the hypothalamus in the brain is continuously monitoring the levels of thyroid hormone in the body.  When an action needs to take place it signals the pituitary gland to take action. This happens in one of two ways either the pituitary gland yells really loud at the thyroid gland telling it to get to work and produce more thyroid hormones (mainly T4 which is an inactive hormone) or it tells the thyroid gland to stop producing thyroid hormones as the thyroid gland is being a bit too zealous and over active. 

This test that GPs request called TSH (thyroid stimulating hormone) doesn't really tell you what the thyroid gland is doing. 

Yes this can give you an understanding of what is going on from the feedback given to the hypothalamus, however, it isn't the whole picture and there can be other issues further down the chain of events, the TSH is released from the pituitary gland NOT the thyroid, it is release as part of a feedback loop of communication.

In my clinic I combine this test with your presenting signs and symptoms and often is the case that this test can be within range and you are told everything is ok but you still don't feel well. 

This can be due to your body not using the T4 thyroid hormone that is being produced in the right way. This is often called functional hypthyroidism or subclinical hypothyroidism.  This means that you may only have a slightly elevated TSH or you may also experience mild signs of hypothyroidism such as fatigue, consistent weight gain, memory problems, depression, an intolerance to cold.  More than likely if your GP requests T4 (which is not often) it will be within range anyway because the releasing of hormones from the thyroid gland isn't usually the problem.

So where is the problem?

It's all about the conversion!!!

T4 needs to be converted to active T3 and this occurs in many different tissues and organs.  Mainly in the liver, and also in the gut, skeletal muscle, brain, and the thyroid gland itself.

When I am assessing thyroid levels in my patients I am also assessing their liver function and gut health.  If there are issues with liver eg fatty liver then there are going to be issues with the conversion process. As a Naturopath we look for the 'pre' (before) signs eg pre-diabetes and pre-fatty liver.  Meaning that I look at your pathology I can tell if your liver isn't happy and if you are heading towards fatty liver if not there already, it can also tell me if this is due to food or alcohol. Understanding your liver is doing what I love to do. If there are any inhibitions to its proper functioning then there will be conversion issues for thyroid hormones. What is also interesting is that even if you are already on thyroid medication (thyroxine) this too still needs to be converted and if there are liver issues, well....

Gut issues also affect the conversion, some of the good bacteria is needed to help with this conversion therefore if you are experiencing issues such as IBS or constipation then this can have an impact on conversion.  What is also interesting is that an underactive thyroid also affects your gut and you can experience low gastric motility or constipation.  This forms part of your treatment plan when you see me in clinic.  We need to work on repairing the lining of the intestines so that we can work on the liver and you don't just reabsorb everything that your body is trying to eliminate in your stool. 

There are many ways hypothyroidism can develop and here is an interesting example.

Liver function slows, preventing the dumping of toxins leading to a decline in gut function, which then leads to an increase in adrenal function which can suppress thyroid function.  Everything is connected.

Diet also plays a major role in thyroid hormone conversion.  Eating a diet high in saturated fats and oils can increase the production of inflammation chemicals in your body and these inflammation chemicals actually prevent the thyroid hormone from being converted. 

This is ground breaking information. You can literally change your metabolism by eating the right foods. 

I have spent endless hours researching through all of the scientific evidence to find research papers to back up my findings. From here I began to create a program.  One program that would help EVERYONE.

This was hard for me as I am a Naturopath who is trained to create individualised treatment plans and I definitely still do this. BUT there were so many components of what I was already doing with each of my patients that followed the same path so I put them all together for everyone to follow.

I then began to add in the recipes and focused on creating meals that were delicious, quick and easy to prepare and that the whole family would love.

There was one last thing that I needed.  Over the years I had researched many many other programs and have seen many people try these programs only to bounce right back to where they started or worse after they finished.

I vowed to myself that the most important component (other than regaining health) was for everyone to be able to sustain the new lifestyle. I created a program that is completely flexible. You can go intense when you need to and not so intense when you don’t.

You can change your habits and stop the cravings, binging, and emotional eating. This a big part of what I do. I help you to understand your relationship with food and turn it into a positive one so you will never feel guilty about eating ever again. 

After getting the ball rolling I begin to use this program in clinic with my patients and within weeks and months I was seeing huge success.  Blood test markers were correcting themselves. People were no longer borderline diabetic, blood pressues where going down. Reflux was non-existent and fat began to melt away with weight loss and increased metabolism and energy.

I knew I was on the right path with so much success for my patients. The program is availabe to all of my patients both in clinic and online. I’m super excited to help everyone reduce their metabolic inflammation and take back their health.

This is why I love being a holistic practitioner.  I connect the dots between everything instead of just looking at individual markers such as TSH.  

If you feel like you may be experiencing signs and symptoms of underactive thyroid such as:

  • Fatigue
  • Weight gain
  • Constipation
  • Puffy face
  • Muscle weakness
  • Intolerance to the cold
  • Thinning hair
  • Depression
  • Impaired memory
  • Foggy brain
  • Painful stiff joints
  • Muscle aches and pains

Then a full assessment with me will help to assess if this is the case and create a treatment plan for you to get you back to balance.  I usually have patients who come to me after being told everything is fine but they know that something is just not quite right. Trust your instincts.

If you are already on thyroid medication, which is supplying you with a synthetic form of the inactive hormone, you may still not be converting this to active thyroid hormone which is essential for metabolism. I can help support the function of the thyroid gland with the correct nutritional support as well as the other systems of the body that are involved in the process of converting the medication into its active form.

Who am I?

I am a Bachelor qualified Naturopath who specialises in improving metabolic processes in the body and reducing metabolic inflammation. Major areas for improvement include gut health, thyroid, kidney, liver, weight loss and mental health. Conditions such as fatty liver, high cholesterol, high blood pressure, type II diabetes, irritable bowel conditions, depression & anxiety. I help my patients by giving them symptomatic relief while working on repairing the underlying causes of metabolic stress and waste accumulation. 

What if the solution was as simple as changing your diet and your mindset. A growing number researchers believe that it is and that you can prevent or even reverse several of our worst diseases.
As a Naturopath and Nutritionist I wholeheartedly believe this could also be possible and that the solution isn't just another pill.  I've spent many years developing my program where I have been able to successfully help my patients reduce and even eliminate their pharma meds, lose weight (most lose 6-8 kilos in 8 weeks) and feel full of energy again and I've helped them take back their health and improve their lives and habits. I can help you too.

Melissa Callaghan BHSc, BTeach

To book an appointment click here 

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