Beyond the Thyroid - Episode 8: 3 Ways Hypothyroidism Shows Up

Welcome to Episode 8 of the Beyond the Thyroid! I’m Dr. Dana Gibbs, and today we're diving deep into hypothyroidism, the most common outcome of a Hashimoto's disease autoimmune attack. Last episode, we explored various triggers for Hashimoto's and discussed how to manage inflammation. In this episode, we’re going to explore the three different ways hypothyroidism can present itself clinically and why these scenarios can be so frustrating for those suffering from Hashimoto's.

The Classic Case: High TSH Levels
The first way hypothyroidism presents itself is through elevated TSH levels, typically above 10. This is the classic scenario where your thyroid gland is not producing enough thyroid hormone, and your pituitary gland is working overtime to signal for more. This is the most straightforward diagnosis, but even then, the treatment is not as simple as it seems.

Subclinical Hypothyroidism: When You Feel Terrible But Labs Look Normal
The second scenario is subclinical hypothyroidism, where your TSH levels are slightly above normal, but your free T4 levels are within the normal range. This situation is particularly troublesome because you can feel terrible—experiencing symptoms like fatigue, weight gain, and depression—yet your doctor may not recognize that there is an effective treatment available. Subclinical hypothyroidism is often overlooked, leading to unnecessary suffering and even increased mortality.

Normal TSH Isn’t Normal: When Labs Don’t Match Symptoms
The third scenario is when your TSH is within the normal range, but your symptoms scream hypothyroidism. This can happen due to issues in thyroid hormone metabolism, such as elevated reverse T3 levels, which block the action of T3 in your cells. This situation is often missed in traditional testing, leaving patients feeling frustrated and unheard.

Why Understanding These Scenarios Matters
Understanding these three different presentations of hypothyroidism is crucial for getting the correct diagnosis and treatment. Many people suffer unnecessarily because their thyroid function tests come back "normal," but their symptoms tell a different story. If you’re struggling with unexplained fatigue, weight issues, or other thyroid-related symptoms, there may be more going on beneath the surface.

In upcoming episodes, I’ll go into more detail about how to test for these issues and interpret the results. We’ll also explore how to tailor treatments for better outcomes. If you or someone you know is struggling with thyroid issues, I encourage you to listen in and share this information. There’s hope for feeling better, even if you’ve been told everything is “normal.”

If you found this episode insightful, please consider leaving a five-star review for the Beyond the Thyroid podcast. Your support helps others find this valuable resource. To learn more about Dr. Gibbs and her approach to hormone health, visit her website at www.danagibbsmd.com. Remember, this podcast is for educational purposes and should not replace personalized medical advice. Stay tuned for more episodes as we continue this journey together beyond the thyroid.