- Primary Hypothyroidism – this is the one thyroid pattern that responds well to replacement hormones. It is also the least common cause of thyroid dysfuction.
- Hypothyroidism secondary to Decreased Pituitary Output – if your pituitary gland (located in your brain) is not producing enough releasing hormone, your thyroid suffers. Giving thyroid hormone further suppresses the pituitary output and you end up worse in the long run.
- Thyroid Underconversion – your thyroid produces most of it’s hormone in a non-active form. Conversion to the active form of the hormone requires proper enzyme function in the liver and in your stomach. No amount of replacement hormone will fix this unless all of the things that affect conversion are fully evaluated and fixed. This is why we do a full metabolic workup and a complete thyroid panel to evaluate thyroid problems.
- Thyroid Overconversion – some people, due to various metabolic imbalances convert too much hormone into the active form. This sounds like it would be beneficial but it is not. It causes the cells to produce less receptor sites because they are being bombarded with thyroid hormone, resulting in symptoms of hypothyroidism despite high levels of hormones in the body. Sadly most people with thyroid overconversion are still placed on replacement, making the problem worse.
- Thyroid Binding Hormone Elevations – many women, especially those on replacement estrogen suffer from this. Another concept you must understand about thyroid hormones is that because they are steroid based, meaning they do not mix well with water, they must be bound to proteins in order to be transported through the blood to cells. If your body creates too much binding protein then you don’t have enough hormones in a “free unbound state” to bind to receptors on cells. This will create symptoms of hypothyroidism despite normal thyroid levels on lab testing.
- Autoimmune Thyroid – this is where your body attacks and kills your thyroid cells. This is the most common cause of low thyroid function in the United States.
These of just a sampling of some of the common hypothyroid patterns. There are 30 known thyroid dysfunctional patterns that exist. Your hormone system, immune system, and neurological system all work in harmony and any effective treatment must look at all of these at once.