A sluggish thyroid making you sick, tired & overweight?

Sluggish thyroid making you sick, tired, and overweight?

Are you one of the 30 million women or 15 million men that have a chronic medical problem that’s both under-diagnosed and under-treated?

Are you suffering from vague symptoms that you think are a normal part of aging?

Written by Mark Hyman, MD

Maybe you feel sluggish in the morning

or have a problem with your memory or trouble concentrating or focusing on tasks

or maybe you have dry skin

or fluid retention

or maybe your sex drive is not what it used to be

or maybe your hands and feet are cold all the time.

Maybe your hair is thinning

or your voice is a little hoarse.

Maybe your fingernails are thick and cracking.

Maybe your cholesterol is high.

Maybe you have trouble losing weight or maybe you’ve gained weight.

Maybe you’re suffering from depression or anxiety.

Maybe you have really bad PMS or you’re suffering from infertility.

You may even have muscle cramps, muscle pain or weakness.

Most of these symptoms would not lead you to go to the emergency room but do significantly affect the quality of your life. And most of us accept them as a normal part of our lives without really questioning them. Occasionally you might go see your doctor who shrugs them off. He or she is an expert in acute illness but often fails miserably when it comes to addressing the subtle changes in your body that affect the quality of your life.

Low sex drive is not necessarily a disease nor is a little dry skin or constipation or being tired. These are not diseases according to conventional thinking but, for you, these are significant problems.

I am talking about a condition that goes undiagnosed in HALF of the 45 million Americans that have it. It’s called hypothyroidism.

What is hypothyroidism?

This is a condition where your overall metabolic gas pedal has slowed down because the master gland that controls it, the thyroid gland, is not functioning at full speed (or even completely missing in the case of thyroidectomy, radioactive iodine or congenital hypothyroidism).

If your thyroid slows down or you don’t have a thyroid gland, every other organ and system in your body slows down – your brain, your heart, your gut, your muscles.

Thyroid hormone is like a master switch that turns on the genes that keep every cell of the body running.

Now this is one of those gray areas in medicine, but doctors tend to think in black and white. It’s not that you either have it or you don’t. You’re pregnant or you’re not. You can’t be just a little bit pregnant. But you can be just a little bit hypothyroid and it can have a dramatic effect on the quality of your life. That’s why millions of people are untreated and thyroid is such a hot potato in medicine.

This problem is further compounded by the view in conventional medicine that you can diagnose hypothyroidism ONLY through one lab test called TSH (thyroid stimulating hormone) and that you only qualify for treatment if your blood level is over 5. This unfortunately leaves a whole group of people with what we call subclinical hypothyroidism. It’s called that because doctors have a hard time diagnosing it.

Subclinical hypothyroidism may show up for you with many low grade symptoms such as fatigue, trouble losing weight, depression, or constipation. It often shows up on blood tests that most doctors never do. So you may not have the full textbook case of hypothyroidism but you might feel badly most of the time and no one can figure out why.

The key is that there is a way to treat hypothyroidism for those with subtle symptoms and make those who are diagnosed and treated with only partially effective treatments like Synthroid or Levoxyl feel even better.

The problems is that having a low thyroid function doesn’t just make you a little tired, it can lead to more serious problems including heart attacks and diabetes.

It takes being a medical detective

I see this all the time in my medical practice with patients coming in with vague complaints that alone may not seem that significant but when you put them all together create a significant story. In fact I remember the story of one patient who was 73 years old. This woman came to see me because she had been to see her doctor with complaints of fatigue, sluggishness, poor memory, mild depression, dry skin, constipation, some fluid retention, and her doctor said, “Well what do you expect? You’re 73 and this is what 73 is supposed to feel like.” But I do not believe that’s true.

I believe that most symptoms of aging that we see are really symptoms of abnormal aging or dysfunction that are related to these imbalances in our core body systems. I find that I have to be a medical detective to find clues, no one else is looking at, and put together the story of why a person is suffering that makes sense.

