The thyroid gland consists of two connected lobes in the neck governing many of the metabolic functions of the body.  Many people are aware of the “classic” symptoms of hypothyroidism, (i.e. dry hair or scalp, excessive coldness, dry skin and weight gain), Some symptoms that are perhaps less well known would include poor sleep, poor concentration, poor mood, irregular menstruations and muscle aches.  As the thyroid works together with and is vital in the optimal function of all other hormones, the full list of possible symptoms is endless.

Often people will come to our office and complain of these problems, saying that though they suspect that they are hypothyroid, they have already been tested and told that they were fine.  On the other hand, some will say that they are already being treated, but their symptoms persist either in whole or in part. 

So, it is often Dr. Leder’s role to explain that simple thyroid tests are often inadequate in fully evaluating the function of this gland.  As a functional medical physician, Dr. Leder’s philosophy about the thyroid diverges from the traditional viewpoint.  Traditionally, certain values on a test called “TSH” determine whether treatment is needed.  However, the viewpoint of alternative medicine is to look beyond this number and set a goal of achieving more than simply a certain number, but rather , achieving optimal function.  Rooted in this alternate philosophy, alternate testing and treatment protocols naturally follow.. How is it that a “good” TSH number can nonetheless often be associated with a weak or low thyroid state? Many factors come into play in affecting thyroid function, and any or all can make a “numerically-good” thyroid function poorly.

Amongst these factors are:

• Autoimmune disease of the thyroid
• Flawed manufacture of the thyroid hormone by the gland.
• Interference with thyroid effectiveness (i.e. foods, nutrients and toxins)
• Thyroid resistance in the peripheral tissue
• Function of the central areas of the brain that govern the thyroid, hypothalamus and pituitary glands

With all of these variables, how does the functional doctor evaluate the thyroid?  A wide variety of laboratory tests can be done to evaluate certain of the above factors, alongside trial and observation during treatment (watching symptom change over time).  The classic distinguishing piece of “holistic” thyroid evaluation is monitoring basal or resting body temperatures (measured under the arm before getting out of bed) or evaluating metabolic rate via oxygen consumption.  The former is easier and quite popular, however other influences on body temperature can interfere (fevers, inflammation etc…).  Nonetheless, so called “Basal Body Temperature” readings taken every morning are the cornerstone of holistic thyroid treatment.  Of course, the traditional methods of testing via ultrasounds and scans are important as well. 

As to treatments, they are as diverse as the causes of thyroid hypofunction.  The type of thyroid must be carefully selected:

• Natural vs. Synthetic
• Prefabricated vs. Compounded
• Very precise dosing
• The use of iodine or other nutrients to improve thyroid function
• The types of product (tablet, capsule, lozenge or even suppository)

Once the medicine is started, treatment is monitored through blood tests, temperatures, and observing any changes/improvements in clinical symptoms. The adrenal glands, somewhat unknown to many, are two small glands that sit atop the kidneys.  Without good adrenal function, the thyroid will not perform at its best.  For this reason, a thorough thyroid diagnostic workup will include evaluation of the adrenals.

In addition to its effect on thyroid function, sluggish or burned-out adrenals can show up as:

• Fatigue
• Anxiety
• Panic Attacks
• Low blood pressure
• Recurrent colds/infections
• Coldness
• Dizziness
• Night sweats
• Cystic acne

The adrenals are critical to healthy emotional and physical health, and should be evaluated if poor function is suspected.  Testing can be done via blood, urine and saliva, and treatment options and, as with thyroid, must be custom-tailored to the needs, goals, health, and lifestyle of each individual patient.

Thorough evaluation of the thyroid and adrenal glands is a cornerstone of functional medicine and a very special area of focus for Dr. Leder when investigating her patients.