A Sluggish Thyroid Can Be Sneaky | Austin Preferred Integrative Medicine

A Sluggish Thyroid Can Be Sneaky

Thyroid Issues

A Sluggish Thyroid Can Be Sneaky

Hypothyroidism, or the slowing of function in the thyroid gland, is an extremely common condition across the population. It happens more frequently as people age and is typically seen in women more than men. But many forward thinking medical providers believe it is even more pervasive than we currently believe. Why? Because a sluggish thyroid can be sneaky and conventional lab tests often overlook important indicators of thyroid issues. So it is up to an individual and their thorough practitioner to pinpoint subtle symptoms as well as examine blood work thoroughly. Treatment plans for hypothyroid conditions should always address nutrition and lifestyle in addition to any discussion of thyroid replacement options, if appropriate. A thyroid lab test and exam should be a routine part of an annual physical.

Even with regular screening, a sluggish thyroid is still a sneaky condition. To understand this, it helps to understand the job of this hard-working little gland. The thyroid is responsible for regulating the body’s metabolism and use of energy on a cellular level. It is in constant communication with the endocrine (hormone) system. But the thyroid only works properly with direct orders from the brain.

The hypothalamus in the brain sends these orders to the pituitary gland which then sends orders to the thyroid by releasing TSH (Thyroid Stimulating Hormone). With this signal, the thyroid releases T4. T4 is an “inactive” thyroid hormone, it circulates in the blood waiting to be used. The body converts T4 to T3 in areas it is needed most to use more energy. T3 is the “active” thyroid hormone that actually gains entrance into cells to aid with energy production. This complex signaling system is amazing and efficient and unfortunately vulnerable to malfunction.

Typically, when a medical provider checks your “thyroid level” they are looking at the TSH level. The lower the TSH, the more active the thyroid is. The higher the TSH, the more sluggish the thyroid is. The latter would be a failure of communication between the pituitary and the thyroid, resulting in hypothyroidism. There is some debate about the level of TSH that indicates hypothyroidism.

Classically, a TSH of 5 or over indicates hypothyroidism, but many clinicians intervene when a TSH is 3 or over. To truly diagnose a sluggish thyroid, it is important to fill in more of the picture. By measuring free T3 and free T4 levels, it is possible to deduce whether hormonal messaging is breaking down before of after the thyroid in the chain of command.  When the thyroid is putting out adequate T4 levels but T3 levels are low, then there is an issue with thyroid conversion. This detail can change what kind of thyroid replacement is ordered.

Stress, lifestyle, and nutrition play major roles in maintaining a healthy thyroid. The body uses essential nutrients such as iodine, zinc, and selenium in the signaling and conversion processes. Chronic stress can drain the body of cortisol, a hormone that is vital for thyroid functioning. Insulin resistance and hypothyroidism are often found together because they create a feedback loop of fatigue, weight gain, and poor health; as seen with diabetes, metabolic syndrome, and obesity.

There are whole books written on the various ways the thyroid system works to keep body systems functioning at their healthiest levels and the ways people suffer when this system goes awry. (See the end of this article for two of my favorites). It is best to catch these system glitches early so they don’t turn into failures. Many times the problem can be remedied by supplements, alterations in diet, and lifestyle modifications. Beyond that, thyroid replacement may be required.

Symptoms of hypothyroidism are not always obvious. They can appear slowly over a long period of time or just manifest in subtle ways. Some people have opposite symptoms to what is most commonly experienced with hypothyroidism. It is best to just pay a visit to your medical provider if you have any new symptoms you are worried about.

Symptoms of Thyroid Issues:

  • Sluggishness in the morning
  • Poor concentration/memory
  • Low-grade depression
  • Dry skin
  • Hoarse voice
  • Thinning hair and eyebrows
  • Coarse hair
  • Low body temperature
  • Muscle pain
  • Muscle weakness/cramps
  • Decreased libido
  • Puffiness around face and eyes
  • High cholesterol
  • Low blood pressure


To learn more about thyroid issues and treatments, make an appointment with me today. APIM’s holistic health services are designed to offer thorough testing and treatments using a natural approach that promotes long-term health and well-being. For more in-depth reading on thyroid issues from a functional perspective, I recommend the following books:

  1. The Thyroid Connection by Amy Myers, MD.
  2. Why do I Still Have Thyroid Symptoms? By Dr. Datis Kharrazian, DHSc, DC, MS.

For more information on holistic health services at Austin Preferred, or to schedule a consultation with our holistic medical provider Nicole Griffis, please call (512) 442-2727.

By: Nicole Griffis, HNP, APRN-BC


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