In this 73 year old patient, I tested for a number of different things and found that she had a sluggish thyroid. She did not quite meet all the criteria of conventional medicine for hypothyroidism but she had Hashimoto’s thyroiditis (which is an autoimmune disease where the immune system attacks your own thyroid gland) that led to her thyroid functioning poorly. Simply by replacing her missing thyroid hormone, giving her some nutritional support, and implementing some simple lifestyle changes, she went from feeling old to feeling alert and energetic and youthful and all of her symptoms cleared up.

I had another patient who was a young 28 year old woman who was chronically constipated and thought this was part of normal life to go to the bathroom every 3 or 4 days. She also felt tired in the morning and had trouble staying up at night to socialize with her friends and being an active 23 year old woman. She thought this was a normal constitutional problem and was stuck living like that. No one had diagnosed the fact that she had a sluggish thyroid. As soon as I nutritionally supported her and eliminated the food allergens she had, particularly gluten which creates inflammation which interferes with thyroid function, then she felt better. Her constipation resolved, she was energetic in the morning, she didn’t need coffee anymore to stay alert, she was able to stay up later at night without any fatigue or limitations.

Another young woman came to see me that had over 30% body fat and was unable to change her body no matter what she did. She ate perfectly, she exercised with a trainer every day, and her body wouldn’t budge. She also had a slightly depressed mood and other vague symptoms. I treated her with a low dose of Armour thyroid, which is natural thyroid hormone replacement medication, and she not only lost 20 pounds and improved her body composition but all her other symptoms went away.

This problem affects men, women, and children of all ages. It’s unfortunately common because of all the stressors in our environment, including toxins like heavy metals and pesticides, and nutritional deficiencies, all of which interfere with our thyroid function.

It is critical to understand that our thyroid is not just linked to our energy and the other symptoms that I described, but is the master metabolism hormone that controls the function and activity of almost every other organ in your body. When it slows down, everything slows down.

The good news is that there are clear ways to diagnose the problem as well as to treat it through a comprehensive approach using functional medicine.

A different approach to thyroid treatment

The first step is to find out if you have any of the chronic symptoms of hypothyroidism or any of the diseases associated with hypothyroidism. You have to ask yourself if you have any of the following symptoms:

___ fatigue
___ poor concentration or memory
___ low grade depression
___ dry skin
___ hoarse voice
___ coarse, thin hair
___ cold hands and fee
___ low body temperature
___ low pulse
___ muscle pain or weakness
___ low sex drive
___ weight gain
___ fluid retention
___ high cholesterol

Once I’ve asked my patients about all these symptoms I do a physical exam for clues to a low functioning thyroid:

___ low body temperature
___ fluid retention
___ thick tongue
___ swollen feet
___ swollen eyelids
___ enlarged thyroid gland
___ excessive ear wax
___ dry mouth
___ coarse skin
___ low blood pressure
___ decreased tendon reflexes
___ hair loss
___ loss of outer third of eyebrows

These are all useful physical signs of hypothyroidism that I can look for and I can put them together with the symptoms into a story of what is causing the problem.

Once I’ve done that and considered all the potential causes of low thyroid function like toxins, allergens, stress, and nutritional deficiencies, the next thing I do is the right blood testing. Most doctors just do TSH, which unfortunately is not a full picture of the thyroid. The newer guidelines of the American College of Endocrinology consider anyone with a TSH level over 3 as having hypothyroidism. Most doctors think that only a TSH above 5 or 10 is worth treating. Unfortunately this leaves millions suffering unnecessarily. There are also other important thyroid lab tests.

___ Free T4
___ Free T3
___ Thyroid Peroxidase Antibodies (TPOAb)
___ Thyroglobulin Antibodies (TgAb)

I also look for associated problems including gluten intolerance, food allergies, heavy metals, stress, as well as vitamin D, selenium, vitamin A, zinc, and omega 3 fat deficiencies.

And then I design a nutritional, lifestyle, and supplement regimen as well as a thyroid hormone replacement plan as a patients needs to regain their health and address this hidden epidemic of unnecessary suffering.

