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Why do so many Americans have hypothyroidism? My question is, why aren’t more of us asking?

Hypothyroidism is one of the most prevalent diseases in America. It is estimated that between 5-25% of the population has a diagnosis of hypothyroidism, and the level of undiagnosed individuals is likely significantly higher. Levothyroxine, the synthetic thyroid medication used to treat hypothyroidism, is currently the #2 most commonly prescribed drug in the US (1). It seems to me that this condition has become so common that many people no longer even think of it as a disease. When patients come to my office for treatment, it is very rarely for hypothyroidism. There is almost always some other concern that brings the patient in, and I often don’t learn that they are hypothyroid until we get to discussion of their medications. “Oh yeah, I guess I should have told you that I also have hypothyroidism,” they say. And I just nod because I hear this every day, and then we go back to talking about their “real” health problems.


I can somewhat understand this almost flippant attitude about hypothyroidism. It’s not cancer. You are probably not going to DIE from hypothyroidism. And the disease symptoms themselves are not usually excruciating: fatigue, depression, hair loss, dry skin, menstrual problems, weight gain, constipation, and high cholesterol. But does that mean these symptoms are normal? Does it mean these symptoms are fun? Does it mean that we shouldn’t still stop and ask WHY a patient’s thyroid is not able to function properly? While not all cases hypothyroidism can be linked to one specific cause, and not all cases (especially if they are long-standing) can be reversed, I guarantee that you have absolutely no chance of healing from any disease unless you find and treat the cause. So below I have outlined some of the top treatable causes of hypothyroidism. And when I say treatable, I mean with more than just simply taking thyroid medication.


Impaired Thyroid Hormone Synthesis:

The production of thyroid hormones is an intricate and sequential process, and it requires very specific nutrients as building blocks and cofactors. The thyroid gland makes two thyroid hormones: T3 and T4. T3 is made directly from T4, and it is the more active hormone, meaning that it is able to directly affect the tissues of the body.


The two basic substrates needed to make thyroid hormone are iodine and tyrosine. Overt tyrosine (an amino acid) deficiency is uncommon, but both elevated and depressed iodine levels can cause hypothyroidism.  While conventional medicine still holds to the fact that iodine deficiency is rare in the US, new research shows that this is not exactly true anymore. Household use of iodized salt has been decreasing steadily, and recent studies report that the iodine content in iodized salt has also decreased (2). The NHANES (National Health and Nutrition Examination Survey) reports that Americans have experienced a significant drop in average body iodine levels in the past 20 years (3). Because excess iodine can also cause thyroid issues, I always test patients for iodine deficiency before recommending iodine as a treatment for hypothyroidism.


Once iodine and tyrosine are combined to make T4, the body still has to convert it to the active hormone T3. This conversion step requires many different nutrient cofactors including zinc, selenium, B12, and numerous antioxidants.  It is also greatly inhibited by stress. Many physicians only order and use the TSH (thyroid-stimulating hormone) level to evaluate for hypothyroidism, but this gives an incomplete picture of thyroid function. I often find that patients will have a TSH and T4 that are in the “normal” range, but a T3 that is low. These patients are not converting properly, and therefore have all the symptoms of hypothyroidism while appearing completely normal on conventional bloodwork. Supplementing with nutrients that support conversion is vitally important in these patients. An additional point worth noting here is that Levothyroxine is only synthetic T4. This means that any patient who has overt hypothyroidism and also has difficulty with hormone conversion will have a less-than-optimal response to the drug.


Autoimmune Disease:

I am shocked at how many of my patients with hypothyroidism don’t know if they have Hashimoto’s disease (the autoimmune form of hypothyroidism). People with Hashimoto’s disease create antibodies to their own thyroid gland, and these antibodies are easily tested for in the blood. My guess is that many of these patients were tested for Hashimoto’s at some point, but don’t remember or weren’t told the results because conventional physicians treat both conditions the same way: with thyroid hormone replacement. But because the diseases have different causes, treating in this manner is significantly less effective. Patients with Hashimoto’s disease need treatments that are specifically aimed at their autoimmune/inflammatory state. Additionally, if patients are not tested for antibodies and treated properly early on in the disease process, those antibodies will eventually do what they were created to do: kill the cells of the thyroid gland. No treatment, natural or not, can bring back dead cells. But if the process is caught early, there are treatments that can help decrease inflammation and antibody levels before significant damage to the thyroid occurs.



A Deficient State of the Body:

Lastly, and in my opinion most importantly, if a patient has a thyroid that is functioning sub-optimally, I can confidently conclude that the patient as a whole is in a deficient state. Simply taking thyroid hormone is not going to fix that. Often in the study of medicine, we get so caught up in learning the intricacies and biochemistry of the organs, cells, and tissues, that we forget the basic fact that the human body is one organism. You can’t separate out one organ and say, “this person is healthy, but their thyroid is sick”. It just doesn’t work that way. To restore health and not simply palliate symptoms, you must treat the whole person. In my practice, I use a specific healing art called homeopathy in order to do this.


The word homeopathy is derived from the Greek words homeo, meaning “similar,” and pathos, meaning “suffering”. Homeopathy operates on a “like cures like” principle. Translated, this means that a patient suffering from symptoms can be treated by micro-doses of a substance capable of producing similar symptoms in a healthy person. This system of medicine has been used empirically for over 200 years, and its efficacy has now been demonstrated in numerous scientific studies and publications. What differentiates homeopathy from other treatments like herbs, vitamins, and medications is that it stimulates the body’s own self-healing mechanisms. Also, due to the use of micro-doses, this method of treatment is very safe and can be used small children, pregnant women, and the elderly without risk of side-effects or drug-drug interactions. For more information on homeopathy, please visit and


If you would like to learn more about how your condition can be treated naturally, please call and schedule a free 15 minute consultation with Dr. Katie Nuckolls, naturopathic physician and owner of Horizon Natural Medicine: 602-359-2893.


(1) April 2014 study by the IMS Institute for Healthcare Informatics:


(3) Hollowell JG, Staehling NW, Hannon WH, Flanders DW, Gunter EW, Maberly GF, et al. Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from National Health and Nutrition Examination Surveys, I and III (1971–1974 and 1988–1994). J Clin Endocrinol Metab. 1998;83:3401-8.


  • Posted by Dr Katie Nuckolls
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