Once you’ve confirmed that a sluggish thyroid is contributing to your symptoms, the good news is that there are many things you can do to improve your thyroid problem.

About Mark Hyman, MD

Dr. Mark Hyman is a practicing family physician and  ten-time #1 New York Timesbestselling author. He is the Director of the Cleveland Clinic Center for Functional Medicine. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and was a regular medical contributor on many television shows including CBS This Morning, Today Show, Good Morning America, CNN, and The View, Katie and The Dr Oz Show. He is the winner of the Linus Pauling Award, The Nantucket Project Award, and was inducted in the Books for Better Life Hall of Fame.

Have you read about the importance of eating the right foods for health, but now you’re confused about what to eat? That’s exactly why Dr. Hyman wrote the book FOOD: What the Heck Should I Eat?

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About Dana Trentini

Dana Trentini founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.


  1. Lynda Reeve says

    My TSH is 1.04 Normal range is .32 – 4.00 in canada
    Free T3 is 2.6 normal is 3.1-6.2
    Free T4 is 13 normal is 9-19

    Am I hypo? I have anxiety, constipation, digestive issues, dry skin, insomnia and other symptoms. Please help doctor says I am fine.

  2. Rebecca Mead says

    So what happens when you have a patient who’s thyroid labs (the 4 mentioned) are sometimes high & sometimes low? I had a very large left goiter removed in 2008 & been suffering ever since. Nobody will prescribe thyroid medication because it works sometimes, but I have heat & cold intolerance, have low & high blood pressure, get fevers & low body temperatures, cannot loose weight even when though I can’t eat for days. I’m really scared because I have all the other hypothyroid symptoms with occasional bouts of hyperthyroidism, no andwers, & it causes so much physical & emotional stress. Oh and now my right thyroid is enlarged. Do doctors ever prescribe synthroid to stop goiter growth? Should I find another endocrinologist?

  3. Lynne Williams says

    I became hypothyroidic following radio active iodine treatment in 2010. I lost 4 of the 5.5stone I’d gained and kept it off for almost four years. Now I’m struggling again along with most of the symptoms named in your post. I’m actually beginning to feel quite ill. Living in the UK, my GP tells me I cannot increase my levothyroxine as my rating is at the top of the government advocated reference range. I thought of requesting a T3 assessment, but even if I’m not converting the thyroxine efficiently, our NHS UK does not prescribe T3. I’m at a loss what to do to help myself.

    • Hi Lynne,

      I suggest you go to see Dr Barry Peatfield in Crawley, UK. I had similar issues to you as I had radio active iodine treatment in 2009 and found that I couldn’t metabolise levothyroxine so felt ill for years. I am now taking NDT (since last year) which suits me much better, although I’m not quite there yet. One of my GPs very kindly prescribed me T3 for some time which was better than T4 but still not entirely suitable in the long term. If you google Dr Peatfield, you can get his phone number and also read his book.

  4. So what do we do if we can’t see this doctor? I’ve tried so many doctors and none will listen! I just am told I need to exercise more and that exercising more would help with my extreme fatigue and inability to lose weight. I did a bootcamp exercise class and have done every diet/lifestyle change possible. Nothing helps! I’m feeling very hopeless and scared I will always just be fat and tired, no matter what I do.

  5. Christina Hinshaw says

    I’ve had my thyroid checked for different times I have every single one of the symptoms except for half blood pressure and they keep on telling me I do not have a thyroid problem that my thyroids OK but my thyroid swollen they wanted to stick a needle in my throat and I told him no because they wouldn’t knock me out to do it they wanted me to stay awake and just number through needles freaked me out so I wouldn’t it’s been about four years ago maybe I need help what do I do

    • Christina Hinshaw says

      There’s a couple mistakes in my post sorry I was talking the text and didn’t check before I shared it so it doesn’t really make sense my thyroid has been checked four times and they wanted to just numb my throat because it was swollen but it was functioning just fine they said makes no sense at all

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